Cerebrovascular Disease In Women Research Articles

OP04_5. Risk for cardiovascular and cerebrovascular diseases in women during first ten years after pre-eclampsia pregnancy in the FINNPEC study

OP04_5. Risk for cardiovascular and cerebrovascular diseases in women during first ten years after pre-eclampsia pregnancy in the FINNPEC study

Sex-Specific Cerebral Blood Flow Alterations in Youth Operated for Congenital Heart Disease.

Background Lower cerebral blood flow (CBF) has previously been documented preoperatively in neonates with congenital heart disease (CHD). However, it remains unclear if these CBF deficits persist over the life span of CHD survivors following heart surgery. When exploring this question, it is critical to consider the sex differences in CBF that emerge during adolescence. Therefore, this study aimed to compare global and regional CBF between postpubertal youth with CHD and healthy peers and examine if such alterations are related to sex. Methods and Results Youth aged 16 to 24 years who underwent open heart surgery for complex CHD during infancy and age- and sex-matched controls completed brain magnetic resonance imaging, including T1-weighted and pseudo-continuous arterial spin labeling acquisitions. Global gray matter CBF and regional CBF in 9 bilateral gray matter regions were quantified for each participant. Compared with female controls (N=27), female participants with CHD (N=25) presented with lower global and regional CBF. In contrast, there were no differences in CBF between male controls (N=18) and males with CHD (N=17). Concurrently, female controls had higher global and regional CBF compared with male controls, with no differences in CBF between female and male participants with CHD. CBF was lower in individuals with a Fontan circulation. Conclusions This study provides evidence of altered CBF in postpubertal female participants with CHD despite undergoing surgical intervention during infancy. Alterations to CBF could have implications for later cognitive decline, neurodegeneration, and cerebrovascular disease in women with CHD.

Association of Gestational Diabetes Mellitus With Overall and Type Specific Cardiovascular and Cerebrovascular Diseases: Systematic Review and Meta-analysis

(BMJ. 2022;378:e070244) Gestational diabetes (GDM) typically resolves after birth, but can cause lingering risk for adverse maternal effects, such as the development of type 2 diabetes and an increased risk in cardiovascular and cerebrovascular disease. There is a lack of information on the risk of type-specific cardiovascular disease, cerebrovascular disease, and thromboembolism following GDM, but these risks are present even in women who do not later develop type 2 diabetes. This systematic review and meta-analysis aimed to quantify the risk of overall and type-specific cardiovascular and cerebrovascular diseases in women who developed GDM using the currently available observational studies.

Long-term risk of cardiovascular and cerebrovascular disease in women with a personal history of placental abruption

Maternal and perinatal health is one of today’s global health priorities. Cardiovascular disease and stroke are the leading causes of maternal mortality. Placental abruption remains a critical concern for maternal morbidity because it has been associated with long-term vascular disease. However, there is neither much literature available in Spanish nor recent evidence elucidating some questions on this topic. Thus, this review aims to synthesize recent evidence on the long-term risk of cardiovascular and cerebrovascular disease in women with a personal history of placental abruption. It was found that, through complex pathophysiological mechanisms involving the structure and functionality of the placental vascular network with subsequent extension of vascular injury and production of proinflammatory and procoagulant factors which remain after delivery, major cardiovascular events are precipitated in the medium and long term. High-quality evidence has shown that the risk of maternal complications in women with placental abruption accounts for 2.14, rising even higher for those with severe placental abruption. In the medium and long term, the mortality risk caused by coronary heart diseases is 2.64 and by cerebrovascular disorders is 1.70, with equal risk for both ischemic and hemorrhagic strokes. It can therefore be concluded that cardiovascular and cerebrovascular risk is imminent in women with a history of placental abruption due to a number of vascular pathophysiological mechanisms. However, this risk is considerably increased when associated with traditional and non-traditional modifiable factors.

Traditional and Non-traditional Cardiovascular Risk Factors and Cardiovascular Disease in Women with Psoriasis.

