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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

It is well known that women in the United States, as in most industrialized countries in the world, are protected from coronary heart disease (CHD), relative to men. It is thought that this protection is by and large due to the effects of female reproductive hormones (i.e., estrogens) on lipid and lipoprotein metabolism and blood pressure, although women's relatively low rates of cigarette smoking are also thought to play a role. However, epidemiological studies that statistically adjust for sex differences in lipids, blood pressure, and smoking status cannot explain sex differences in CHD morbidity and mortality. Also, inconsistent with a simple main-effect model of reproductive hormones are data showing elevated risk of myocardial infarction and stroke among women who use oral contraceptives. Men who are prescribed estrogens have elevated risk of CHD, and case-control studies show that male CHD patients have elevated estradiol, compared to controls. This article suggests that simple main-effect models of female protection from CHD are inadequate. It argues that reproductive hormones are important determinants of protection from CHD, in interaction with behavioral characteristics. It also demonstrates that reproductive hormones can influence behavioral characteristics and that behavioral characteristics can influence the effects of reproductive hormones on CHD risk factors.
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PMID:Interactive effects of behavior and reproductive hormones on sex differences in risk for coronary heart disease. 268 28

The study was designed to evaluate the effect of electromyographic (EMG) biofeedback on the recovery of arm function after stroke. Patients who had impaired arm function and were between 2 and 8 weeks after stroke were randomly allocated to receive either treatment incorporating EMG biofeedback or a control treatment in addition to their routine physiotherapy. The two groups of 20 patients were compared before and after 6 weeks of treatment and at follow-up 6 weeks later. There were no significant differences between the groups before treatment or at follow-up, but at the end of treatment those who received EMG biofeedback scored significantly higher on tests of arm function. Patients with severe impairment were shown to benefit most from EMG biofeedback but there was no difference in response to treatment according to patient's age or side of stroke. Men had higher arm function scores than women before and at the end of treatment, but not at follow-up.
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PMID:The effectiveness of EMG biofeedback in the treatment of arm function after stroke. 270 23

Men aged 40-64 years with mild to moderate hypertension [diastolic blood pressure (DBP) 100-130 mmHg] were randomized to treatment with a diuretic (n = 3272) or a beta-blocker (n = 3297), with additional drugs if necessary, to determine whether a beta-blocker based treatment differs from thiazide diuretic based treatment with regard to the prevention of coronary heart disease (CHD) events and death. Patients with previous CHD, stroke or other serious diseases, or with contraindications to diuretics or beta-blockers were excluded. If normotension (DBP less than 95 mmHg) was not achieved by monotherapy, other antihypertensive drugs were added, but the two basic drugs were not crossed over. Patients were assessed at 6-monthly intervals. The mean follow-up for end-points was 45.1 months. Blood pressure (BP) side effects and end-points were recorded in a standardized manner. Entry characteristics and the BP reduction achieved were very similar in both treatment groups. All analyses were made on an intention-to-treat basis. The incidence of CHD did not differ between the two treatment groups. The incidence of fatal stroke tended to be lower in the beta-blocker treated group than in the diuretic treated group. Total mortality and the total number of end-points were similar in both groups. The percentage of patients withdrawn due to side effects was similar, whereas the number of reported symptoms, according to a questionnaire, was higher for patients on beta-blockers. The incidence of diabetes did not differ between the two groups. Subgroup analyses did not detect a difference in the effect of beta-blockers compared with diuretics in smokers as opposed to non-smokers, and beta-blockers also had the same effects as diuretics in the quartile with the highest predicted risk for CHD. Beta-blockers and thiazide diuretics were approximately equally well tolerated. The two drugs had a similar BP reducing effect although additional drugs had to be given more often in the diuretic group. Antihypertensive treatment based on a beta-blocker or on a thiazide diuretic could not be shown to affect the prevention of hypertensive complications, including CHD, to a different extent.
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PMID:Beta-blockers versus diuretics in hypertensive men: main results from the HAPPHY trial. 289 81

