Risk factors involved in the occurrence of ischemic stroke

Cardiology Department, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Republic of MoldovaIntroduction: About 60% to 80% of all ischemic strokes can be attributed to increasing blood pressure, blood cholesterol, smoking, diabetes mellitus and atrial fibrillation [American Heart Association, June 29 2006; Potential New Risk Factors for Ischemic Stroke. What Is Their Potential? Graeme J. Hankey]. Hypertension is the single most important modifiable risk factor for ischemic stroke. Various lifestyle factors have been associated with increased stroke risk. These include obesity, physical inactivity, diet, and acute triggers such as emotional stress. Obesity has been associated with higher levels of blood pressure, blood glucose, and atherogenic serum lipids, which are independent risk factors for stroke. Materials and Methods: Our study included 50 patients with hypertension and cognitive impairment, hospitalized in the cardiology department, Holy Trinity Hospital. We determined the association between MMSE score and incident CV events, adjusted for stroke, diabetes mellitus, atrial fibrillation, smoking and sedentary. We divided patients according to MMSE in 3 categories: 1. Lack of cognitive dysfunction: M M SE-24-30points; 2. Moderate cognitive dysfunction: M M SE-18-23points; 3. Severe cognitive dysfunction: 0-17points. Maximum score for MMSE is 30 points. The table shows that severe cognitive deficit is characteristic of patients with stroke, sedentary, diabetes mellitus. Moderate cognitive dysfunction was characteristic for smoking patients, diabetes mellitus and atrial fibrillation. Conclusion: Doctors have long called high blood pressure “the silent killer” because a person can have high blood pressure and never have any symptoms. Blood pressure is the most important risk factor in the occurrence of stroke. In our study we tried to demonstrate the relationship between high blood pressure and other risk factors involved in the occurrence stroke, and cognitive deficits caused by these

Hypertension as a risk factor for stroke

Cardiology Department, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Republic of MoldovaIntroduction: Uncontrolled high blood pressure increases a person’s stroke risk by four to six times. Over time, hypertension leads to atherosclerosis and hardening of the large arteries. The risk of stroke is directly related to how high the blood pressure is. Case presentation: The patient X 63 years old, women hospitalized in Holy Trinity with Clinical Diagnosis: Left hemisphere stroke with mild right hemiparesis. Motor dysphasia. Arterial hypertension III degree, very high additional risk. Ischemic heart disease. Stable angina pectoris functional class II. Heart Failure II NYHA. Diabetes mellitus type II. Complaints at the admission: Limitation of movements in the right hand and leg, speech disorders, memory disturbances, general weakness. History of current disease: She is considered hypertensive for 10 years, she followed regular medical treatment. On March 7, morning when she woke up, she felt a general weakness, dizziness, lost of consciousness for a short period of time. Hereditary history: aggravated (mother suffered from hypertension, died of ischemic stroke). Medical history: hypertension for 10 years, diabetes mellitus type II-7years. Objective data: General condition of medium gravity; Body mass index (BMI) = 36.98-obesity class 2(G = 90 kg, T = 156 cm). Cardiovascular: auscultation of heart sounds rhythmic, attenuate, with noise II aorta. Blood pressure - 180/80 mmHg on left hand, 175/80 mm Hg on right hand. SCORE Index - risk of developing a cardiovascular event in the next 10 years is 6.5%. Mini Mental State Examination severe cognitive impairment (19 points). Neurological examination: - asymmetric face; - swallowing preserved; - deviated to the right tongue; - right-mild hemiparesis, hypotonia; - pathological reflexes: Babinski sign positive on right side. Investigations and laboratory results: - Biochemical analysis of blood - total cholesterol-7 mmol/1; - ECG: sinus rhythm, heart rate=72, intermediate axis, left ventricular hypertrophy. - Head Computed Tomography scan: Discussion: Major risk factor is the patient's uncontrolled hypertension values. Patient’s other cardiovascular risk factors: diabetes mellitus type II, women age over 60, dyslipidemia, obesity, stress. Conclusion: Stroke is a serious problem that has a multitude of causative global risk factors. A large percentage of strokes can be prevented if risk factors are known and closely monitored. Reducing the incidence of stroke requires prevention and management of changeable risk factors

Cardiovascular events and cognitive impairement

Cardiology Department, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Republic of MoldovaIntroduction: Cardiovascular disease is an important risk factor for cognitive impairment. It is also assumed that cognitive impairment may increase the risk of future cardiovascular events (CV). There is a growing interest in the relationship between cardiac and cognitive functions, both of which are often impaired in the elderly. Also significant cognitive impairment occurring after stroke and myocardial infarction. Objectives: To determine the association between risks of cognitive impairment using scores on the Mini-Mental State Examination (MMSE) and CV events. Methods: Our study included 50 patients (11 strokes, 16 myocardial infarctions and 23 congestive heart failures) hospitalized in the Cardiology Department of Holy Trinity Hospital. We divided patients according to MMSE in 3 categories: 1. Lack of cognitive dysfunction: M M SE-24-30points; 2. Moderate cognitive dysfunction: M M SE-18-23 points; 3. Severe cognitive dysfunction: M M SE-0-17 points. Maximum score for MMSE is 30 points. The table shows that severe cognitive deficit is characteristic for patients with stroke and congestive heart failure. Moderate cognitive dysfunction was characteristic for patients with myocardial infarction and stroke. MMSE Scale is an useful tool in detecting cognitive deficit as areas for patients with stroke, while the most characteristic are impairment of orientation (place), attention and calculation. For patients with myocardial infarction the most characteristic are impairment of recall and comprehension, for patients with congestive heart failure the most characteristic are impairment of registration, writing and copying. Discussion: We found that baseline MMSE had the strongest association with stroke. Previous studies have shown that a prior history of clinical stroke is a much stronger predictor of recurrent stroke than myocardial infarction and congestive heart failure. Conclusion: MMSE is detecting tool for cognitive impairment in predicting cardiovascular events

Stroke and cardiovascular risk factors

Cardiology Department, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Republic of MoldovaIntroduction: According to world-heart-federation in the world each year about 15 million people suffer a stroke, of which more than a third die and one third remain disabled for life. AVC worldwide represents the second leading cause o f disability, being preceded by dementia. W orld-heart-federation also provides data such as stroke, global rarely is encountered in persons aged less than 40 years and is the fifth leading cause of death for people aged between 15-59 years, and two due to persons over the age of 60 years. Objective: In this study we tried to evaluate the trend of the risk factors and their effects in causing stroke. Materials and Method: The study involved 50 hypertensive patients, including 11 diagnosed with stroke. Data were collected from records of clinical observation and discussions with patients. Risk factors based on which the study was conducted are: hypertension, sex, age, hypercholesterolemia, smoking, diabetes, atrial fibrillation. Our data show that smoking, diabetes, dyslipidemia, and atrial fibrillation are the risk factors for stroke. Data obtained elucidates that the number of cardiovascular risk factors increased risk for developing of stroke. Discussion: We found that hypertension, smoking, diabetes and hypercholesterolemia as the most important factors in the occurrence of stroke. Conclusion: Stroke is serious problem worldwide, including the multitude of risk factors that can cause it. So a large number of strokes can be prevented if the risk factors are known, if they are effectively monitored patients at risk and whether the treatment administered fighting appropriate risk factors

Images from the Hidden Gallery

This research is part of the project Creative Agency and Religious Minorities: Hidden Galleries in the Secret Police Archives in Central and Eastern Europe. The project has received funding from the European Research 2020 research and innovation programme No. 677355