Women with cardiovascular disease are underdiagnos-ed, undertreated and under-represented in research. Even though the increased risk of cardiovascular disease among patients with psoriasis is well establi-shed, only a few studies have examined women with psoriasis. This study examined the prevalence of cardio-vascular risk factors and cardiovascular disease among women with psoriasis. Using the Copenhagen City Heart Study and the Copenhagen General Population Study, 66,420 women were included in a cross-sectional design. Of these, 374 (0.56%) women had hospital-diagnosed psoriasis. Women with vs with-out hospital-diagnosed psoriasis had higher odds ratios of having traditional cardiovascular risk factors, including hypertriglyceridaemia, smoking, obesity, type 2 diabetes, and low physical activity, and of having non-traditional cardiovascular risk factors, including low level of education, high level of psycho-social stress, and low-grade inflammation. Compared with women from the general population, the multi-variable adjusted odds ratio of heart failure and ischaemic cerebrovascular disease in women with hospital-diagnosed psoriasis was 2.51 (95% confidence interval 1.33-4.73) and 2.06 (1.27-3.35). In conclusion, women with hospital-diagnosed psoriasis have a higher prevalence of traditional and non- traditional cardiovascular risk factors, and increased risk of heart failure and ischaemic cerebrovascular disease, even after adjusting for these cardiovascular risk factors.

The risk for future cerebrovascular disease in pregnant women with Moyamoya disease: a nationwide population-based study in South Korea

BackgroundPhysiologic changes during pregnancy affect the development of postpartum cerebrovascular disease (CVD) in women with Moyamoya disease. Due to the rare prevalence of Moyamoya disease and its large regional variations, large-scale based studies on the risk of CVD after delivery have not been conducted. This study aimed to evaluate whether women with Moyamoya disease have an increased risk of CVD after delivery.MethodsResearch data was collected from the National Health Insurance Claims Database of the Health Insurance Review and Assessment Service. Patients who delivered in Korea from 2007 to 2014 were enrolled in this study. We classified women as having CVD if they were diagnosed with any of the following conditions between delivery and December 31, 2016; cerebral infarction (I63.X in the International Classification of Diseases-10th Revision [ICD-10]) and/or intracranial hemorrhage (I61.X, I62.X in ICD-10) and/or subarachnoid hemorrhage (I60.X in ICD-10). Women with Moyamoya disease were identified as having I67.5 in ICD-10. We matched the study cohort by the ratio of 1:10 to analyze the risk CVD occurrence. The matching technique applied in this study was based on the variables of age and parity. To evaluate the adjusted hazard ratio (HR) for CVD in women with Moyamoya disease, we used multivariate Cox proportional hazard regression.ResultsAmong a total of 3,611,216 Korean women who underwent delivered, we identified 412 women with Moyamoya disease diagnosis and 1420 age- and parity-matched women without Moyamoya disease (control). Compared to the control group, women with Moyamoya disease had a significantly higher rate of Cesarean section, overt DM, and essential hypertension (all p < 0.0001). Among women with Moyamoya disease, 55 (13.35%) women developed CVD within the follow-up postpartum period. The presence of Moyamoya disease was associated with an increased risk of CVD after delivery (adjusted HR 37.42; 95% confidence interval (CI) 17.50-80.02 within 2.3 years) after adjusting for pregnancy-induced hypertension, gestational diabetes mellitus, pregestational diabetes, chronic hypertension.ConclusionThis population based study showed that the occurrence rate of CVD after delivery was higher in women with Moyamoya disease than in those without. Therefore, careful and long-term postpartum surveillance is required for women with Moyamoya disease.

Cerebrovascular disease in women.

Cerebrovascular disease is a major cause of morbidity, mortality, and disability in women. The spectrum of disease differs between men and women, with women being particularly vulnerable to certain conditions, especially during specific periods of life such as pregnancy. There are several unique risk factors for cerebrovascular disease in women, and the influence of some traditional risk factors for stroke is stronger in women. Moreover, disparities persist in representation of women in clinical trials, acute intervention, and stroke outcomes. In this review, we aimed to explore the epidemiology, etiologies, and management of cerebrovascular disease in women, highlighting some of these differences and the growing need for sex-specific management guidelines and health policies.

Результати вивчення факторів ризику розвитку цереброваскулярних хвороб у жінок міста Києва

