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Stroke detecting software to be rolled out across New Zealand

Health Minister Jonathan Coleman

Health Minister Jonathan Coleman, left, meets with stroke patient Judith Allen at Wellington Hospital, assisted by clinical nurse Lai-Kin Wong.

MAARTEN HOLL/FAIRFAX NZ

Judith Allen was trying to roll over in bed. Instead she fell on the floor, unable to move her limbs.

Six weeks after the stroke, the 75-years-old from Tawa is still in Wellington Hospital with half her body paralysed, recovering.

Her husband, Eddie Allen, said the couple had both been healthy for their age, staying active and watching their diet.

“It just strikes with such suddenness out of blue. There was no indication at all that anything was wrong,” he said.

Judith was rushed to hospital and within hours she had fallen into a drowsy semi sleep that gripped her for more than two weeks, leaving her unable to speak.

“I think the brain just goes into a holding pattern for a while to recover from the trauma,” her husband said.

Judith was one of several stroke patients at Wellington Hospital visited by Health Minister Jonathan Coleman on Thursday.  He was announcing the nationwide roll-out of new stroke diagnosis software for general practitioners, aimed at detecting the early signs of stroke.

These warning signs included transient ischemic attacks or mini strokes. The aim was to identify patients before they ended up in hospital.

About one in five people who suffer a mini stroke have a full-blown stroke within days.

Coleman said stroke was the third biggest cause of death in New Zealand and, while overall rates were not going up, it was increasingly affecting younger people and Maori. Early symptoms of a stroke were not picked up, he said, using the example of former All Black Piri Weepu’s stroke in 2014, which took weeks to diagnose.

“It will save lives … it brings simplicity and clarity to a very complex area,” Coleman said.

Whether the software would have picked up on early signs of Judith’s upcoming stroke is unknown.

Her recovery has been complicated by secondary bowel problem. She is planning to attend a family wedding in Auckland in December but her husband said that is unlikely.

Whether she will ever recovery the use of left side of her body, which she refers to as her “heavy lump”, is also uncertain.

However Judith remains determined to return to her old life, pointing to a teddy bear in the corner of her room holding a “be positive” sign.

“I will get there. The teddy tells me to be positive.”

STROKE IN NEW ZEALAND

* Stroke kills about 2500 people a year in New Zealand, making it the country’s third-biggest killer.

* Nearly one in three people who suffer a stroke die, while another third are left permanently disabled.

* The likelihood of suffering a stroke increases with unhealthy lifestyle choices. Alcohol, high salt intake, a lack of exercise and smoking can all increase your risk.

* High blood pressure is the biggest risk factor for a stroke.

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Crankiness could cause your heart attack.

Careful your tantrum doesn't turn in to a heart attack.<br /><br /><br /><br /> Photo / 123RF
Careful your tantrum doesn’t turn in to a heart attack. 

The risk of having a heart attack shoots up following an outburst of anger, a study among hospital heart patients has found.

The study, published in a European medical journal, found the risk of heart attack was 8.5 times higher in the two hours following an acute episode of anger than during a patient’s baseline levels of anger on a 1 to 7 scale.

Read more: When can you start having sex after a heart attack?

The authors say their findings appear to confirm the indications of earlier research – and experience – that anger can act as a trigger for a heart attack. They advocate considering “strategies to protect individuals most at risk during times of acute anger”.

The researchers studied patients suspected of having a heart attack who were admitted for primary angioplasty treatment at Royal North Shore Hospital in Sydney between 2006 and 2012.

Anger during the 48 hours preceding symptom onset was self-assessed by the 313 patients’ reporting from on the scale on which 1 was “calm”, and 7 was “enraged, out of control, throwing objects, hurting yourself or others”. The threshold of acute anger in the study was defined as level 5 – “very angry, body tense, maybe fists clenched, ready to burst”.

Seven of the confirmed heart attack patients (2.2 per cent) had reached an anger of at least level 5 within the two-hours before their symptoms began.

Based on the subjects’ usual patterns, the relative risk of onset of heart attack symptoms occurring within two hours of reaching anger level 5 or above was calculated as 8.5 times greater than that associated with normal levels on the anger scale.

The trigger events for the 313 patients included road rage, work stress and family rows.

