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stroke
Posted: Sun Dec 14, 2014 12:07 pm
by 1eye
Increased risk of ischaemic stroke among patients with multiple sclerosis; Tseng C, Huang W, Lin C, Chang Y; European Journal of Neurology (Nov 2014)
BACKGROUND AND PURPOSE Inflammatory processes including autoimmune diseases which ignite endothelial dysfunction and atherosclerosis may promote development of cardiovascular diseases including ischaemic stroke. This study aimed to evaluate whether multiple sclerosis (MS) increases stroke risk.
METHODS A national insurance claim data set of 22 million enrollees in Taiwan was used to identify 1174 patients with MS and 4696 randomly selected age- and gender-matched controls from 1 January 1997 to 31 December 2010. Both cohorts were followed up until the occurrence of stroke or censor. Relevant covariates, such as age, gender, hypertension, diabetes, hyperlipidaemia, coronary artery disease, congestive heart failure and pregnancy, were included for further survey. The hazard ratio (HR) of stroke was assessed using a Cox proportional hazards regression model.
RESULTS After adjusting for the relevant covariates, the MS cohort had an increased risk of stroke (adjusted HR = 12.1 for 1 year; adjusted HR = 4.69 for 2-5 years) compared with the control cohort within 5 years of follow-up. Amongst participants without comorbidities, the MS cohort was still at a greater stroke risk than the control cohort [HR 4.93, 95% confidence interval (CI) 2.85-8.55]. Moreover, in the population aged ≤40, MS was associated with a significantly increased risk of stroke (HR 12.7, 95% CI 3.44-46.7).
CONCLUSIONS Multiple sclerosis is declared to be associated with an increased risk in developing stroke, which requires closer attention to this group of patients for stroke prevention, especially in the younger population.
Re: stroke
Posted: Sun Dec 14, 2014 7:36 pm
by jackD
I have posted about this Stroke Risk in the aneurism board.
The problem is those nasty MMP-9s being elevated in MS.
MMp-9s like to eat the "elastin" in the artery walls. This is the rubber band stuff that allows the artery walls to flex and return back to the normal shape.
If the MMP-9s eat too much of this stuff a balloon effect occurs and creates such a weak spot that it is at high risk of rupturing. Bleeding and big clots forming is the results.
Anything that lowers MMP-9s can slow aneurism growth.
I have posted a list of Thingies that lower MMP-9 in the Avonex board.
http://www.thisisms.com/forum/avonex-f5/topic4186.html
jackD
Neurologia. 2004 Jul-Aug;19(6):312-20.
[Metalloproteinases and neurovascular injury].
[Article in Spanish]
Castillo J1, Leira R, Blanco M.
Abstract
Matrix metalloproteinases (MMP) are a family of proteases involved in the remodelling of the extracellular matrix. In physiological conditions, the activity of MMP is regulated on several levels: gene transcription, activation of inactive precursors, and inhibition by endogenous factors. Loss of control and increased expression and activity of MMP have been implicated in various diseases (cancer, arthritis, vascular aneurysms, atherosclerosis, etc.). In the central nervous system, MMP are involved in the mechanisms associated with neuroinflammation, which is different in vascular and non-vascular diseases. MMP, especially MMP-9, have been shown to induce a high breakdown capacity, especially in the arteriolar basement membrane, leading to cerebral edema and secondary hemorrhage. In human clinical aspects, MMP are associated to intracerebral hemorrhage growth and with the development of complications in ischemic stroke. Combination therapies explicitly involving MMP inhibition could be of value in future treatment strategies.
