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

The impact of blood pressure upon total and cause-specific mortality during 10 years of follow-up was studied for 7610 Japanese men in Hawaii, aged 45-68 at baseline examination. The age adjusted rate of total mortality for men with definite hypertension (WHO criteria) was twice that for normotensive men. The relative risk of mortality was five for all cardiovascular diseases (CVD), four for coronary heart disease (CHD), and six for stroke. Men with borderline hypertension also had significantly high mortality rates intermediate between the definite hypertensives and the normotensives. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) were the most important independent predictors of total, CVD, CHD and stroke mortality in multivariate analysis, taking account of 11 other known risk factors. However, SBP was more strongly related to total, CVD and CHD mortality than was DBP, whereas the reverse was true for stroke mortality. There was no significant association of either SBP or DBP with cancer and other non-cardiovascular mortality in multivariate analysis. Men who were receiving antihypertensive medication at baseline examination had a higher mortality from CVD, CHD and stroke as compared to untreated men in every category of blood pressure status. This apparently paradoxical finding probably reflects more advanced status of hypertension existing before treatment rather than adverse effects of drugs per se; however, this latter possibility cannot be dismissed.
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PMID:The impact of elevated blood pressure upon 10-year mortality among Japanese men in Hawaii: the Honolulu Heart Program. 688 58

It has been shown previously that coronary heart disease was less likely to develop in Japanese men in Honolulu who drank alcoholic beverages than in those who abstained, and that the more they drank (up to about 60 ml/day of ethanol) the lower the risk. In this report on the same men, it is shown that the same sort of relation holds for mortality from coronary heart disease but that the reverse is true for death from cancer and from stroke. Men who drank were more likely to die from these causes than those who abstained, and the more they drank the greater the risk of death. Men who drank relatively large amounts were more likely to die from cirrhosis of the liver than other men. The resultant curve for total mortality is u-shaped, the lowest risk being for men who consumed from 1 to 10 ml/day of ethanol. Even at that low level of consumption, however, the risk of death from cancer or stroke was greater than it was for nondrinkers. In short, for this population of Japanese men, alcohol consumption appears to have some benefits and some hazards with regard to mortality, and the benefit or hazard depends on which cause of death is being considered.
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PMID:Alcohol and mortality: the Honolulu Heart Study. 735 89

Marital status and indices of social support are associated with mortality due to coronary heart disease and stroke. This association seems not entirely due to differences in recognised cardiovascular disease risk factors. The Western Sydney Stroke risk in the Elderly Study examined the relationship between marital status, living arrangements, widowhood and extent of social support, and risk factors for cardiovascular disease in men and women aged over 65 years. Unmarried men had the lowest mean HDL-C levels. Men living alone had the highest mean systolic blood pressures. The lower mean HDL-C levels and higher DBP levels seen among widows were not statistically significant after adjustment for differences in past medical history and education levels. The extent of social support was not associated with any significant differences in cardiovascular risk factor levels among men or women. We conclude that some of the increased risk of cardiovascular disease associated with socio-demographic factors among men in this age-group may be due to differences in primary cardiovascular disease risk factors. However, some of the mechanisms underlying risk of cardiovascular disease in this age-group remains obscure.
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PMID:Social support, marital status and living arrangement correlates of cardiovascular disease risk factors in the elderly. 774 15

To examine whether age differentially modifies the physiological response to exercise in men and women, we performed gated radionuclide ventriculography with measurement of left ventricular volumes at rest and during peak upright cycle exercise in 200 rigorously screened healthy sedentary volunteers (121 men and 79 women) aged 22-86 yr from the Baltimore Longitudinal Study of Aging. At rest in the sitting position, age-associated declines in heart rate (HR) and increases in systolic blood pressure occurred in both sexes. Whereas resting cardiac index (CI) and total systemic vascular resistance (TSVR) in men did not vary with age, in women resting CI decreased 16% and TSVR increased 46% over the six-decade age span. Men, but not women, demonstrated an age-associated increase of approximately 20% in sitting end-diastolic volume index (EDVI), end-systolic volume index (ESVI), and stroke volume index over this age span. Peak cycle work rate declined with age approximately 40% in both sexes, but at any age it was greater in men than in women even after normalization for body weight. At peak effort, ejection fraction (EF), HR, and CI were reduced similarly with age while ESVI and TSVR were increased in both sexes; EDVI increased 35% with age and stroke work index (SWI) rose 19% in men, but neither was related to age in women; and stroke volume index did not vary with age in either sex. When hemodynamics were expressed as the change from rest to peak effort as an index of cardiovascular reserve function, both sexes demonstrated age-associated increases in EDVI and ESVI and reductions in EF, HR, and CI. However, the exercise-induced reduction in ESVI and the increases in EF, CI, and SWI from rest were greater in men than in women. Thus, age and gender each have a significant impact on the cardiac response to exhaustive upright cycle exercise.
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PMID:Impact of age on the cardiovascular response to dynamic upright exercise in healthy men and women. 777 34

