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Alcohol consumption, blood pressure, and the risk of stroke.

https://arctichealth.org/en/permalink/ahliterature101849
Source
Curr Hypertens Rep. 2011 Jun;13(3):208-13
Publication Type
Article
Date
Jun-2011
Author
Matti Hillbom
Pertti Saloheimo
Seppo Juvela
Author Affiliation
Department of Neurology, Oulu University Hospital, Box 20, Oulu 90 029 OYS, Finland. matti.hillbom@oulu.fi
Source
Curr Hypertens Rep. 2011 Jun;13(3):208-13
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Alcohol Drinking - adverse effects
Alcoholic Intoxication - complications
Blood Pressure - drug effects
Cerebral Hemorrhage - chemically induced
Circadian Rhythm
Finland - epidemiology
Humans
Hypertension - chemically induced - complications - mortality
Risk factors
Stroke - epidemiology - etiology
Subarachnoid Hemorrhage - chemically induced
Abstract
A synergistic effect of alcohol and hypertension has been suggested to increase the risk for stroke. However, the contribution of alcohol-induced hypertension to stroke morbidity and mortality may be greater than observed, because the effects of different drinking patterns have not been separately investigated. Alcohol-induced transient peaks in systolic blood pressure may predispose to stroke. Recent studies have measured time trends of blood pressure elevations in relation to alcohol consumption. They found a significant morning surge in blood pressure, which was related to alcohol intake in a dose-dependent manner and was independent of smoking. Men with a severe form of hypertension showed a 12-fold increased risk for cardiovascular disease mortality associated with heavy binge drinking. Binge drinking is a significant risk factor for stroke. Hypertensive patients should be warned about the risks of alcohol and urged to avoid binge drinking because of an increased risk for all subtypes of stroke.
PubMed ID
21327566 View in PubMed
Less detail

Association between warfarin combined with serotonin-modulating antidepressants and increased case fatality in primary intracerebral hemorrhage: a population-based study.

https://arctichealth.org/en/permalink/ahliterature256819
Source
J Neurosurg. 2014 Jun;120(6):1358-63
Publication Type
Article
Date
Jun-2014
Author
Pekka Löppönen
Sami Tetri
Seppo Juvela
Juha Huhtakangas
Pertti Saloheimo
Michaela K Bode
Matti Hillbom
Author Affiliation
Departments of Neurosurgery.
Source
J Neurosurg. 2014 Jun;120(6):1358-63
Date
Jun-2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Anticoagulants - adverse effects - therapeutic use
Antidepressive Agents - adverse effects - therapeutic use
Cerebral Hemorrhage - epidemiology - mortality
Depression - drug therapy
Drug Therapy, Combination
Female
Finland - epidemiology
Humans
Kaplan-Meier Estimate
Male
Retrospective Studies
Risk factors
Serotonin Uptake Inhibitors - adverse effects - therapeutic use
Stroke - prevention & control
Survival Rate
Treatment Outcome
Warfarin - adverse effects - therapeutic use
Abstract
Patients receiving oral anticoagulants run a higher risk of cerebral hemorrhage with a poor outcome. Serotonin-modulating antidepressants (selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors [SNRIs]) are frequently used in combination with warfarin, but it is unclear whether this combination of drugs influences outcome after primary intracerebral hemorrhage (PICH). The authors investigated case fatality in PICH among patients from a defined population who were receiving warfarin alone, with aspirin, or with serotonin-modulating antidepressants.
Nine hundred eighty-two subjects with PICH were derived from the population of Northern Ostrobothnia, Finland, for the years 1993-2008, and those with warfarin-associated PICH were eligible for analysis. Their hospital records were reviewed, and medication data were obtained from the national register of prescribed medicines. Kaplan-Meier survival curves were drawn to illustrate cumulative case fatality, and a Cox proportional-hazards analysis was performed to demonstrate predictors of death.
Of the 176 patients eligible for analysis, 17 had been taking aspirin and 19 had been taking SSRI/SNRI together with warfarin. The 30-day case fatality rates were 50.7%, 58.8%, and 78.9%, respectively, for those taking warfarin alone, with aspirin, or with SSRI/SNRI (p = 0.033, warfarin plus SSRI/SNRI compared with warfarin alone). Warfarin combined with SSRI/SNRI was a significant independent predictor of case fatality (adjusted HR 2.10, 95% CI 1.13-3.92, p = 0.019).
Concurrent use of warfarin and a serotonin-modulating antidepressant, relative to warfarin alone, seemed to increase the case fatality rate for PICH. This finding should be taken into account if hematoma evacuation is planned.
PubMed ID
24506245 View in PubMed
Less detail