PMID: 15199420 [PubMed - indexed for MEDLINE]
Re: stroke
Posted: Mon Dec 15, 2014 9:37 am
by cheerleader
Thanks for this paper, 1eye--
Wanted to give the link--
http://onlinelibrary.wiley.com/doi/10.1 ... 8/abstract
There has been a lot of published research coming from Taiwan on the vascular connection to MS, specifically in ultrasonic findings in the jugular veins. We've seen several teams of researchers at recent ISNVD conferences, and the young investigator's award went to a Taiwanese doctor this year for her research "The Nature of abnormal ultrasonic findings in internal jugular veins"--I can only imagine that word of these researchers findings, linking venous malformations and brain injury, is out in the Taiwanese neurological community. Here's more on the recent conference. Neurologist Dr. Chung, the mentor of the award winning doctor, has been very vocal, and busy publishing over the last decade, on the link of venous malformations and neurodegenerative conditions.
http://isnvd.org/pdf/2014WinterNewsletter.pdf
Here's Dr. Chung's most recent publication on
jugular venous reflux and ischemic stroke:
This study evaluated the relationship between spontaneous echo contrast (SEC) in the internal jugular vein (JV), atherosclerotic markers and ischemic stroke. One hundred twenty patients with acute ischemic stroke and 120 controls were recruited. SEC score correlated with plasma level of fibrinogen (coefficient: 0.105, p = 0.022), hemoglobin (coefficient: 0.122, p = 0.008) and presence of JV reflux (coefficient: 0.314, p < 0.001) and peak flow velocity (coefficient: -0.244, p < 0.001) in the corresponding JV, but did not correlate with carotid plaque score (coefficient: 0.042, p = 0.358) or intima-media thickness (coefficient: 0.067, p = 0.303).
Multivariate regression analysis revealed that fibrinogen level, SEC score, intima-media thickness, plaque score and history of coronary artery disease were associated with acute ischemic stroke. In conclusion, the severity of SEC in the JV might represent the tendency toward thrombogenesis in diseased cerebral circulation possibly through mechanisms other than arterial atherosclerosis.
http://www.ncbi.nlm.nih.gov/pubmed/24768488
Here are all of Dr. Chung's publications on the jugular veins and neurological disease:
http://www.ncbi.nlm.nih.gov/pubmed?term ... d=24768488
So, here is another paper out of Taiwan from a different institution, putting the chicken first--it is the "autoimmune" nature of MS which is increasing vascular issues, by "igniting" endothelial dysfunction. But it is just a review, showing us the link to ischemic stroke. Yes, stroke prevention measures and endothelial health would be wise. Also wise to examine what is causing jugular venous reflux. It's not just about carotid arteries, as Dr. Chung has been showing us, timely venous return is essential to brain health.
cheer
Re: stroke
Posted: Sat Jan 10, 2015 12:13 pm
by jackD
jackD wrote:I have posted about this Stroke Risk in the aneurism board.
The problem is those nasty MMP-9s being elevated in MS.
MMp-9s like to eat the "elastin" in the artery walls. This is the rubber band stuff that allows the artery walls to flex and return back to the normal shape.
If the MMP-9s eat too much of this stuff a balloon effect occurs and creates such a weak spot that it is at high risk of rupturing. Bleeding and big clots forming is the results.
Anything that lowers MMP-9s can slow aneurism growth.
I have posted a list of Thingies that lower MMP-9 in the Avonex board.
http://www.thisisms.com/forum/avonex-f5/topic4186.html
jackD
Neurologia. 2004 Jul-Aug;19(6):312-20.
[Metalloproteinases and neurovascular injury].
[Article in Spanish]
Castillo J1, Leira R, Blanco M.
Abstract
Matrix metalloproteinases (MMP) are a family of proteases involved in the remodelling of the extracellular matrix. In physiological conditions, the activity of MMP is regulated on several levels: gene transcription, activation of inactive precursors, and inhibition by endogenous factors. Loss of control and increased expression and activity of MMP have been implicated in various diseases (cancer, arthritis, vascular aneurysms, atherosclerosis, etc.). In the central nervous system, MMP are involved in the mechanisms associated with neuroinflammation, which is different in vascular and non-vascular diseases. MMP, especially MMP-9, have been shown to induce a high breakdown capacity, especially in the arteriolar basement membrane, leading to cerebral edema and secondary hemorrhage. In human clinical aspects, MMP are associated to intracerebral hemorrhage growth and with the development of complications in ischemic stroke. Combination therapies explicitly involving MMP inhibition could be of value in future treatment strategies.
PMID: 15199420 [PubMed - indexed for MEDLINE]
Hate to say it but I just had a little "stroke" 7 days in hospital (31 dec -7jan15).