The etiologies of low back pain and the biomechanics and pathology of the lumbar spine as they relate to tennis stroke mechanics have been reviewed, and a treatment protocol has been presented. A recent survey of the Men's Professional Tennis Tour is the only article found that discusses low back pain in tennis players; the orthopaedic and sports medicine literature is otherwise devoid of any relevant studies. Because this one survey indicates that 38 per cent of 143 tennis players missed at least one tournament because of low back problems, it seems obvious that an epidemiologic study on low back pain in racquet sports is vital to a more thorough understanding of the problem.
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PMID:Low back pain in the competitive tennis player. 296 50

Our understanding of the responses of men and women to cold stress is extremely limited. Various scientists have suggested that there could be gender differences in thermoregulatory responses due to sexual dimorphism in body fatness and its distribution, in body surface area, and in mass. In addition, there are also several lines of evidence supporting the hypothesis that there are gender-specific physiological responses to body cooling. In cold water studies, women cool more rapidly than men when at rest; this potentially greater stimulus does not result in a greater metabolic response by the women. If both groups increase their metabolism by performing a prescribed amount of exercise, there are no differences in body cooling. However, if they exercise spontaneously, the women select a lower metabolic rate and experience greater body cooling. Thus, it appears that women are less thermally sensitive to cold water. In cold air stress women have a lower mean skin temperature than men, but this is not observed in peripheral skin sites. In contrast to cold water, women do not experience greater drops in deep body temperature than men in cold air. Furthermore, men may be more metabolically sensitive than women to cold air stress. Men also respond to cold air with a bradycardia and increased stroke volume, while women show no change in these parameters. Similarly, men show a greater blood pressure response than women to local cooling of a hand or the face. Many of these gender-specific responses cannot be explained fully by differences in body morphology and support the concept that men and women respond differently to the cold.
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PMID:Thermal, metabolic, and cardiovascular changes in men and women during cold stress. 305 20

Total mortality and cardiovascular disease (CVD) mortality and morbidity during 10 years of follow-up in relation to systolic blood pressure (SBP) at entry were compared between a random sample of 7455 men, aged 47-54 years at entry, in whom multifactorial risk-factor intervention including intense efforts to detect and treat hypertension had been performed [the Primary Prevention Trial (PPT)], and a similar population (from an observational study) in which intervention, on CVD risk factors was kept to a minimum (the Study of Men Born in 1913). Total mortality, CVD mortality, coronary heart disease (CHD) and stroke incidence increased with SBP in both populations, but levelled off above the cut-off point for antihypertensive treatment in the population subjected to multifactorial CVD risk factor intervention. In this population total mortality was reduced by 30%, CVD mortality by 37%, CHD morbidity by 13% and stroke morbidity by 30% above the cut-off point for blood pressure intervention compared with the incidence predicted from the observational study. These findings indicate that multifactorial intervention, and especially antihypertensive treatment, have preventive effects in the hypertensive part of the middle-aged male population.
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PMID:Mortality and morbidity in relation to systolic blood pressure in two populations with different management of hypertension: The Study of Men Born in 1913 and the Multifactorial Primary Prevention Trial. 358 64

Men who snore heavily have an increased incidence of hypertension, angina, stroke, and neuropsychologic dysfunction, which may be due to nocturnal oxygen desaturation. Nocturnal oxygen therapy might be beneficial to such individuals by improving oxygenation and relieving tissue hypoxia. Twenty-eight asymptomatic heavy snoring men were recruited for polysomnographic monitoring during sleep. During the first half-night, air was breathed through a nasal cannula, and during the latter half-night, 2 L/min oxygen was administered. Breathing air, 20 subjects demonstrated sleep apneas, hypopneas and nocturnal oxygen desaturation. Eighteen subjects had more than ten apneas plus hypopneas per hour. Thirteen subjects reached low oxygen saturation below 80 percent and eight below 70 percent. Only 13 of the 20 subjects showed improvement with oxygen therapy. Apneas alone were not decreased in frequency and were lengthened with oxygen therapy. Episodes of oxygen desaturation were improved by oxygen therapy and consequently, rates of hypopnea were decreased. Severe sleep apnea, hypopnea and oxygen desaturation are common in asymptomatic male snorers, and oxygen therapy is not always beneficial.
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PMID:Snoring, nocturnal hypoxemia, and the effect of oxygen inhalation. 362 20