One of the researchers, Dr Thomas Buckley, said the absolute risk of any one anger episode triggering a heart attack was low, but the study showed the danger was real.

The increased risk of heart attack following intense anger or anxiety probably resulted from increased heart rate and blood pressure, tightening of blood vessels and increased clotting – physiological changes that were all associated with triggering of heart attacks.

By Martin Johnston

New Zealand Herald 24/2/2015.

Stroke app provides hope in the face of concerning stats

Stroke riskometer

Stroke app provides hope in the face of concerning stroke statistics

Stroke is one of New Zealand’s leading killers. One in six New Zealanders will experience a stroke in their lifetime, many resulting in death or disability, yet how many of us know how to reduce our risk of having a stroke?

Up to 90 per cent of strokes could be prevented if stroke risk factors were managed appropriately. With this in mind, an app developed by an AUT Professor is aiming to reduce the incidence of stroke and save lives around the world.

The Stroke RiskometerTM is the brainchild of AUT University’s Professor Valery Feigin. It was brought to market by AUT Enterprises Ltd, so that its potential health benefits could be shared with vast numbers of people world-wide.

The free Stroke RiskometerTM app enables users to assess their individual stroke risk on a smartphone or tablet. It evaluates factors such as age, gender, ethnicity, family history and lifestyle, and is already being used by health-conscious people in more than 70 countries.

According to Professor Feigin, the Stroke RiskometerTM helps users to play an active role in managing their health.

“We don’t need to wait until stroke strikes – we can act now and take control of our health. Stroke is much easier to prevent than to treat, and by making good lifestyle choices we can reduce our chances of suffering a stroke.”

“The Stroke RiskometerTM helps people to see what impact steps like exercising more, eating a healthier diet and drinking less alcohol are having on their personal risk profile, and helps users to stay motivated and maintain the positive lifestyle changes they choose to make”, says Professor Feigin.

Users seeking additional means of managing their risks can purchase the Stroke RiskometerTM Pro, enabling them to save and track results, share their risk profile with family members and health professionals, and access internationally recognised guidelines on mitigating stroke risk factors.

Professor Feigin says users of the app will not only be taking action against stroke, but will also be managing their risk of experiencing heart disease and dementia.

The Stroke RiskometerTM is endorsed by the World Stroke Organization and is available for download through the Apple App and Google Play stores.

 

 

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Controllable Risk Factors – Atrial Fibrillation

Controllable Risk Factors – Atrial Fibrillation

Artriall FibrillationAtrial fibrillation (AF) is a major risk factor for stroke, making a person five times more likely to have a stroke. About 15 percent of all people who have strokes have AF, too. People who have been diagnosed with AF have already taken the first step to preventing AF-related stroke. Unfortunately, many New Zealanders’ who have AF don’t know it. Three out of four AF-related strokes can be prevented — if you are already diagnosed, beat the odds of having a stroke due to AF by understanding stroke symptoms, response and available treatments to control AF.

Most New Zealanders’ over the age of 40 are at risk for having AF. Take preventive steps by self-testing for an irregular heartbeat with:

Atrial Fibrillation (AF) and Stroke 

What is AF and how is it related to stroke?

AF is a type of irregular or “racing” heartbeat that can cause blood to collect in the heart and potentially form a clot, which can travel to a person’s brain and cause a stroke or brain attack.  This condition increases a person’s risk for stroke by 500%. Plus, three out of four AF-related strokes can be prevented. AF-related strokes are also more deadly. In fact, more than 70% of AF patients who have strokes will die as a result. The prevalence of AF increases with increasing age, particularly from age 50 years. The overall prevalence of AF is approximately 1%, increasing to approximately 10% in people aged ≥ 80 years.1, Approximately one-third of the estimated 35,000 people in New Zealand with AF will be asymptomatic.2

 Who is most likely to have AF?
While it can occur at any age, AF is more common as you grow older. About five percent of people 65 years old have AF. One in every 20 people over the age of 70 has AF and it’s more common in those with high blood pressure, heart disease or lung disease.

