WASHINGTON — The government plans to substantially increase disability benefits for veterans with mild traumatic brain injuries, acknowledging for the first time that veterans suffering from this less severe version of the Iraq war's signature wound will struggle to make a living.
"We're saying it's real," said Tom Pamperin, a deputy director for the Department of Veteran Affairs, about the significance of the change to benefits in the regulation the VA plans to publish today. Up to 320,000 troops who served in Iraq and Afghanistan suffered traumatic brain injury, a RAND Corp. study estimated this year. The vast majority of the cases are mild and came from exposure to an explosion, often from a roadside bomb. Most veterans with mild cases recover, Pamperin said, but some are left with permanent problems.
Compensation could reach $600 a month, the VA said. Currently, veterans with symptoms such as headaches, dizziness, sensitivity to light, ringing in the ears and irritability and insomnia collect $117. After it takes effect in 30 days, the new regulation will benefit between 3,500 and 5,000 veterans a year, the department said. It estimated the changes would cost an extra $120 million through 2017.
More than 1.6 million U.S. troops have served in Iraq and Afghanistan. About half of those are now veterans, and slightly less than half of those veterans have sought health care from the VA, records show. In the past year, the department has screened 190,000 of these veterans for brain injury. About 20% showed signs of a brain injury, but only about 5% were confirmed as suffering the wound.
The regulation modifies a 1961 rating schedule for mild brain trauma and brings compensation for this ailment into the 21st Century, said Lonnie Bristow, chairman of an Institute of Medicine committee that studied veterans' benefits.
The old regulation failed to recognize that wounds such as brain injuries from blasts — which do not show up on scans — are only understood by what patients say they are suffering, Bristow said.
"VA has been assessing their injuries based on outdated science," said Sen. Daniel Akaka, D-Hawaii, chairman of the Veterans Affairs Committee.
Veterans groups, such as the Disabled American Veterans, applauded the change. However, they said the estimated numbers of traumatic brain injury cases may prove low, because the science around blast damage to the brain is still new.
Veterans who have suffered the most severe brain injuries will not receive much, if any, extra money because existing regulations provided adequate compensation in serious cases, Pamperin said. Consolidating all brain injury standards into one regulation, he said, will make it easier for veterans to get extra benefits to pay for special circumstances such as being housebound by the injury. USA Today Gregg Zoroya
Tuesday, September 23, 2008
Sunday, August 31, 2008
Even W/Out Dementia Mental Skills Decline Years Before Death
The American Academy of Neurology issued the following announcement:Even without dementia, mental skills decline years before death
A new study shows that older people's mental skills start decliningyears before death, even if they don't have dementia. The study ispublished in the August 27, 2008, online issue of Neurology, the medicaljournal of the American Academy of Neurology."These changes are different and separate from the changes in thinkingskills that occur as people get older," said study author ValgeirThorvaldsson, MSc, of Göteberg University in Sweden. "We foundaccelerated changes in people's mental skills that indicated a terminaldecline phase years before death."The start of the decline is different for various cognitive abilities.Perceptual speed, which measures how quickly people can compare figures,begins declining nearly 15 years before death. Spatial ability startsdeclining nearly eight years before death. And verbal ability startsdeclining about six-and-a-half years before death.
The study involved 288 people with no dementia who were followed fromage 70 to death, with an average age at death of 84. The participants'mental skills were measured up to 12 times over a period of 30 years,and they were evaluated to make sure they had not developed dementia.A number of factors may explain this terminal decline in mental skills,Thorvaldsson said. "Cardiovascular conditions such as heart disease ordementia that is too early to be detected could be factors," he said."Increased health problems and frailty in old age often lead toinactivity, and this lack of exercise and mental stimulation couldaccelerate mental decline."Thorvaldsson noted that verbal abilities declined sharply in theterminal phase and did not decline significantly due to age only. "Thisindicates that people remain stable in their verbal abilities unlessthey are experiencing disease processes that also increase theirmortality risk," he said. "A change in verbal ability might therefore beconsidered a critical marker for degeneration in health in older people."