Of the 300,000 deaths attributable to smoking among women in developed countries in 1985, 21% were coded to lung cancer, for example, 41% to cardiovascular diseases, primarily coronary heart disease and stroke, and 18% to chronic obstructive pulmonary disease. Overall, female deaths rates from lung cancer in developed countries increased by almost 200% between 1957 and 1987. Smoking and tobacco consumption is a health risk for women at all ages. All women, regardless whether they are pregnant, performing oral contraception or estrogen replacement should not smoke; if they are not able to stop on their own, appropriate counselling and therapy should be provided according to the state of the art. Women who smoke typically go through the menopause 2 or 3 years earlier than non-smokers. Cigarette smoking to increase the risk of estrogen-deficiency diseases, as cardiovascular risk and postmenopausal osteoporosis. Many women want to give up smoking for a number of reasons, such as health, freedom from smoking dependence, financial worries and of course pregnancy. Women find it more difficult to quit than men because of lack of social support, more reliance on cigarette to cope with stress and anxiety and fear of weight gain. Although many women manage to refrain from smoking for a long, they may relapse in situations involving negative emotions, such as conflicts, stress, loss. Men however, tend to relapse in positive situations, such as social events. Smoking cessation programmes have to cover specifically women's need including basic health education, discussion of withdrawal symptoms, strategies to maintain non-smoking and prevent relapse, continuing group support, stress management, advice on weight management, nutrition, fitness and exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Women and smoking]. 777 22

Fifteen men and 11 normally ovulating women were each tested twice for cardiovascular stress reactivity, cognitive/behavioral performance, and mood during a variety of stressors. Each women was tested during both the follicular and luteal phase of her menstrual cycle, with men matched for number of days between testing. Although the genders did not differ in blood pressure reactivity during either phase of the cycle, during both phases of the menstrual cycle women exhibited greater heart rate reactivity and tended towards greater cardiac index increases, greater pre-ejection period decreases, and lesser vascular tone relative to men. Additionally, the menstrual cycle was observed to influence gender differences in stroke volume index responses. Specifically, stroke volume index responses for women were significantly greater in their luteal versus follicular phase resulting in a marginally significant pattern whereby women's stroke volume index responses were greater than men's luteally but less than men's follicularly. Men and women also differed in cognitive performance and mood assessment during the tasks, but the majority of these differences were unaffected by the menstrual cycle.
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PMID:Hemodynamic stress responses in men and women examined as a function of female menstrual cycle phase. 780 67

Changing and often declining health among elderly individuals makes interpreting the long-standing association between self-reported health (SRH) and mortality potentially problematic. This analysis of the Longitudinal Study of Aging from 1984 through 1986 explores changes over time in the association between a single self-report of health and survival among 4380 noninstitutionalized individuals aged 70 and older. Health was reported as excellent or very good (excellent/very good), good, fair or poor. The association between SRH and survival was modeled controlling for age, race, education, marital status, body mass index, difficulty performing activities of daily living, social contacts, self-reported stroke, heart disease, cancer, diabetes and recent hospitalization. Among women, SRH and survival were associated in a nonproportional model, with relative hazard declining over time. Women with poor vs excellent/very good SRH had adjusted relative hazards at 5, 14, 23 and 32 months of 3.8 [95% confidence interval (CI) 2.0-7.1], 2.7 (95% CI: 1.8-4.1), 2.0 (95% CI: 1.3-3.0), and 1.4 (95% CI: 0.7-2.7). The declining relative hazard was due to an increasing mortality rate over time among women initially reporting excellent/very good health. SRH was associated with survival among men in a proportional model (constant relative hazard over time). Men with poor vs excellent/very good SRH had an adjusted relative hazard of 1.7 (95% CI: 1.1-2.6) over the entire follow-up. The relative hazard of lesser magnitude among men reflects the weaker SRH-survival association, possibly too weak for any interaction with time to be detected. The constant relative hazard is also consistent with a rapid decline in health before death among men. The diminishing SRH-survival association among women is consistent with their longer period of declining health before death.
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PMID:Self-reported health and survival in the Longitudinal Study of Aging, 1984-1986. 789 59

