Posts Tagged ‘Stroke prevention’

High-paying Jobs for Women Cause Women to Pay a Price in Cardiovascular Health

Thursday, November 18th, 2010

High-paying jobs typically equate to high-stress jobs for most individuals, that is, fast-paced jobs with a lot of responsibilities and little creativity.  As women have entered the workforce and fought for equality in all types of employment situations, they have slowly and gradually been successful in most venues; we have yet to see a female President of the USA.  Some jobs are much more creative allowing the expression of individual skills while others require strict adherance to company policy (or parent company policy), little decision-making ability, and productivity-driven payscales.  These latter types of jobs, regardless of the gender of the employee, often lead to job strain, a type of psychologic stress that seems to have potent effects on an individual’s health.

This week, the great city of Chicago (a bustling hub-bub of big corporations and highstress jobs) hosted the American Heart Association’s annual meeting.  Abstract 18520 was presented; it was titled, “Women with High Job Strain Have 40 Percent Increased Risk of Heart Disease.”  The study elaborates on details related to job security and the types of cardiovascular ailments.  This was a landmark study, funded by the National Institutes of Health (NIH), called the Women’s Health Study, and it followed 17, 451 women and their development of cardiovascular disease over a 10-year period.  Previous studies related to stress and cardiovascular disease have focused on men.

Women with high job strain were at a 40% increased risk overall of heart attack, ischemic stroke, coronary artery bypass surgery, balloon angioplasty/stent and even death!  The increased risk of heart attack alone in these women was 88%! The study further delineates that even women in high stress jobs who have significant control over decision-making are also at an increased risk long-term of cardiovascular disease.  Women who suffer job insecurity (fear of losing one’s job) are at risk for particular risk factors that contribute to cardiovascular disease (high blood pressure, high cholesterol, obesity), but no direct correlation to the end-effects of cardiovascular disease could be statistically supported.  This truly supports the notion that psychological stress plays a role in the development of cardiovascular disease.

The National Women’s Health Information Center is a government-sponsored organization that collects information on all types of women’s health topics and offers up-to-date information and advice on the topics.  In the Heart Health and Stroke section, the statistics are numbing; coronary artery disease is the number 1 killer amongst women while stroke is the number 3 killer of women.  In other words, women are 4 to 6 times more likely to die of heart disease than of breast cancer according to the American Academy of Family Physicians (AAFP).

Interestingly, breast cancer has much more awareness and publicity as compared to women and heart disease.  This is surprising since the symptoms of heart attack or angina pectoris in women are often atypical, much like the silent growth of microscopic cancer cells in women’s breasts.  Women, for whatever reason, do not necessarily experience the “crushing chest pain” that most people equate with a heart attack; they might develop generalized fatigue or weakness, lightheadedness, back pain, upper abdominal discomfort or simply a feeling of nervousness or anxiety.

Hmm- try being a highly-stressed 48-year-old female executive telling an ER doctor that you are feeling anxious and a little short of breath; you will be given paper bag for breathing and a Valium pill to take instead of an EKG, aspirin, oxygen and nitroglycerine.  A male would most likely get the second treatment!  Litigation involving this aspect of medicine often involves a failure to diagnose the disease.

Now, let’s get back to this landmark Women’s Health Study.  There is finally a long-term study that reports some very frightening statistics for women.  It is time for women to start advocating for themselves and performing primary interventions such as exercise, healthy weight maintenance, smoking cessation, low-fat/high fiber diets, and routine physical exams.  Both the AAFP website (linked above) and the U.S. Food and Drug Administration website offer tips for reducing women’s risk of heart attack and stroke; they will soon have to incorporate job-related stress as potential risk prevention interventions.  Employers, as well, might need to re-examine work policies and provide stress-relief activities for their employees, especially of they do not want to lose them to premature death and disability.

Another abstract presented at these same American Heart Association Scientific Sessions in Chicago addressed a controversial but nonetheless seemingly stroke-protective intervention.  From men’s and women’s  studies, mild to moderate alcohol consumption on a daily basis is associated with a reduction in risk of heart attack, but women were limited to one alcoholic beverage per day.   Abstract 19870 titled, “Alcohol Consumption and Risk of Stroke in Women,” concluded that women who consumed moderate amounts of alcohol on  a daily basis were not at an increased risk of stroke and may be healthier overall in the long-term.