Suffered from Alien Hand/Arm stroke symptoms. Presently lots of sever brain fog. The Alien has gone away.
jackD
Re: stroke
Posted: Sat Jan 10, 2015 12:42 pm
by jimmylegs
OUCH jack, what a way to ring in the new year. hope you feel lots better soon.
possibly of interest to all, in a future/preventative sense:
Intake of Potassium, Magnesium, Calcium, and Fiber and Risk of Stroke Among US Men
http://circ.ahajournals.org/content/98/12/1198.short
Intakes of cereal fiber and magnesium, but not of calcium, were also inversely associated with risk of total stroke. Use of potassium supplements was also inversely related to risk of stroke, particularly among men taking diuretics (relative risk, 0.36; 95% CI, 0.18, 0.72). Although these data do not prove a causal relationship, they are consistent with the hypothesis that diets rich in potassium, magnesium, and cereal fiber reduce the risk of stroke, particularly among hypertensive men.
Prospective Study of Calcium, Potassium, and Magnesium Intake and Risk of Stroke in Women
https://stroke.ahajournals.org/content/30/9/1772.full
Intakes of calcium, potassium, and magnesium were each inversely associated with age- and smoking-adjusted relative risks of ischemic stroke, excluding embolic infarction of nonatherogenic origin (n=347). Adjustment for other cardiovascular risk factors, including history of hypertension, attenuated these associations, particularly for magnesium intake. ... The association of risk with calcium intake did not appear to be log linear; the increase in risk was limited to the lowest quintile of intake, and intakes >≈600 mg/d did not appear to reduce risk of stroke further.
Serum and Dietary Magnesium and Risk of Ischemic Stroke
http://aje.oxfordjournals.org/content/169/12/1437.short
Higher serum magnesium levels were associated with lower prevalence of hypertension and diabetes mellitus at baseline. During the 15-year follow-up, 577 ischemic strokes occurred. Serum magnesium was inversely associated with ischemic stroke incidence. ... After adjustment for hypertension and diabetes, the rate ratios were attenuated to nonsignificant levels. ... Low serum magnesium levels could be associated with increased risk of ischemic stroke, in part, via effects on hypertension and diabetes.
Relationship of serum magnesium concentration to risk of short-term outcome of acute ischemic stroke
http://informahealthcare.com/doi/abs/10 ... 012.759696
Conclusion. Higher serum magnesium concentration was associated with lower risk of NIHSS ≥ 10/death; there was a dose–response relationship between serum magnesium concentration and risk of NIHSS ≥ 10/death.
Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies
http://ajcn.nutrition.org/content/95/2/362.short
Dietary magnesium intake is inversely associated with risk of stroke, specifically ischemic stroke.
Re: stroke
Posted: Sat Jan 10, 2015 2:24 pm
by Scott1
Hi Jack,
Sorry to hear that. I hope all goes well with you.
What tests did they conduct regarding the stroke? Did they have a perspective on why it happened?
Regards
Re: stroke
Posted: Sat Jan 10, 2015 3:20 pm
by jackD
Scott1 wrote:Hi Jack,
Sorry to hear that. I hope all goes well with you.
What tests did they conduct regarding the stroke? Did they have a perspective on why it happened?
Regards
They did a cat san immediately and then two days later fallowed it with a MRI.
Cause in my case it is extreme high blood pressure that did me in. It is very high again tonight (199/120) and I am trying everything I know to get it down. I have special meds for these events as wells a double dose of some others.
Re: stroke
Posted: Sat Jan 10, 2015 4:06 pm
by jimmylegs
re high bp - may i inquire as to your daily magnesium regimen, jack? and if you've had your serum level tested at all?
Re: stroke
Posted: Sat Jan 10, 2015 6:19 pm
by jackD
jimmylegs wrote:re high bp - may i inquire as to your daily magnesium regimen, jack? and if you've had your serum level tested at all?
I take 3 200mg magnesium citrate daily plus the 100 mg magnesium dioxide in the cheap multivitamin.