Cerebrovascular diseases in the leading countries of the world occupy the second place among all the causes of death and become the main cause of disability of the population in working age. Preventive measures for the development of cerebrovascular disease are directed at eliminating or reducing the impact of risk factors of disease. The objective: to define risk factors for the development of cerebrovascular disease in women under the age of 40 years residing in Kyiv. Materials and methods. 420 women under the age of 40 years residing in Kyiv were questioned with the use of sociological method. A universal adapted questionnaire was used to conduct the research. The results were processed with the application of statistical method and the method of structural-and-logical analysis. Results. It has been defined that up to 32.0% of women have risk factors for developing cerebrovascular diseases of medical nature, up to 69.0% – of hereditary nature, up to 69.0% – of those associated with lifestyle and 32.0% – of socio-economic nature. Among women who did not have a diagnosis of cerebrovascular disease 24.6±2.2% of the polled have hypertensive disease. At the same time, 21.9±2.1% of them do not follow the doctor’s recommendations on healthy lifestyle and 13.8±1.7% of them do not follow the recommendations of the doctor on taking medications. Among women who have been diagnosed with cerebrovascular disease 31.7±2.3% of the polled have hypertensive disease. At the same time, 48.7±2.5% of them do not follow the doctor’s recommendations on healthy lifestyle and 38.5±2.4% do not follow the recommendations of the doctor regarding the intake of medicines. All that leads to high risks of developing a cerebral stroke. Conclusions. A high level of risk factors for cerebrovascular disease was defined among women aged up to 40 years of life residing in Kyiv that requires the introduction of comprehensive information and sanitary preventive programs. Keywords: Kyiv, women, cerebrovascular diseases, risk factors.

Preeclampsia and Cerebrovascular Disease.

Preeclampsia and Cerebrovascular Disease.

Gender and Age Characteristics of Mortality From Diseases of the Circulatory System of the Moscow region. Data 2016 year

Data on 2016 mortality of Federal Service of State Statistics (Rosstat) and territorial service of state statistics of the Moscow Region were used in this analysis. Analysis was conducted for men and women divided in age groups ≤50, 50-59, 60-69, and ≥50 years. Diseases were classified in accordance with 10th Revision of International Statistical Classification of Diseases (ICD10). Population of the Moscow Region territory on January 1, 2016, amounted 7 318 647 (men 46.2, women 53.8 %, persons of working age 58.9 %). Contribution in the mortality structure of chronic ischemic heart disease (IHD) and cerebro-vascular diseases in women was greater than in men (80 vs. 68 %, respectively, р&lt;0.0001). Contribution of acute IHD, IHD unrelated heart diseases, and vascular diseases in men was significantly greater than in women (30 vs. 18 %, respectively, р&lt;0.0001). In the age group over working age mortality indexes were substantially higher compared with those in working age. In men these indexes became 10-20 times while in women - 30-130 times higher. Despite positive dynamics of mortality from diseases of the circulatory system (45.3 % lowering from 2008 to 2016) it is necessary to strengthen efforts directed to correction risk factors of IHD and implementation of timely diagnostics and correction of IHD unrelated diseases.

Enfermedad cerebrovascular hemorrágica en la eclampsia asociada al síndrome HELLP

Introducción. La eclampsia (E) y el síndrome HELLP (H) son dos complicaciones de la preeclampsia que, asociadas, pueden aumentar la morbimortalidad materna. La principal complicación y la causa principal de muerte de esta asociación EH/HE es la enfermedad cerebrovascular hemorrágica (ECH). Objetivos. Determinar diferencias entre las mujeres con EH/HE que presentan ECH y las que no. Definir los tipos de ECH en mujeres con EH/HE. Diseño. Estudio transversal comparativo. Pacientes. Casos de EH/HE en el Hospital Regional Docente de Cajamarca, Perú, 2015. Intervenciones. Se dividió las pacientes con EH/HE en dos grupos: sin ECH y con ECH. Se utilizó el software SPSS 20.0. La comparación de los grupos se realizó con la U de Mann Whitney y chi cuadrado. Fueron diferencias significativas cuando p&lt; 0,05. Resultados. Hubo 23 mujeres con EH/HE: 18 (78,3%) sin ECH y 5 (21,7%) con ECH. Comparamos las mujeres con EH/HE que tenían o no ECH. ECH tuvo OR 4,44 (IC95% 1,19 a 16,55) con p=0,043 de riesgo de muerte, y las plaquetas menores de 30 000 tuvieron OR 4,44 (IC95% 1,19 a 6,55) con p=0,043 de riesgo de ECH. Además, la permanencia en UCI fue mayor que en las que no tuvieron ECH. La mortalidad fue 60%. El 80% de las ECH mostró compromiso ventricular. Hubo 66,7% de hemorragia subaracnoidea y 66,7% de hemorragia intraventricular (HIC). En las HIC, el 100% tuvo compromiso lobar, de las cuales 66,7% mostró compromiso occipital. Conclusiones. La ECH en mujeres con síndrome HELLP asociado a eclampsia estuvo relacionado a valores más bajos de plaquetas y aumentó el riesgo de muerte y estancia en cuidados intensivos.