What are the symptoms?
A normal heart beats 60 to 100 times per minute. Patients with AF can experience heartbeats as fast as 450 times per minute. Often, AF has no visible symptoms. Some people with AF describe fluttering, racing or pounding sensations in their chests. Others may only experience dizziness, fainting or lightheadedness during an episode.

How can I tell if I have AF?
The simple “Check Your Pulse” test can be done once a month. The test checks for an irregular pulse – a sign of possible AF. Ask your doctor to check as well. Remember you are checking for heart RHYTHM, not RATE. In other words you are checking for how your heart is beating and not how many times it beats in a 60-second period.

Check Your Pulse Test for Irregular Pulse
Step 1.
Turn your left hand so your palm is facing up. Place the first two fingers of your right hand on the outer edge of your left wrist, just below where you wrist and thumb meet.

Step 2. Slide your fingers toward the centre of your wrist until you find your pulse.

Step 3. Press your fingers down onto your wrist until you feel your pulse, being careful not to press too hard. Move your fingers around until the pulse is easy to feel.

Step 4. Feel you pulse for 60 seconds. Don’t count the beats. Just pay attention to whether the rhythm seems regular or irregular. A regular pulse will feel even and consistent. An irregular pulse will feel erratic and unpredictable. 

Treatments for AF
Most AF-related strokes could be prevented with anti-coagulation treatments, yet up to two-thirds of AF patients who had strokes were not prescribed anti-coagulants or blood thinners. Anticoagulation can reduce the risk of first stroke by 68 percent. There are several reasons why current drugs are not being prescribed including interactions with diet and other drugs, the necessity for frequent blood tests and monitoring and concerns about increased risk of bleeding. But, there are new drugs on the horizon that may have fewer complications and will eliminate the monitoring issues associated with current treatments.

The goal for treating AF is to restore the normal, regular rhythm of your heart. Often, this can be done with medications or the use of electrical stimulation. If these efforts are not successful, AF treatment concentrates on protecting you from the blood clots that could travel from the heart to the brain, causing strokes. To reduce the risk of stroke, doctors can prescribe clot-preventing medications, which can greatly reduce stroke risk if taken properly.

Check out http://afib.co.nz/index.html for further information on treatments, explanations of Afib and to hear a pod cast by Harvey White talking on the risks and treatments of AF.

Check out http://www.bpac.org.nz/BPJ/2011/october/af.aspx for further information on treatments, management and the types of Afib.

Common AF symptoms:Heart palpitations.A sudden pounding, fluttering or racing sensation in the chest,   sometimes referred to as “butterflies”.Dizziness or feeling light-headed.

A thorough heart check-up at the doctor includes testing for blocked blood vessels and irregular heart rhythms, including AF. Because AF, like high blood pressure, cholesterol and some other heart diseases, often has no outward symptoms, the only way to confirm the presence of AF is to perform an electrocardiogram (ECG).

normal-ecgDuring an ECG, sensitive electrodes are placed on the chest. These electrodes pick up the electrical impulses generated by the body that cause the heart to beat. The impulses are sent to a T.V. screen or a piece of paper called an ECG strip. By examining the specific pattern of electrical impulses, a doctor can determine whether a patient has AF. Doctors may choose to treat this form of heart disease by prescribing medication or by an electrical shock to the chest to return the beating back to normal.

Talk to a doctor about the best stroke prevention options for you. Then take responsibility and enjoy a healthy lifestyle. The lifestyle adjustments — such as eating healthy foods and quitting smoking — made today may reduce the risk of stroke tomorrow.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke. This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

References

  1. Kannel W, Wolf P, Benjamin E, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N-9N.
  1. Lip G. Stroke in atrial fibrillation: epidemiology and thromboprophylaxis. J Thromb Haemost 2011;9 (suppl 1):344-51.
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TIA

TIA means:

T = Transient

I = Ischemic

A = Attack

A transient ischemic attack (TIA)

A transient ischemic attack (TIA) is an event, sometimes called a mini-stroke, with stroke symptoms that lasts less than 24 hours before disappearing. While TIAs generally do not cause permanent brain damage, they are a serious warning sign of stroke and should not be ignored!

Up to 40 percent of all people who have experienced a TIA will go on to have an actual stroke. Most studies show that nearly half of all strokes occur within the first 2 days after a TIA. In fact:

Within 2 days after a TIA, 5 percent of people will have a stroke.

