Tag Archives: blood pressure

Stroke Prevention Trial Has Immediate Implications for Treating Patients

Captured by Houston Methodist Hospital 

People who received intensive medical treatment following a first stroke had fewer second episodes and were less likely to die than people who received brain stents in addition to medical treatment, according to a new report in the New England Journal of Medicine, to be published online Sept. 7. All patients in the study had experienced one stroke and were considered at high risk for a second one.

Two co-authors on the paper were Methodist Neurological Institute investigators involved in the NIH-funded trial – Dr. David Chiu, principal investigator and medical director of Methodist’s Eddy Scurlock Stroke Center, and Dr. Richard Klucznik, co-investigator and interventional neuro-radiologist.

“This study is important because it will impact the way we treat stroke patients with arterial blockage in the brain,” said Chiu. “Over the past several years, we have improved treatments for intracranial atherosclerosis, and this research shows that intensive medical management is the key to preventing stroke recurrence.”

The Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) study enrolled more than 450 patients at 50 sites across the United States

Co-authors say stroke patients with recent symptoms and intracranial arterial blockage of 70 percent or greater should be treated with an aggressive medical therapy that mirrors the regimen used in this trial. The regimen used in the study included daily blood-thinning medications and the aggressive control of blood pressure and cholesterol.

The Methodist Neurological Institute had the fourth largest patient enrollment nationwide (20). New enrollment in the study was stopped in April because early data showed significantly more strokes and deaths occurred among the stented patients at the 30-day mark compared to the group who received the medical management alone. All patients will continue to be followed for two years to determine the long term effects of both interventions.

In addition to the intensive medical program, half of the patients in the study received an intervention of a self-expanding stent called a Gateway-Wingspan that widens a major artery in the brain and facilitates blood flow. The study patients at Methodist who received a stent (10) suffered no complications from stenting. Read more…

 

OSU Physicals Go Beyond Basics

Captured by The Columbus Dispatch

Erica Taffany is 25 years old and thin. She’s no stranger to workouts, but since college, she found herself exercising less.

Still, she figured she was healthy. Then she recently saw her doctor, who suggested she undergo a more in-depth physical.

Taffany, who lives in the Short North, thought it was a good idea and paid $50 for an assessment at the Labs in Life installment at COSI.

There, she learned that her cardiovascular strength was below normal for her age. So was her flexibility. To top it off, her body fat was much higher than she expected, even though she’s at an ideal weight, according to her body mass index, or BMI.

Taffany sees Dr. Anup Kanodia, a family practitioner who is part of the Center for Personalized Health Care at Ohio State University Medical Center.

Ohio State is putting a major emphasis on “P4 medicine,” which stands for predictive, preventive, personalized and participatory, including the recent addition of a P4 scholars program to its medical school.

With that philosophy in mind, Kanodia decided he’d like to get more out of his patients’ physicals than the standard measures of weight, blood pressure, cholesterol and resting pulse.

Whether a person is fat or thin doesn’t tell the whole story, he said.

“BMI is not the best way to look at physical fitness. Many people have a high BMI who exercise and are a lot healthier than people with a low BMI who are couch potatoes. There’s a thing called ‘skinny fat,’” Kanodia said.

And simply advising patients to exercise a few times a week leaves a lot out of the conversation.

“I ask them what they want out of life; do they want to be the best gardener? The best grandma?”

More-detailed information on physical health, including strength, body fat and flexibility, can help patients improve their quality of life, Kanodia said.

The program at COSI (which is run by Ohio State researchers) was a good fit for Kanodia and his partner in the effort, James Onate, co-director of OSU Sports Medicine’s movement-analysis and performance-research program.

The analysis gives a comparison of strength, aerobic endurance and flexibility and compares those against population-based data. That way, patients find out how they compare with others their age, Onate said. Read more…