Hypertension and stroke in Asia: A comprehensive review from HOPE Asia

Turana, Yuda; Tengkawan, Jeslyn; Chia, Yook Chin; Nathaniel, Michael; Wang, Ji‐Guang; Sukonthasarn, Apichard; Chen, Chen‐Huan; Minh, Huynh Van; Buranakitjaroen, Peera; Shin, Jinho; Siddique, Saulat; Nailes, Jennifer; Park, Sungha; Teo, Boon Wee; Sison, Jorge; Soenarta, Arieska Ann; Hoshide, Satoshi; Tay, Jam Chin; Sogunuru, Guru Prasad; Zhang, Yuqing; Verma, Narsingh; Wang, Tzung‐Dau

doi:10.1111/jch.14099

Cited by 93 publications

(74 citation statements)

References 79 publications

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“…Between 1990 and 2019, the number of incident stroke cases increased by approximately 70% worldwide [ 1 ]. In Asia, the incidence of stroke is around 116 to 483 per 100,000 individuals annually [ 2 ]. Particularly in Singapore, the incident of stroke cases increased from 5890 to 8849 between 2010 and 2019 [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Examining the Influence of Social Interactions and Community Resources on Caregivers’ Burden in Stroke Settings: A Prospective Cohort Study

Koh

Matchar

et al. 2021

IJERPH

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Since the introduction of the integrated care model, understanding how social interactions and community resources can alleviate caregivers’ burden is vital to minimizing negative patients’ outcomes. This study (n = 214) examined the associations between these factors and caregivers’ burden in stroke settings. It used 3-month and 1-year post-stroke data collected from five tertiary hospitals. Subjective and objective caregivers’ burdens were measured using Zarit burden interview and Oberst caregiving burden scale respectively. The independent variables examined were quality of care relationship, care management strategies for managing patients’ behaviour, family caregiving conflict, formal service usage and assistance to the caregiver. Significant associations were determined using mixed effect modified Poisson regressions. For both types of burden, the scores were slightly higher at 3 months as compared to 1 year. Poorer care-relationship (relative risk: 0.81, 95% confidence interval (CI): 0.70–0.94) and adopting positive care management strategies (relative risk: 1.05, 95% CI: 1.02–1.07) were independently associated with a high subjective burden. Providing assistance to caregivers (relative risk: 2.45, 95% CI: 1.72–3.29) and adopting positive care management strategies (relative risk: 1.03, 95% CI: 1.02–1.04) were independently associated with a high objective burden. Adopting positive care management strategies at 3 months had a significant indirect effect (standardised β: 0.11, 95% CI: 0.01 to 0.20) on high objective burden at one year. Healthcare providers should be aware that excessive care management strategies and assistance from family members may add to caregivers’ burden.

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Section: Introductionmentioning

confidence: 99%

Examining the Influence of Social Interactions and Community Resources on Caregivers’ Burden in Stroke Settings: A Prospective Cohort Study

Koh

Matchar

et al. 2021

IJERPH

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“…Previous research showed that SBP was associated with stroke recurrence[ 25 ]. Turana et al [ 26 ] also found that SBP was positively correlated with stroke incidence, and adherence to hypertension treatment is to be the main goal in the prevention of stroke occurrence in several countries in Asia. In addition, in a cohort study, Zhuo et al [ 27 ] identified SBP as a risk factor for 2-year post-ischemic stroke recurrence prediction.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for relapse and nomogram for relapse probability prediction in patients with minor ischemic stroke

Lei¹,

Yin²,

Huang³

et al. 2021

WJCC

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BACKGROUND The identification of risk factors for recurrence in patients with minor ischemic stroke (MIS) is a critical medical need. AIM To develop a nomogram for individualized prediction of in-hospital recurrence in MIS patients. METHODS Based on retrospective collection, a single-center study was conducted at the First Affiliated Hospital of Anhui Medical University from January 2014 to December 2019. Univariate and multivariate logistic regression analyses were used to determine the risk factors associated with MIS recurrence. The least absolute shrinkage and selection operator regression was performed for preliminary identification of potential risk factors. Uric acid, systolic blood pressure, serum total bilirubin (STBL), and ferritin were integrated for nomogram construction. The predictive accuracy and calibration of the nomogram model were assessed by the area under the receiver operating characteristic curve (AUC-ROC) and Hosmer-Lemeshow test, respectively. RESULTS A total of 2216 MIS patients were screened. Among them, 155 were excluded for intravascular therapy, 146 for unknown National Institutes of Health Stroke Scale score, 195 for intracranial hemorrhage, and 247 for progressive stroke. Finally, 1244 patients were subjected to further analysis and divided into a training set ( n = 796) and a validation set ( n = 448). Multivariate logistic regression analysis revealed that uric acid [odds ratio (OR): 0.997, 95% confidence interval (CI): 0.993-0.999], ferritin (OR: 1.004, 95%CI: 1.002-1.006), and STBL (OR: 0.973, 95%CI: 0.956-0.990) were independently associated with in-hospital recurrence in MIS patients. Our model showed good discrimination; the AUC-ROC value was 0.725 (95%CI: 0.646-0.804) in the training set and 0.717 (95%CI: 0.580-0.785) in the validation set. Moreover, the calibration between nomogram prediction and the actual observation showed good consistency. Hosmer-Lemeshow test results confirmed that the nomogram was well-calibrated ( P = 0.850). CONCLUSION Our present findings suggest that the nomogram may provide individualized prediction of recurrence in MIS patients.