Within 3 months after a TIA, 10 to 15 percent of people will have a stroke.

What are the symptoms of a TIA? The symptoms of a TIA and stroke are basically the same. Someone having a TIA or stroke may experience one or more of the following symptoms:

  • Sudden numbness or weakness of the face, arm, leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination

If you have any of these symptoms or see them in someone else, even for a short time, call 911 or have someone take you to the hospital immediately. Treatment can be more helpful if given quickly. Stroke strikes FAST. You should too!

What causes a TIA? Blood vessels carry blood throughout the body. When a blood vessel in the brain becomes blocked for a short period of time, the blood flow to that area of the brain slows or stops. This lack of blood (and oxygen) often leads to temporary symptoms such as slurred speech or blurry vision.

TIAs are usually caused by one of three things:

  • Low blood flow at a narrow part of a major artery carrying blood to the brain, such as the carotid artery
  • A blood clot in another part of the body (such as the heart) breaks off, travels to the brain, and blocks a blood vessel in the brain
  • Narrowing of the smaller blood vessel in the brain, blocking blood flow for a short period of time; usually caused by plaque (a fatty substance) build up

How can TIA be managed? The goal of TIA management is to prevent a future stroke. The medicine and therapy used depends on the exact cause of the TIA. In addition to lifestyle changes such as diet and exercise, your doctor may recommend drugs to treat high blood pressure, high cholesterol or heart disease. These changes may reduce your risk of further TIA or stroke.

There are many medicines that help prevent blood clots from forming, reducing the risk of full-blown stroke.

If a TIA is caused by blockage in the main artery in the neck that supplies blood to the brain, called the carotid artery, surgeries may be required to open the artery and prevent a stroke. These procedures are known as endarterectomy and stenting.

Talk to a doctor about the best stroke prevention options for you. Then take responsibility and enjoy a healthy lifestyle. The lifestyle adjustments — such as eating healthy foods and quitting smoking — made today may reduce the risk of stroke tomorrow.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

 

Controllable Risk Factors – Diabetes

People with diabetes are up to 4 times as likely to have a stroke as someone who does not have the disease, mainly because many people with diabetes have health problems that are also stroke risk factors.

In New Zealand (total population 4.3 million with 70% Caucasian, 7.9% Maori, 5.7% Asian, 4.4% Pacific peoples, 7.8% mixed, 3.8% unspecified) the Ministry of Health estimates that 210, 000 people will be affected with diabetes by 2010. Estimated diabetes prevalence data for 2010 in persons over the age of 15 of different ethnic groups are as follows: South Asians 12.4%, Maori 7.8%, Pacific peoples 11.6%, Caucasians 5.3% and a national average of 6.1%.

What is diabetes?
Diabetes is a disease that affects a person’s ability to move blood sugar, or glucose, out of the blood and into the cells where it is used as the body’s primary source of fuel.

There are 2 types of diabetes, Type I (insulin dependent) and Type II (non-insulin dependent). Type I diabetes usually emerges in childhood and is characterised by the body’s inability to produce enough insulin. Insulin is the hormone the body uses to convert sugar, starches and other food into energy needed for daily life.

Type II diabetes is more common. More than 90 percent of New Zealanders with diabetes have Type II diabetes. With Type II, the body is able to produce insulin, but tissues develop a resistance to it and blood sugar levels rise above normal. It generally develops during adulthood and may escape notice for some time because many symptoms of the disease frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability and blurry vision seem harmless.

Diabetes Type 2 Causes

How is diabetes linked to stroke?
Many people with diabetes have health problems that increase their risk for stroke.

Uncontrolled high blood pressure, or hypertension, is a major risk factor and leading causes of stroke. As many as 2 out of 3 adults with diabetes have high blood pressure.

Heart attack and atrial fibrillation (a type of irregular heart beat) are also common among people with diabetes, and both increase the risk for stroke.

Many people with diabetes also have high cholesterol, increasing their risk for stroke. Build-up of LDL cholesterol, sometimes called the “bad” cholesterol, can block blood vessels and reduce blood flow to the brain. Any time blood flow to the brain is decreased, the risk for stroke increases.