A new study shows that older people's mental skills start decliningyears before death, even if they don't have dementia. The study ispublished in the August 27, 2008, online issue of Neurology, the medicaljournal of the American Academy of Neurology."These changes are different and separate from the changes in thinkingskills that occur as people get older," said study author ValgeirThorvaldsson, MSc, of Göteberg University in Sweden. "We foundaccelerated changes in people's mental skills that indicated a terminaldecline phase years before death."The start of the decline is different for various cognitive abilities.Perceptual speed, which measures how quickly people can compare figures,begins declining nearly 15 years before death. Spatial ability startsdeclining nearly eight years before death. And verbal ability startsdeclining about six-and-a-half years before death.
The study involved 288 people with no dementia who were followed fromage 70 to death, with an average age at death of 84. The participants'mental skills were measured up to 12 times over a period of 30 years,and they were evaluated to make sure they had not developed dementia.A number of factors may explain this terminal decline in mental skills,Thorvaldsson said. "Cardiovascular conditions such as heart disease ordementia that is too early to be detected could be factors," he said."Increased health problems and frailty in old age often lead toinactivity, and this lack of exercise and mental stimulation couldaccelerate mental decline."Thorvaldsson noted that verbal abilities declined sharply in theterminal phase and did not decline significantly due to age only. "Thisindicates that people remain stable in their verbal abilities unlessthey are experiencing disease processes that also increase theirmortality risk," he said. "A change in verbal ability might therefore beconsidered a critical marker for degeneration in health in older people."
Friday, August 29, 2008
Brains of Stroke Survivors Show Improvement From Exercise
Depending on where in the brain it occurs, a stroke can result in paralysis, difficulties with breathing, swallowing, walking and balance, or problems understanding language.
People who have suffered a stroke may benefit from walking on a treadmill years after the brain injury, according to researchers who saw signs of the brain healing itself.
The results, published in Monday's issue of the journal Stroke: Journal of the American Heart Association, suggest the brain retains the capacity to rewire itself when exercised months or years after conventional physical therapy ends.
"This is great news for stroke survivors because results clearly demonstrate that long-term stroke damage is not immutable and that with exercise it's never too late for the brain and body to recover," said Dr. Daniel Hanley, a neurology professor at the Johns Hopkins University School of Medicine in Baltimore, who helped lead the study.
A stroke is a brain injury caused by a lack of blood. It happens to 50,000 Canadians each year.
Depending on where in the brain it occurs, a stroke can result in paralysis, difficulty breathing, swallowing, walking and keeping one's balance, or problems understanding language, among other symptoms.
'Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke.'— Dr. Richard Macko
The study involved 71 people with an average of 63. They all had had a stroke at least six months
before the study began, and on average, it happened four years earlier. When the study started, half of the subjects could walk without assistance, while the others used a cane, walker or a wheelchair.
Regardless of disability, half of the participants walked on a treadmill for 40 minutes three times a week for six months, while the rest did stretching exercises for the same time. Those who were physically impaired because of the stroke used supporting slings or tethers to help them complete the exercises.
Changes in brain activity
Physical therapists increased the intensity of the workouts over time by increasing the speed and incline on the treadmill, although their aerobic capacity was never taxed beyond recommended levels.
The researchers used functional magnetic resonance imaging on 32 subjects chosen equally from both groups to look for possible changes in brain activity during the study.
The scans showed increased activity in the brainstem areas associated with walking in the treadmill group, while no changes were seen in the stretching group.
"This suggests that the brain is responsible for the improvement we saw in patients' walking ability," said study author Dr. Andreas Luft, a professor of neurorehabilitation at the University of Zurich in Switzerland.
"It seems to be recruiting other regions to take on the job of areas damaged by stroke."
Among the treadmill walkers, walking speed improved by 51 per cent compared with 11 per cent among the stretchers. The treadmill walkers also improved their mobility and aerobic fitness by about 18 per cent, while no change was seen in the stretching group, the researchers said.
Most stroke rehabilitation programs focus on short-term improvements and end a few months after someone has had a stroke.
"Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke," said Dr. Richard Macko, a professor of neurology at the University of Maryland School of Medicine who also helped lead the study.
People who have suffered a stroke may benefit from walking on a treadmill years after the brain injury, according to researchers who saw signs of the brain healing itself.
The results, published in Monday's issue of the journal Stroke: Journal of the American Heart Association, suggest the brain retains the capacity to rewire itself when exercised months or years after conventional physical therapy ends.
"This is great news for stroke survivors because results clearly demonstrate that long-term stroke damage is not immutable and that with exercise it's never too late for the brain and body to recover," said Dr. Daniel Hanley, a neurology professor at the Johns Hopkins University School of Medicine in Baltimore, who helped lead the study.