This study was conducted since virtually no information was available concerning age- and gender-related differences in cardiovascular adjustments to cold exposure. Men and women between the ages of 20 and 30 and 51 and 72 yr, wearing swim suits, rested for 2 h in 28, 20, 15, and 10 degrees C ambient temperatures (Ta), with 40% relative humidity. Cardiac output (Qc) and stroke volumes (Qs) were higher in younger than older subjects regardless of Ta. Cardiac output was not influenced by gender, but all cold exposures resulted in increased Qs and decreased heart rate in men but not women. Regardless of age or gender, Qc increased about 10% only during exposure to 10 degrees C. Cold exposure resulted in minimal increases in the mean systolic and diastolic pressures (Pa) of the younger subjects. The Pa of older subjects were higher than in the young during 28 degrees C exposures and increased during all cold exposures. Total peripheral resistance and forearm blood flows were higher in older than young subjects exposed to cold. Total peripheral resistance, systolic and diastolic Pa, and finger and forearm blood flows were not affected by gender, but hand plus forearm blood flows were higher in men than women exposed to 28 degrees C. Although Qc appeared adequate to meet increased oxygen demands of shivering in the older subjects, rising Pa may become limiting in extended exposures. A similar response in hypertensive or angina-prone individuals may result in some untoward responses.
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PMID:Cardiovascular reactions to cold exposures differ with age and gender. 396 10

A random population sample from two countries of eastern Finland was studied in 1972, measuring eg the serum total cholesterol and triglycerides, blood pressure, and smoking. The participation rate among men aged 30 to 59 was 92%. Men who had had a myocardial infarction, angina or cerebral stroke in the preceding 12 months were excluded. During the seven-year follow-up 211 men had an acute myocardial infarction (AMI), 59 men had a cerebral stroke and 185 men died of any disease. The serum total cholesterol (greater than or equal to 8.0 mmol/l) had a positive association with the risk of AMI (relative risk RR = 2.8, 95% Cl = 1.8-4.3) and the risk of death (RR = 2.2, 95% Cl = 1.3-3.7) among men aged 30-49 but only with the risk of AMI (RR = 2.0, 95% Cl = 1.3-3.1) among those aged 50-59 based on multiple logistic models including also age, serum triglycerides, diastolic blood pressure, smoking and obesity. Serum triglycerides (greater than or equal to 2.8 mmol/l) had a positive risk factor-adjusted association with the risk of cerebral stroke (RR = 2.7, 95% Cl = 1.0-7.1) among men aged 30-49, but no independent association with the risk of AMI or death.
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PMID:Relation of serum cholesterol and triglycerides to the risk of acute myocardial infarction, cerebral stroke and death in eastern Finnish male population. 684 Sep 55

The mortality risk associated with different sleeping patterns was assessed by use of the 1965 Human Population Laboratory survey of a random sample of 6928 adults in Alameda County, CA and a subsequent 9-year mortality follow-up. The analysis indicates that mortality rates from ischemic heart disease, cancer, stroke, and all causes combined were lowest for individuals sleeping 7 or 8 h per night. Men sleeping 6 h or less or 9 h or more had 1.7 times the total age-adjusted death rate of men sleeping 7 or 8 h per night. The comparable relative risk for women was 1.6. The association between sleeping patterns and all causes of mortality was found to be independent of self-reported trouble sleeping and self-reported physical health status at the time of the 1965 survey. Simultaneous adjustment for age, sex, race, socioeconomic status, physical health status, smoking history, physical inactivity, alcohol consumption, weight status, use of health services, social networks, and life satisfaction reduced the relative mortality risk associated with sleeping patterns to 1.3 (p less than or equal to 0.04).
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PMID:Mortality risk associated with sleeping patterns among adults. 687 79


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