Brain damage may be more severe and extensive if blood sugar is high when a stroke happens. Careful regulation of blood sugar, either with insulin or blood sugar-lowering pills, can help.

Diagnosis
Being tested for diabetes is quick and easy with the help of a doctor. A doctor’s office will collect a blood sample and then check blood sugar levels with a fasting plasma glucose (FPG) test. High blood sugar levels may signal diabetes.

Treatments for Diabetes
Both types of diabetes can be controlled, reducing the risk of long-term health problems such as stroke. Type I is treated by closely monitoring blood sugar and taking daily shots of insulin. Type II, which is worsened by obesity, can frequently be controlled through weight loss, exercise and changes in eating habits. Daily insulin injections are not always necessary.

The good news? Stroke risk can be reduced by managing diabetes — it’s never too late to better manage personal health with a doctor’s help.

Other ways to help manage diabetes:

  • Foot Care: Inspect feet daily for signs of trouble. Have foot sores or calluses checked by a doctor or podiatrist.
  • Eye Care: See the eye doctor at least once a year. Diabetes can lead to eye disease, but there are treatments available if problems are caught early.
  • Dental Care: See the dentist every six months. Excess blood sugar in the mouth makes it a good home for bacteria, which can lead to infection.
  • Be More Active: Physical activity can lower blood sugar, blood pressure and cholesterol; help insulin work more effectively; improve blood circulation; and keep joints flexible.
  • Eat a Healthy Diet: Eat smaller portions, more fruits and vegetables, and foods that are high in fiber. Also, watch salt, fat and sugar intake.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.

This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

Controllable Risk Factors – Cholesterol

What is cholesterol?
Cholesterol is a soft, waxy fat (lipid) that is made by the body. It is found in the bloodstream and in all of your body’s cells. The body needs cholesterol to form cell membranes, some hormones and vitamin D.

Cholesterol is also found in some foods, such as eggs, meats and dairy products.

Because cholesterol does not dissolve in the blood on its own, it must be carried to and from cells by particles called lipoproteins. There are two main types of lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain
High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain

LDL is often called the “bad” cholesterol. It can cause plaque build-up. Plaque is a thick, hard substance that can clog arteries. Recent studies show that high levels of LDL and triglycerides (blood fats) raise the risk of ischemic stroke. Plaque can also increase risk of a transient ischemic attack (TIA) where stroke symptoms go away within 24 hours.

The second main type of cholesterol is high-density lipoprotein (HDL), often called the “good” cholesterol. High levels of HDL may reduce stroke risk.

  • How does cholesterol affect stroke risk?
    High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain and cause a stroke. High cholesterol may also increase the risk of heart disease and atherosclerosis, which are both risk factors for stroke.
  • What increases cholesterol levels?
    Many things can affect cholesterol levels. Some can be changed and some cannot.

Things you can change:

  1. Diet — Foods high in saturated fat and cholesterol can increase cholesterol levels.
  2. Weight — Being overweight can increase your cholesterol levels.
  3. Exercise — People who are not active tend to have higher cholesterol levels.

Things you cannot change:

  1. Family History — If someone in your family has high cholesterol, you are more likely to have high cholesterol.
  2. Age — Most people experience an increase in cholesterol levels until about the age of 65.
  3. Gender — Women under age 50 tend to have lower cholesterol and those in menopause have higher levels.

How often should I be checked for high cholesterol?

  • All adults age 20 and older should have their cholesterol checked at least once every five years.
  • Cholesterol should be checked more frequently in men older than 45 and women older than 55.
  • People with a family history of high cholesterol should be checked more often.
  • People who have high cholesterol should be checked more often.

What can I do to manage my cholesterol?

  1. Eat a healthy diet
  2. Eat low-fat foods especially foods low in saturated fat. This includes vegetables, fruits, lean meats such as chicken and fish, low-fat dairy products and a limited number of egg yolks.
  3. Bake, broil, steam or grill your food (instead of frying).
  4. Add fibre to your diet, including whole grains or dried beans.
  5. Talk to your doctor about any necessary medical treatment that may help control cholesterol levels

A Head of Stroke Dedicated to Reconnection after Stroke

A Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.

This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.