A stroke is a brain injury caused by a lack of blood. It happens to 50,000 Canadians each year.
Depending on where in the brain it occurs, a stroke can result in paralysis, difficulty breathing, swallowing, walking and keeping one's balance, or problems understanding language, among other symptoms.
'Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke.'— Dr. Richard Macko
The study involved 71 people with an average of 63. They all had had a stroke at least six months
before the study began, and on average, it happened four years earlier. When the study started, half of the subjects could walk without assistance, while the others used a cane, walker or a wheelchair.
Regardless of disability, half of the participants walked on a treadmill for 40 minutes three times a week for six months, while the rest did stretching exercises for the same time. Those who were physically impaired because of the stroke used supporting slings or tethers to help them complete the exercises.
Changes in brain activity
Physical therapists increased the intensity of the workouts over time by increasing the speed and incline on the treadmill, although their aerobic capacity was never taxed beyond recommended levels.
The researchers used functional magnetic resonance imaging on 32 subjects chosen equally from both groups to look for possible changes in brain activity during the study.
The scans showed increased activity in the brainstem areas associated with walking in the treadmill group, while no changes were seen in the stretching group.
"This suggests that the brain is responsible for the improvement we saw in patients' walking ability," said study author Dr. Andreas Luft, a professor of neurorehabilitation at the University of Zurich in Switzerland.
"It seems to be recruiting other regions to take on the job of areas damaged by stroke."
Among the treadmill walkers, walking speed improved by 51 per cent compared with 11 per cent among the stretchers. The treadmill walkers also improved their mobility and aerobic fitness by about 18 per cent, while no change was seen in the stretching group, the researchers said.
Most stroke rehabilitation programs focus on short-term improvements and end a few months after someone has had a stroke.
"Many stroke survivors believe there's nothing to be gained from further rehabilitation, but our results suggest that health and functional benefits from walking on a treadmill can occur even decades out from stroke," said Dr. Richard Macko, a professor of neurology at the University of Maryland School of Medicine who also helped lead the study.
Thursday, July 10, 2008
How Foods Affect Brain Health, Cognitive Functions; Omega-3, Folic acid, Curcumin
The University of California, Los Angeles, issued the following news release: Scientists learn how food affects the brain. In addition to helping protect us from heart disease and cancer, a balanced diet and regular exercise can also protect the brain and ward off mental disorders.” Food is like a pharmaceutical compound that affects the brain," said Fernando Gomez-Pinilla, a UCLA professor of neurosurgery and physiological science who has spent years studying the effects of food, exercise and sleep on the brain. "Diet, exercise and sleep have the potential to alter our brain health and mental function. This raises the exciting possibility that changes in diet are a viable strategy for enhancing cognitive abilities, protecting the brain from damage and counteracting the effects of aging."Gomez-Pinilla analyzed more than 160 studies about food's affect on the brain; the results of his analysis appear in the July issue of the journal Nature Reviews Neuroscience and are available online atwww.nature.com/nrn/journal/v9/n7/abs/nrn2421.html.Omega-3 fatty acids -- found in salmon, walnuts and kiwi fruit -- provide many benefits, including improving learning and memory and helping tonight against such mental disorders as depression and mood disorders, schizophrenia, and dementia, said Gomez-Pinilla, a member of UCLA'sBrain Research Institute and Brain Injury Research Center. Synapses in the brain connect neurons and provide critical functions; much learning and memory occurs at the synapses, Gomez-Pinilla said."Omega-3 fatty acids support synaptic plasticity and seem to positively affect the expression of several molecules related to learning and memory that are found on synapses," Gomez-Pinilla said. "Omega-3 fatty acids are essential for normal brain function.” Dietary deficiency of omega-3 fatty acids in humans has been associated with increased risk of several mental disorders, including attention-deficit disorder, dyslexia, dementia, depression, bipolar disorder and schizophrenia," he said. "A deficiency of omega-3 fatty acids in rodents results in impaired learning and memory.” Children who had increased amounts of omega-3 fatty acids performed better in school, in reading and in spelling and had fewer behavioral problems, he said. Preliminary results from a study in England show that school performance improved among a group of students receiving omega-3 fatty acids. In an Australian study, 396 children between the ages 6 and 12 who were given drink with omega-3 fatty acids and other nutrients (iron, zinc, folic acid and vitamins A, B6, B12 and C) showed higher scores on tests measuring verbal intelligence and learning and memory after six months and one year than a control group of students who did not receive the nutritional drink. This study was also conducted with 394 children in Indonesia. The results showed higher test scores for boys and girls in