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“…Stroke is the fourth-largest cause of mortality, and, in the United States in 2018-2019, its primary types were ischemic infarction (87%), primary hemorrhage (10%), and subarachnoid hemorrhage (3%) [1]. On the other hand, Asians have a higher incidence of primary hemorrhage (25%) than Caucasians (10-17%), but the incidence of ischemic infarction increased in different countries of Asia (1.7-16%) during the period 2014-2017 [2]. Stroke incidence increases with age, and after 55 years, the incidence doubles with each subsequent decade; it is higher in men than women [1].…”

Section: Introductionmentioning

confidence: 99%

“…The increase is related to hyperglycemia, dyslipidemia, hypertension, and platelet aggregation with age, and their management prevents ischemic infarction. Ischemic infarction reduces the blood flow, resulting in a decrease in oxygen and nutrients, and it is treated by removing the clot [2]. The treatment delay develops neuronal cell death to induce adverse outcomes, such as vision problems, paralysis in the limbs, dizziness, confusion, and coordination loss due to blockage in the brain areas.…”

Section: Introductionmentioning

confidence: 99%

Alleviation of Neuronal Cell Death and Memory Deficit with Chungkookjang Made with Bacillus amyloliquefaciens and Bacillus subtilis Potentially through Promoting Gut–Brain Axis in Artery-Occluded Gerbils

Zhang

Ryu

et al. 2021

Foods

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Short-term fermented soybeans (chungkookjang) with specific Bacillus (B.) spp. have anti-obesity, antidiabetic, and anti-stroke functions. We examined the hypothesis that the long-term consumption of B. amyloliquefaciens SCGB 1 fermented (CKJ1) and B. subtilis SCDB 291 (CKJ291) chungkookjang can alleviate clinical symptoms and hyperglycemia after ischemic stroke by promoting the gut microbiota–brain axis. We examined this hypothesis in Mongolian male gerbils with stroke symptoms induced by carotid artery occlusion. The artery-occluded gerbils were divided into five groups: no supplementation (Control, Normal-control), 4% cooked soybeans (CSB), CKJ1, or CKJ291 in a high-fat diet for 3 weeks. The carotid arteries of gerbils in the Control, CSB, CKJ1, and CKJ291 groups were occluded for 8 min and they then continued on their assigned diets for an additional 3 weeks. Normal-control gerbils had no artery occlusion. The diets in all groups contained an identical macronutrient composition using starch, casein, soybean oil, and dietary fiber. The CSB, CKJ1, and CKJ291 groups exhibited less neuronal cell death than the Control group, while the CKJ1 group produced the most significant reduction among all groups, as much as 85% of the Normal-control group. CKJ1 and CKJ291 increased the blood flow and removal of blood clots, as determined by Doppler, more than the Control. They also showed more improvement in neurological disorders from ischemic stroke. Their improvement showed a similar tendency as neuronal cell death. CKJ1 treatment improved memory impairment, measured with Y maze and passive avoidance tests, similar to the Normal-control. The gerbils in the Control group had post-stroke hyperglycemia due to decreased insulin sensitivity and β-cell function and mass; the CKJ291, CSB, and CKJ1 treatments protected against glucose disturbance after artery occlusion and were similar to the Normal-control. CKJ1 and CKJ291 also reduced serum tumor necrosis factor-α concentrations and hippocampal interleukin-1β expression levels, compared to the Control. CKJ1 and CKJ291 increased the contents of Lactobacillus, Bacillus, and Akkermansia in the cecum feces, similar to the Normal-control. Picrust2 analysis showed that CKJ1 and CKJ291 increased the propionate and butyrate metabolism and the starch and glucose metabolism but reduced the lipopolysaccharide biosynthesis and fatty acid metabolism compared to the Control. In conclusion, daily CKJ1 and CKJ291 intake prevented neuronal cell death and memory dysfunction from the artery occlusion by increasing blood flow and β-cell survival and reducing post-stroke-hyperglycemia through modulating the gut microbiome composition and metabolites to influence the host metabolism, especially inflammation and insulin resistance, protecting against neuronal cell death and brain dysfunction. CKJ1 had better effects than CKJ291.

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Hypertension and stroke in Asia: A comprehensive review from HOPE Asia

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 93 publications

References 79 publications

Examining the Influence of Social Interactions and Community Resources on Caregivers’ Burden in Stroke Settings: A Prospective Cohort Study

Examining the Influence of Social Interactions and Community Resources on Caregivers’ Burden in Stroke Settings: A Prospective Cohort Study

Risk factors for relapse and nomogram for relapse probability prediction in patients with minor ischemic stroke

Alleviation of Neuronal Cell Death and Memory Deficit with Chungkookjang Made with Bacillus amyloliquefaciens and Bacillus subtilis Potentially through Promoting Gut–Brain Axis in Artery-Occluded Gerbils

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