The women in our office got a good laugh when these studies were placed side-by-side since our conclusion was that the boss should sponsor a happy hour on a weekly basis! All kidding aside, these new data offer both  some chilling reality checks and some hope that more research regarding modern women’s health topics will be on the horizon.  One thing is for sure — there needs to be more awareness, advocacy and primary prevention!

What programs do you have at your workplace for stress reduction?

Photo from the-invisible-gym.com

Editorial Comment (Brian Nash): To all employees (especially the women!), there will not be a firm-sponsored, weekly Happy Hour. Nice try, though.

Stroke Warnings:Most People Who Experience Minor Strokes Do Not Recognize Its Symptoms

Thursday, April 29th, 2010

According to an article published by WebMD, a recent study suggests that most people who experience minor strokes or transient ischemic attacks (TIA’s) do not recognize their symptoms and/or do not seek timely medical attention.A stroke is generally defined as an interruption of blood flow to the brain.

Strokes can be divided into two categories: hemorrhagic strokes and ischemic strokes. TIA is a condition that manifests itself with stroke-like symptoms for less than 24 hours. TIA does not by itself result in lasting neurological damage. However, people who experience TIA episodes often develop strokes. According to the article, one in 20 patients with TIA will develop a major stroke.

After interviewing about 1000 patients, researchers concluded that about 70% of the patients did not recognize TIA or minor stroke symptoms and that less than half of the patients with these conditions sought medical attention within three hours from the onset of symptoms.    

If you are at an increased risk for developing a stroke, ask your doctor for information on TIA and stroke symptoms. Early medical intervention is key in treating stokes. Please take some time to familiarize yourself with some of the TIA/stroke symptoms.


According to the article, people who experience minor strokes may develop one or more of the following:

  • sudden numbness or weakness in the face, arms or legs, especially on one side of the body
  • sudden trouble speaking or understanding
  • confusion
  • sudden vision problems in one or both eyes
  • dizziness, loss of balance, or sudden trouble walking
  • severe headache with no obvious cause

Remember – time is of the essence in getting treatment. Certain therapies (e.g. tPA) simply can not be administered to you if too many hours pass.

Contributing author: Jon Stefanuca

Landmark NIH Clinical Trial Comparing Two Stroke Prevention Procedures Shows Surgery and Stenting Equally Safe and Effective

Tuesday, March 2nd, 2010

The National Institutes of Health issued a news release regarding a landmark clinical trial relating to stroke.

A stroke can be one of the most devastating medical conditions that a person can suffer. Not only can it cause immediate death (stroke is the third leading cause of death in the United States), but it can also cause severe neurologic deficits that can leave a once-healthy person with severe mental and physical limitations. Therefore, researchers are always looking at new ways to try to prevent stroke.

The National Institute of Health (NIH) recently published the results of a major nine-year clinical trial that evaluated two methods of preventing future stroke: carotid endarectomy, or CEA, which is a surgical procedure to clear blocked blood flow, and carotid artery stenting, which is a newer and less invasive procedure that implants a small, expandable device in the artery to widen the blocked area. The good news for patients is that both methods proved to be safe and effective in both men and women.

“The CREST trial results show that we now have two safe and effective methods to treat carotid artery   disease directly, the tried and true CEA, and the new kid on the block, CAS,” said Thomas G. Brott, M.D., professor of neurology and director for research at Mayo Clinic in Jacksonville, and the study’s national principal investigator. “

The study found that the two methods were not perfectly equal, however. In patients over 70 years old, for example, the surgical procedure (CEA) results were slightly superior to stenting. Also, the study noted a difference in heart attacks and strokes:

The investigators found that there were more heart attacks in the surgical group, 2.3 percent compared to 1.1 percent in the stenting group; and more strokes in the stenting group, 4.1 percent versus 2.3 percent for the surgical group in the weeks following the procedure.

What this study means to patients is that doctors now have two safe and effective means of trying to prevent future stroke, and can choose the procedure that best fits that patient.

“The CREST trial provides doctors and patients with much needed risk/benefit information to help choose the best carotid procedure based on an individual’s health history. This personalized decision making should translate into improved patient outcomes,” said Walter J. Koroshetz, M.D., deputy director of NINDS.

Added Dr. Brott, “People have some very good options for stroke prevention that we hope will not only extend the length but also the quality of their lives.”

Contributing Author: Michael Sanders