Australia, but only for girls in Indonesia. Getting omega-3 fatty acids from food rather than from capsule supplements can be more beneficial, providing additional nutrients,Gomez-Pinilla said. Scientists are learning which omega-3 fatty acids seem to be especially important. One is docosahexaenoic acid, or DHA, which is abundant in salmon. DHA, which reduces oxidative stress and enhances synaptic plasticity and learning and memory, is the most abundant omega-3 fatty acid in cell membranes in the brain.” The brain and the body are deficient in the machinery to make DHA; ithas to come through our diet," said Gomez-Pinilla, who was born and raised in salmon-rich Chile and eats salmon three times a week, along with a balanced diet. "Omega-3 fatty acids are essential.” A healthy diet and exercise can also reduce the effect of brain injury and lead to a better recovery, he said. Recent research also supports the hypothesis that health can be passed down through generations, and a number of innovative studies point to the possibility that the effects of diet on mental health can be transmitted across generations, Gomez-Pinilla said. A long-term study that included more than 100 years of birth, death, health and genealogical records for 300 Swedish families in an isolated village showed that an individual's risk for diabetes and early death increased if his or her paternal grandparents grew up in times of food abundance rather than food shortage.” Evidence indicates that what you eat can affect your grandchildren’s brain molecules and synapses," Gomez-Pinilla said. "We are trying to find the molecular basis to explain this.” Controlled meal-skipping or intermittent caloric restriction might provide health benefits, he said. Excess calories can reduce the flexibility of synapses and increase the vulnerability of cells to damage by causing the formation of free radicals. Moderate caloric restriction could protect the brain by reducing oxidative damage to cellular proteins, lipids and nucleic acids, Gomez-Pinilla said. The brain is highly susceptible to oxidative damage. Blueberries have been shown to have a strong antioxidant capacity, he noted. In contrast to the healthy effects of diets that are rich in omega-3fatty acids, diets high in trans fats and saturated fats adversely affect cognition, studies indicate. Junk food and fast food negatively affect the brain's synapses, saidGomez-Pinilla, which eats fast food less often since conducting this research. Brain synapses and several molecules related to learning and memory is adversely affected by unhealthy diets, he said. Emerging research indicates that the effects of diet on the brain, combined with the effects of exercise and a good night's sleep, can strengthen synapses and provide other cognitive benefits, he added. In Okinawa, an island in Japan where people frequently eat fish and exercise, the lifespan is one of the world's longest, and the population has a very low rate of mental disorders, Gomez-Pinilla noted. Folic acid is found in various foods, including spinach, orange juice and yeast. Adequate levels of folic acid are essential for brain function, and foliate deficiency can lead to neurological disorders such as depression and cognitive impairment. Foliate supplementation, either by itself or in conjunction with other B vitamins, has been shown to be effective in preventing cognitive decline and dementia during aging and enhancing the effects of antidepressants. The results of a recent randomized clinical trial indicate that a three-year folic acid supplementation can help reduce the age-related decline in cognitive function. In patients with major depression and schizophrenia, levels of signaling molecule known as brain-derived neurotrophic factor, or BDNF, are reduced. Antidepressants elevate BDNF levels, and most treatments for depression and schizophrenia stimulate BDNF. Here, too, omega-3fatty acids are beneficial, as is the curry spice curcumin, which has-been shown to reduce memory deficits in animal models of Alzheimer’s disease and brain trauma. BDNF is most abundant in the hippocampus and the hypothalamus -- brain areas associated with cognitive and metabolic regulation. The high consumption of curcumin in India may contribute to the low prevalence of Alzheimer's disease on the subcontinent. In humans, a mutation in a BDNF receptor has been linked to obesity and impairments in learning and memory."BDNF is reduced in the hippocampus, in various cortical areas and in the serum of patients with schizophrenia," Gomez-Pinilla said. "BDNFlevels are reduced in the plasma of patients with major depression.” Smaller food portions with the appropriate nutrients seem to be beneficial for the brain's molecules, such as BDNF, he said. Gomez-Pinilla showed in 1995 that exercise could have an effect on the brain by elevating levels of BDNF. He noted that while some people have extremely good genes, most of us are not so lucky and need a balanced diet, regular exercise and a goodnight's sleep. The National Institutes of Health’s National Institute of Neurological Disorders and Stroke funded the research
Wednesday, July 9, 2008
A 10% Prevalence of Silent Stroke Found in "Healthy" Adults
About 10% of apparently healthy middle-aged adults have experienced silent cerebral infarcts (SCI), according to the latest results from the Framingham Offspring Study. Furthermore, the study found risk factors typically associated with clinical stroke, including hypertension, elevated serum homocysteine, and carotid artery disease, are also associated with midlife SCI.