Effect of increased warfarin use on warfarin-related cerebral hemorrhage: a longitudinal population-based study.

https://arctichealth.org/en/permalink/ahliterature132625
Source
Stroke. 2011 Sep;42(9):2431-5
Publication Type
Article
Date
Sep-2011
Author
Juha Huhtakangas
Sami Tetri
Seppo Juvela
Pertti Saloheimo
Michaela K Bode
Matti Hillbom
Author Affiliation
Department of Neurology, Oulu University Hospital, Box 20, 90 029 OYS, Finland. juha.huhtakangas@ppshp.fi
Source
Stroke. 2011 Sep;42(9):2431-5
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Anticoagulants - administration & dosage - agonists
Cerebral Hemorrhage - chemically induced - mortality
Female
Finland - epidemiology
Humans
Incidence
International Normalized Ratio - adverse effects
Male
Middle Aged
Registries
Retrospective Studies
Warfarin - administration & dosage - adverse effects
Abstract
Warfarin use has rapidly increased with the aging of the population. We investigated the temporal trends in the incidence and outcome of warfarin-related intracerebral hemorrhages (ICHs) in a defined population.
We identified all subjects with first-ever primary ICH during 1993 to 2008 among the population of Northern Ostrobothnia, Finland. The number of warfarin users was obtained from the national register of prescribed medicines kept by the Social Insurance Institution of Finland. We calculated the annual incidence of warfarin-related ICHs, 28-day case fatality, and deaths from the primary bleed.
The proportion of warfarin users among the population increased 3.6-fold from 0.68% in 1993 to 2.28% in 2008. Of a total of 982 patients with ICH, 182 (18.5%) had warfarin-related ICH. One-year survival rate after onset of stroke was 35.2% among warfarin users and 67.9% among nonusers. The annual incidence (P=0.062) and 28-day case fatality of warfarin-related ICHs (P=0.002) decreased during the observation period. Warfarin users were older (mean difference 6.6; 95% CI, 5.0 to 8.1; P
Notes
Comment In: Stroke. 2011 Sep;42(9):2383-421799157
PubMed ID
21799168 View in PubMed
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The impact of functional status at three months on long-term survival after spontaneous intracerebral hemorrhage.

https://arctichealth.org/en/permalink/ahliterature46946
Source
Stroke. 2006 Feb;37(2):487-91
Publication Type
Article
Date
Feb-2006
Author
Pertti Saloheimo
Tuuli-Maaria Lapp
Seppo Juvela
Matti Hillbom
Author Affiliation
Department of Neurology, Oulu University Hospital, Finland. pertti.saloheimo@fimnet.fi
Source
Stroke. 2006 Feb;37(2):487-91
Date
Feb-2006
Language
English
Publication Type
Article
Keywords
Aged
Blood pressure
Case-Control Studies
Cerebral Hemorrhage - complications - mortality - therapy
Cerebrovascular Accident - pathology - therapy
Cohort Studies
Diabetes Complications
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Pneumonia - metabolism
Prognosis
Recurrence
Research Support, Non-U.S. Gov't
Risk factors
Smoking
Time Factors
Tomography, X-Ray Computed - methods
Treatment Outcome
Abstract
BACKGROUND AND PURPOSE: Few studies have assessed long-term prognosis and risk factors for death after spontaneous intracerebral hemorrhage (ICH). Patients who survive the acute phase may run different prognoses, depending on their disability, treatment, and lifestyle. The present study was performed to find out the predictors for long-term mortality after ICH. METHODS: We assessed 7-year prognosis in a population-based cohort of patients who had survived the first 3 months after ICH (n=140). Controls (n=206) living in the same geographical area were randomly drawn from the population register and followed up for the same time. RESULTS: Seven-year mortality was significantly higher in ICH patients than in controls (32.9 and 19.4%, respectively; P=0.0034). The annual risk for death in ICH patients was 5.6%, and the annual risk for fatal recurrent ICH was 1.3%. The ICH patients with good recovery at 3 months showed similar risk for death as controls. Recurrent ICH and pneumonia were the most common causes of death in ICH patients. Cigarette smoking, age, and diabetes seemed to increase the risk for death in patients and controls. CONCLUSIONS: Survivors of ICH run a higher long-term risk for death than age- and sex-matched controls. However, those who show good recovery at 3 months run a similar outcome as controls.
PubMed ID
16373642 View in PubMed
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Improved survival of patients with warfarin-associated intracerebral haemorrhage: a retrospective longitudinal population-based study.