Got my pressure down to 188/114. I am going to try some Zanaflex next.
jackD
Re: stroke
Posted: Sat Jan 10, 2015 7:54 pm
by jimmylegs
hmmm that's quite a bit, i wonder if you're not absorbing due to a cofactor issue, some other inhibiting dietary or supplemental influence, or just because citrate isn't as absorbable as mag glycinate. have you tracked your daily potassium intake? and have you had a serum mag test done? do you have vit d3 in your regimen, and if so how much? actually can i ask about your whole regimen atm, doses forms and timing? if there's something that can be tweaked that might help, wouldn't want that info to be missed.
188/114 that's still pretty high huh :S what was it at its worst, iima? i tend to have the opposite problem. i was 70 over 50 once. too dehydrated.
Re: stroke
Posted: Sun Jan 11, 2015 1:12 am
by NHE
Hi Jack,
I'm so sorry to hear about your stroke. I hope that you're getting better now.
Regarding blood pressure, have your doctors measured your levels of homocysteine? High levels of homocysteine have been found to be associated with high blood pressure.
Here are some sample articles...
Folate Deficiency Is Associated With Oxidative Stress, Increased Blood Pressure, and Insulin Resistance in Spontaneously Hypertensive Rats
http://www.ncbi.nlm.nih.gov/pmc/article ... hps015.pdf
Inflammation and hypertension in rheumatoid arthritis.
http://www.ncbi.nlm.nih.gov/pubmed/23996293
High Homocysteine Levels Are Independently Related to Isolated Systolic Hypertension in Older Adults
http://circ.ahajournals.org/content/96/6/1745.long
MTHFR C677T polymorphism and its homocysteine-driven effect on blood pressure
http://onlinelibrary.wiley.com/doi/10.1 ... .12276/pdf
Plasma homocysteine levels in Indian patients with essential hypertension and their siblings.
http://www.ncbi.nlm.nih.gov/pubmed/?term=12739826
Re: stroke
Posted: Mon Jan 12, 2015 12:00 pm
by cheerleader
Hey Jack---
I'm SO sorry to read about your stroke. Hang in there, friend. Hope you get a handle on blood pressure, etc.
Not to pile on with the advice....but if you get any sunshine in the DC area, head outdoors for a bit to soak up some rays. Or maybe look into a sun lamp. My brother lives in Baltimore, so I know it's been pretty cold. Lots of heart attacks and strokes happen in the dreary winter. Here's why I suggest sun--all about nitric oxide, your skin and how UV rays can help heal your heart and bring your blood pressure down.
take care....better days ahead!
cheer
Re: stroke
Posted: Sat Jan 17, 2015 1:03 pm
by jackD
I would like to add that I am taking some VINPOCETINE to help recover from my little stroke and to prevent future strokes.
Face sagging left side gone and all other symptoms gone.
My blood pressure problem has been resolved current 138/68.
I have lost 25 lbs and intend to lose another 20 lbs.
VINPOCETINE is wonderful stuff check it out in PubMed. Good stuff for STROKES
jackD
Re: stroke
Posted: Sat Jan 17, 2015 2:03 pm
by Scott1
Great news Jack,
Weight is not an issue for me so I wouldn't know how to move it like that. It might help someone though if you can describe what you changed to achieve that.
Regards
Re: stroke
Posted: Sat Jan 17, 2015 2:34 pm
by jackD
the techie stuff new on pubmed ...
Molecules. 2014 Dec 26;20(1):335-347.
Anti-Inflammatory Effects of Vinpocetine in Atherosclerosis and Ischemic Stroke: A Review of the Literature.
Zhang L1, Yang L2.
Abstract
Immune responses play an important role in the pathophysiology of atherosclerosis and ischemic stroke. Atherosclerosis is a common condition that increases the risk of stroke. Hyperlipidemia damages endothelial cells, thus initiating chemokine pathways and the release of inflammatory cytokines-this represents the first step in the inflammatory response to atherosclerosis. Blocking blood flow in the brain leads to ischemic stroke, and deprives neurons of oxygen and energy. Damaged neurons release danger-associated molecular patterns, which promote the activation of innate immune cells and the release of inflammatory cytokines. The nuclear factor κ-light-chain-enhancer of activated B cells κB (NF-κB) pathway plays a key role in the pathogenesis of atherosclerosis and ischemic stroke. Vinpocetine is believed to be a potent anti-inflammatory agent and has been used to treat cerebrovascular disorders. Vinpocetine improves neuronal plasticity and reduces the release of inflammatory cytokines and chemokines from endothelial cells, vascular smooth muscle cells, macrophages, and microglia, by inhibiting the inhibitor of the NF-κB pathway. This review clarifies the anti-inflammatory role of vinpocetine in atherosclerosis and ischemic stroke.