The study's findings are consistent with previous community-based studies, which have estimated the prevalence of SCI between 5.8% and 17.7%, depending on age, ethnicity, presence of comorbidities, and imaging techniques.
"Our study shows that, in a middle-aged population free of clinical disease, there is a distressingly high prevalence of subclinical disease, as evidenced by these silent infarcts, which we know increase the risk of clinical stroke and cognitive impairment," study investigator Sudha Seshadri, MD, from Boston University School of Medicine, in Massachusetts, told Medscape Neurology & Neurosurgery.
"These findings also reinforce the need for clinicians to aggressively detect and manage cardiovascular risk factors, perhaps even earlier than midlife," she added.
The study is published online June 26 in Stroke.
Atrial Fibrillation Link
In addition to the prevalence data, the investigators also found that stroke risk factors, including hypertension, elevated plasma homocysteine, carotid stenosis, and increased carotid artery intimal medial thickness, are also significantly associated with silent infarcts.
Another, somewhat surprising, finding, said Dr. Seshadri, was a significant link between atrial fibrillation (AF) and SCI, with the data revealing that AF increased the risk for prevalent SCI more than 2-fold.
According to Dr. Seshadri, this finding may be an indication that AF is a simultaneous outcome, rather than a cause of SCI.
"While it is possible that tiny emboli resulting from atrial fibrillation may be causing these silent infarcts, it is probable that some of the risk factors for AF are the same as those for SCI. Therefore, it may be that atrial fibrillation is a marker for silent infarcts, rather than a cause, and that the 2 conditions are occurring together," she said.
An offshoot of the Framingham Heart Study, a longitudinal study that began in 1948 with the goal of identifying common risk factors for cardiovascular disease, the Framingham Offspring Study, which began in 1971, includes the children and children's spouses of the original cohort.
With an average age of 62 years, the current sample included 2040 offspring who attended the sixth examination (1996-1998) and underwent volumetric brain magnetic resonance imaging (MRI) in 2001 and were free of clinical stroke.
In addition, subjects were assessed using the Framingham Stroke Risk Profile (FSRP), a validated instrument that predicts 10-year probability of incident stroke and includes age, systolic blood pressure, antihypertensive therapy, diabetes mellitus, cigarette smoking, cardiovascular disease, AF, and left ventricular hypertrophy.
Subjects also underwent carotid imaging and measurement of cholesterol concentrations as well as plasma homocysteine.
Need to Follow Guidelines
Among the 10.7% of study subjects who had MRI evidence of silent infarcts, 84% had a single lesion, most commonly located in the basal ganglia (52%). One third of the lesions were subcortical, and 10% were cortical lesions.
According to the study, the aggregate FSRP score was significantly associated with prevalent SCI. Of the FRSP variables, AF, hypertension, and systolic blood pressure were all associated with an increased risk for silent infarct.
Of the variables not included in the FRSP, plasma homocysteine, carotid stenosis of 25% or greater, and increased intimal medial thickness were also associated with a higher risk for prevalent SCI. Neither age nor sex modified the effect of any of the risk factors on SCI prevalence.
The finding that there is a link between elevated homocysteine may warrant consideration of including SCI as an outcome in future studies looking at the potential benefit of vitamin supplementation.
While the study's findings are not necessarily surprising, said Dr. Seshadri, they do underscore the need to follow guidelines for the early diagnosis and prevention of hypertension and atherosclerosis and their risk factors.
Unfortunately, she said, such guidelines have not been optimally implemented for a variety of reasons. "For instance, we know that over a lifetime, 9 out of 10 people will develop hypertension. When a condition is that common it tends to be regarded as the 'norm.' But we also know that the 10% of people who do not develop high blood pressure are healthier and live longer, better-quality lives. I would argue that even though a condition is regarded as the norm it should still be treated aggressively," she said.