https://arctichealth.org/en/permalink/ahliterature272676
Source
Int J Stroke. 2015 Aug;10(6):876-81
Publication Type
Article
Date
Aug-2015
Author
Juha Huhtakangas
Sami Tetri
Seppo Juvela
Pertti Saloheimo
Michaela K Bode
Vesa Karttunen
Anni Käräjämäki
Matti Hillbom
Source
Int J Stroke. 2015 Aug;10(6):876-81
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Aged
Anticoagulants - adverse effects - therapeutic use
Blood Coagulation Factors - therapeutic use
Cerebral Hemorrhage - chemically induced - drug therapy - epidemiology
Coagulants - therapeutic use
Female
Finland - epidemiology
Humans
Longitudinal Studies
Male
Retrospective Studies
Survival Analysis
Treatment Outcome
Warfarin - adverse effects - therapeutic use
Abstract
Warfarin-associated intracerebral haemorrhage carries poor outcome due to rapid haemorrhage growth. Reversal of warfarin anticoagulation with prothrombin complex concentrate has been implemented as an acute treatment option for these subjects.
We investigated whether survival of subjects with warfarin-associated intracerebral haemorrhage had improved after implementation of reversal of warfarin anticoagulation with prothrombin complex concentrate.
We identified all subjects with warfarin-associated intracerebral haemorrhage during 1993-2008 among the population of Northern Ostrobothnia, Finland. From 2004 onwards, prothrombin complex concentrate was used in Oulu University Hospital, the only hospital treating intracerebral haemorrhage subjects in the region, to counteract the effect of warfarin in subjects with warfarin-associated intracerebral haemorrhage. We compared the outcomes of subjects admitted during 1993-2003 and 2004-2008 and those treated and not treated with prothrombin complex concentrate. We also explored the predictors for one-year survival of the warfarin-associated intracerebral haemorrhage subjects.
We identified altogether 181 subjects who had intracerebral haemorrhage while on warfarin. One-year survival was significantly (P?=?0·031) higher for the 60 subjects admitted during 2004-2008 (43·3%) than for the 121 admitted before 2004 (30·6%). In multivariable analysis, prothrombin complex concentrate treatment reduced one-year case fatality (hazard ratio 0·52, 95% confidence interval 0·29-0·93). Thromboembolic complications did not occur more frequently among those treated with prothrombin complex concentrate.
The survival of warfarin-associated intracerebral haemorrhage subjects among the population of Northern Ostrobothnia has improved likely because of introduction of prothrombin complex concentrate.
PubMed ID
23231388 View in PubMed
Less detail

Poststroke epilepsy in long-term survivors of primary intracerebral hemorrhage.

https://arctichealth.org/en/permalink/ahliterature283441
Source
Neurology. 2017 Jun 06;88(23):2169-2175
Publication Type
Article
Date
Jun-06-2017
Author
Anna-Maija Lahti
Pertti Saloheimo
Juha Huhtakangas
Henrik Salminen
Seppo Juvela
Michaela K Bode
Matti Hillbom
Sami Tetri
Source
Neurology. 2017 Jun 06;88(23):2169-2175
Date
Jun-06-2017
Language
English
Publication Type
Article
Keywords
Aged
Brain - diagnostic imaging
Cerebral Hemorrhage - complications - diagnostic imaging - epidemiology - therapy
Epilepsy - diagnostic imaging - epidemiology - etiology
Female
Finland
Follow-Up Studies
Humans
Hypertension - epidemiology - etiology
Incidence
Kaplan-Meier Estimate
Male
Proportional Hazards Models
Retrospective Studies
Risk factors
Seizures - diagnostic imaging - epidemiology - etiology
Stroke - complications - diagnostic imaging - epidemiology - therapy
Survivors
Abstract
To identify the incidence and predisposing factors for development of poststroke epilepsy (PSE) after primary intracerebral hemorrhage (PICH) during a long-term follow-up.
We performed a retrospective study of patients who had had their first-ever PICH between January 1993 and January 2008 in Northern Ostrobothnia, Finland, and who survived for at least 3 months. These patients were followed up for PSE. The associations between PSE occurrence and sex, age, Glasgow Coma Scale (GCS) score on admission, hematoma location and volume, early seizures, and other possible risk factors for PSE were assessed using the Cox proportional hazards regression model.
Of the 615 PICH patients who survived for longer than 3 months, 83 (13.5%) developed PSE. The risk of new-onset PSE was highest during the first year after PICH with cumulative incidence of 6.8%. In univariable analysis, the risk factors for PSE were early seizures, subcortical hematoma location, larger hematoma volume, hematoma evacuation, and a lower GCS score on admission, whereas patients with infratentorial hematoma location or hypertension were less likely to develop PSE (all variables p
PubMed ID
28476758 View in PubMed
Less detail

6 records – page 1 of 1.