PMID: 25549058 [PubMed - as supplied by publisher]
Proc Natl Acad Sci U S A. 2010 May 25;107(21):9795-800. doi: 10.1073/pnas.0914414107. Epub 2010 May 6.
Vinpocetine inhibits NF-kappaB-dependent inflammation via an IKK-dependent but PDE-independent mechanism.
Jeon KI1, Xu X, Aizawa T, Lim JH, Jono H, Kwon DS, Abe J, Berk BC, Li JD, Yan C.
Abstract
Inflammation is a hallmark of many diseases, such as atherosclerosis, chronic obstructive pulmonary disease, arthritis, infectious diseases, and cancer. Although steroids and cyclooxygenase inhibitors are effective antiinflammatory therapeutical agents, they may cause serious side effects. Therefore, developing unique antiinflammatory agents without significant adverse effects is urgently needed. Vinpocetine, a derivative of the alkaloid vincamine, has long been used for cerebrovascular disorders and cognitive impairment. Its role in inhibiting inflammation, however, remains unexplored. Here, we show that vinpocetine acts as an antiinflammatory agent in vitro and in vivo. In particular, vinpocetine inhibits TNF-alpha-induced NF-kappaB activation and the subsequent induction of proinflammatory mediators in multiple cell types, including vascular smooth muscle cells, endothelial cells, macrophages, and epithelial cells. We also show that vinpocetine inhibits monocyte adhesion and chemotaxis, which are critical processes during inflammation. Moreover, vinpocetine potently inhibits TNF-alpha- or LPS-induced up-regulation of proinflammatory mediators, including TNF-alpha, IL-1beta, and macrophage inflammatory protein-2, and decreases interstitial infiltration of polymorphonuclear leukocytes in a mouse model of TNF-alpha- or LPS-induced lung inflammation. Interestingly, vinpocetine inhibits NF-kappaB-dependent inflammatory responses by directly targeting IKK, independent of its well-known inhibitory effects on phosphodiesterase and Ca(2+) regulation. These studies thus identify vinpocetine as a unique antiinflammatory agent that may be repositioned for the treatment of many inflammatory diseases.
Comment in
Vinpocetine as a potent antiinflammatory agent. [Proc Natl Acad Sci U S A. 2010]
PMID: 20448200 [PubMed - indexed for MEDLINE] PMCID: PMC2906898
Biomed Res Int. 2014;2014:324307. doi: 10.1155/2014/324307. Epub 2014 Dec 7.
Vinpocetine and pyritinol: a new model for blood rheological modulation in cerebrovascular disorders-a randomized controlled clinical study.
Alkuraishy HM1, Al-Gareeb AI1, Albuhadilly AK2.
Abstract
Blood and plasma viscosity are the major factors affecting blood flow and normal circulation. Whole blood viscosity is mainly affected by plasma viscosity, red blood cell deformability/aggregation and hematocrit, and other physiological factors. Thirty patients (twenty males + ten females) with age range 50-65 years, normotensive with history of cerebrovascular disorders, were selected according to the American Heart Stroke Association. Blood viscosity and other rheological parameters were measured after two-day abstinence from any medications. Dual effects of vinpocetine and pyritinol exhibit significant effects on all hemorheological parameters (P < 0.05), especially on low shear whole blood viscosity (P < 0.01), but they produced insignificant effects on total serum protein and high shear whole blood viscosity (P > 0.05). Therefore, joint effects of vinpocetine and pyritinol improve blood and plasma viscosity in patients with cerebrovascular disorders.
PMID: 25548768 [PubMed - in process] PMCID: PMC4274818
The current edition of Life Extension Magazine FEB 2015 has a VERY GOOD discussion of the benefits of VINPOCETINE.
jackD