The study was supported by the National Heart, Lung, and Blood Institute; the National Institute on Aging; and the National Institute of Neurological Disorders and Stroke. The study authors have disclosed no relevant financial relationships.
Stroke. Published online June 26, 2008.
The study's findings are consistent with previous community-based studies, which have estimated the prevalence of SCI between 5.8% and 17.7%, depending on age, ethnicity, presence of comorbidities, and imaging techniques.
"Our study shows that, in a middle-aged population free of clinical disease, there is a distressingly high prevalence of subclinical disease, as evidenced by these silent infarcts, which we know increase the risk of clinical stroke and cognitive impairment," study investigator Sudha Seshadri, MD, from Boston University School of Medicine, in Massachusetts, told Medscape Neurology & Neurosurgery.
"These findings also reinforce the need for clinicians to aggressively detect and manage cardiovascular risk factors, perhaps even earlier than midlife," she added.
The study is published online June 26 in Stroke.
Atrial Fibrillation Link
In addition to the prevalence data, the investigators also found that stroke risk factors, including hypertension, elevated plasma homocysteine, carotid stenosis, and increased carotid artery intimal medial thickness, are also significantly associated with silent infarcts.
Another, somewhat surprising, finding, said Dr. Seshadri, was a significant link between atrial fibrillation (AF) and SCI, with the data revealing that AF increased the risk for prevalent SCI more than 2-fold.
According to Dr. Seshadri, this finding may be an indication that AF is a simultaneous outcome, rather than a cause of SCI.
"While it is possible that tiny emboli resulting from atrial fibrillation may be causing these silent infarcts, it is probable that some of the risk factors for AF are the same as those for SCI. Therefore, it may be that atrial fibrillation is a marker for silent infarcts, rather than a cause, and that the 2 conditions are occurring together," she said.
An offshoot of the Framingham Heart Study, a longitudinal study that began in 1948 with the goal of identifying common risk factors for cardiovascular disease, the Framingham Offspring Study, which began in 1971, includes the children and children's spouses of the original cohort.
With an average age of 62 years, the current sample included 2040 offspring who attended the sixth examination (1996-1998) and underwent volumetric brain magnetic resonance imaging (MRI) in 2001 and were free of clinical stroke.
In addition, subjects were assessed using the Framingham Stroke Risk Profile (FSRP), a validated instrument that predicts 10-year probability of incident stroke and includes age, systolic blood pressure, antihypertensive therapy, diabetes mellitus, cigarette smoking, cardiovascular disease, AF, and left ventricular hypertrophy.
Subjects also underwent carotid imaging and measurement of cholesterol concentrations as well as plasma homocysteine.
Need to Follow Guidelines
Among the 10.7% of study subjects who had MRI evidence of silent infarcts, 84% had a single lesion, most commonly located in the basal ganglia (52%). One third of the lesions were subcortical, and 10% were cortical lesions.
According to the study, the aggregate FSRP score was significantly associated with prevalent SCI. Of the FRSP variables, AF, hypertension, and systolic blood pressure were all associated with an increased risk for silent infarct.
Of the variables not included in the FRSP, plasma homocysteine, carotid stenosis of 25% or greater, and increased intimal medial thickness were also associated with a higher risk for prevalent SCI. Neither age nor sex modified the effect of any of the risk factors on SCI prevalence.
The finding that there is a link between elevated homocysteine may warrant consideration of including SCI as an outcome in future studies looking at the potential benefit of vitamin supplementation.
While the study's findings are not necessarily surprising, said Dr. Seshadri, they do underscore the need to follow guidelines for the early diagnosis and prevention of hypertension and atherosclerosis and their risk factors.
Unfortunately, she said, such guidelines have not been optimally implemented for a variety of reasons. "For instance, we know that over a lifetime, 9 out of 10 people will develop hypertension. When a condition is that common it tends to be regarded as the 'norm.' But we also know that the 10% of people who do not develop high blood pressure are healthier and live longer, better-quality lives. I would argue that even though a condition is regarded as the norm it should still be treated aggressively," she said.
The study was supported by the National Heart, Lung, and Blood Institute; the National Institute on Aging; and the National Institute of Neurological Disorders and Stroke. The study authors have disclosed no relevant financial relationships.
Stroke. Published online June 26, 2008.
Subscribe to:
Posts (Atom)