Men have significantly more atherosclerotic disease than women. Platelet-mediated thrombosis plays a role in the initiation of myocardial infarction and stroke. Citrated whole blood from male and female donors was perfused through an annular system over everted human umbilical artery segments. Comparisons were made between platelet adherence and thrombus formation on subendothelium, platelet aggregation in citrated whole blood, hematologic variables, and the bleeding time. Platelet spreading and adherence were approximately 22% greater with male blood (P < 0.001), whereas thrombus formation on subendothelium and collagen- and arachidonic acid-induced platelet aggregation did not show sex-related differences. Platelet aggregation with adenosine diphosphate was greater in women, related to their lower hematocrit values. By contrast, in women hematocrit values showed a slight but significant positive correlation with platelet adherence on subendothelium. Fibrinogen was significantly correlated with collagen- and adenosine-diphosphate-induced platelet aggregation and with platelet adherence, spreading, and thrombus formation on subendothelium. The mean bleeding time was slightly longer in women than in men (P = 0.118). Platelet aggregation was not associated with the bleeding time except for collagen-induced platelet aggregation in males; the latter was significantly correlated with platelet adherence and spreading in both sexes, while arachidonic acid-induced platelet aggregation predicted platelet adherence and spreading in males. Male blood shows enhanced primary hemostatic activity; this may predispose men to atherosclerosis.
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PMID:Sex differences in platelet adherence to subendothelium: relationship to platelet function tests and hematologic variables. 790 Jul 41

The prevalence of coronary heart disease (CHD), cardiovascular disease (CVD) and associated risk factors was studied in 413 men aged 70-89, the survivors of the Finnish cohorts of the Seven Countries Study. Men were divided into five categories according to manifestations of prevalent CVD: I, history or ECG evidence of previous myocardial infarction (MI; 48 men, 12%); II, typical angina pectoris (AP; 56 men, 14%); III, other ischaemic electrocardiographic (ECG) changes (82 men, 20%); IV, stroke, transient ischaemic attack, intermittent claudication or minor ECG changes (other CVD; 78 men, 19%); V, free of CVD (149 men, 36%). Both systolic and diastolic blood pressures were lowest in men with previous MI and in men free of CVD, and highest in men with other ischaemic ECG changes (P = 0.017). Low HDL-cholesterol (< 0.9 mmol/l) was more prevalent and the total/HDL-cholesterol ratio and triglyceride levels were higher in men with prevalent CHD (P < 0.05). Total and LDL-cholesterol, smoking, body mass index, fibrinogen, coagulation factor VIIc, apolipoprotein A-I, apolipoprotein B and lipoprotein(a) were not associated with prevalent CVD. The results show that manifestations of CHD and CVD are common among elderly Finnish men. Low HDL-cholesterol, total/HDL ratio, triglycerides and hypertension were associated with manifest CVD cross-sectionally.
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PMID:Prevalence of coronary heart disease and associated risk factors among elderly Finnish men in the Seven Countries Study. 814 50

A sample of 155 adults, age 18-49 years, including nearly equal subgroups of Black and White men and women, underwent evaluation of cardiovascular reactivity during 5 behavioral stressors. Among the men, overall blood pressure increases to tasks did not differ, but Blacks showed generally higher total peripheral resistance, whereas Whites showed greater heart rate and cardiac output increases. Among the women, the same racial-group differences were evident during certain tasks, but not during others. Men showed greater overall systolic blood pressure increases than did women, and they also showed less recovery toward baseline levels in systolic and diastolic pressure and stroke volume 5 min after the stressors. Other gender differences were task specific. The possible contributions of structural changes in the myocardium and vasculature, of altered sympathetic receptor distribution, and of task-specific behavioral factors influencing task involvement are discussed.
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PMID:Race and gender comparisons: I. Hemodynamic responses to a series of stressors. 822 59


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