Preeclampsia-eclampsia and future cardiovascular risk among women in Taiwan

ObjectiveThis study aims to examine the long-term cardiovascular and cerebrovascular risks in a large cohort of women with past history of preeclampsia and/or eclampsia. Materials and methodsThis is a retrospective longitudinal study using National Health Insurance Research Database from 1996 to 2010. We identified 1295 women with preeclampsia and eclampsia. The control group was 5180 pregnant women without preeclampsia/eclampsia, who were matched for age and date of delivery. The incidences of diabetes, dyslipidemia, hypertension and cardiovascular events after pregnancy were identified from medical records after the date of delivery to the date of an event or the end of the study. ResultsThe median follow-up duration was 9.8 years (interquartile 5.1–12.7 years). The incidences of diabetes, dyslipidemia, hypertension, congestive heart failure and cerebrovascular disease events were significantly greater in women with eclampsia or preeclampsia than those in controls. Eclampsia or preeclampsia increased the risk of diabetes, dyslipidemia, hypertension, congestive heart failure and cerebrovascular disease events (hazard ratio [HR] 3.84 and 5.42, P < 0.0001; HR 2.75 and 3.40, P < 0.0001; HR 6.52 and 7.31, P < 0.0001; HR 9.07, P = 0.0060 and 7.39, P < 0.0001; HR 10.71, P < 0.0001 and 3.47, P = 0.0048, respectively). The survival curves for the development of congestive heart failure and cerebrovascular disease in women with eclampsia/preeclampsia and in control differed significantly (Log-rank test P < 0.0001). From the curve, we can find dramatic increases of congestive heart failure and cerebrovascular disease incidences at roughly 3 years and 10 years since the diagnosis of eclampsia/preeclampsia. ConclusionsOur study revealed that women with a history of preeclampsia/eclampsia were at increased risks for subsequent diagnoses of diabetes, dyslipidemia, hypertension, congestive heart failure and cerebrovascular disease. Preventive counseling, more vigilant screening and management for the modifiable risks should be provided to the affected women. Clinicians should closely monitor these patients in the first three years postpartum and continuously for up to at least a decade.

Comparison of lipid profiles and inflammation in pre- and post-menopausal women with cerebral infarction and the role of atorvastatin in such populations

BackgroundThe risks of atherosclerotic cardiovascular and cerebrovascular diseases in women rapidly increase with age in post-menopausal women. We aimed to investigate the lipid profiles in peri-menopausal women with cerebral infarction and to explore the effects of atorvastatin intervention.MethodsWe collected women aged 40-60 with cerebral infarction between January 2013 and December 2016. Atorvastatin was applied for 6 months in all included patients. Blood lipid profiles, serum pro-inflammation cytokines, intracranial plaque and NIH stroke scale (NIHSS) scores were evaluated before and after atorvastatin treatment.ResultsTotally 210 patients were included. Before atorvastatin treatment, post-menopausal patients had significantly higher levels of triglyceride, cholesterol, low-density lipoprotein and a reduced level of high-density lipoprotein than those in pre-menopausal patients. Blood levels of pro-inflammatory cytokines including interleukin (IL)-1, IL-6 and tumor necrosis factor-α were higher in post-menopausal patients, who had larger intracranial plaques than pre-menopausal patients. Consistently, post-menopausal patients had higher NIHSS scores than pre-menopausal ones. Atorvastatin reduced NIHSS scores and improved dyslipidemia in patients and eliminated the differences of these parameters between pre- and post-menopausal patients.ConclusionsPost-menopausal patients were severer than pre-menopausal patients in terms of dyslipidemia, systemic inflammation and NIHSS scores. Atorvastatin may be beneficial for women with cerebral infarction.

Sex Matters in Neuroinfectious Diseases.

Although sex and gender have a major impact on the susceptibility and immunologic response to infectious diseases, these factors are often neglected. Identifying the mechanisms underlying sex-based differences in infectious diseases will facilitate the rational design and implementation of preventive and therapeutic strategies that reduce risk and improve outcomes for women and men. In this article, we discuss two examples in neuroinfectious diseases of how sex matters: (1) the heightened risk of cerebrovascular disease in women living with HIV infection and (2) the implications of Zika virus infection on sexual and reproductive health and vaccine development for women.

THERAPY OF ARTERIAL HYPERTENSION AND PREVENTION OF CARDIOVASCULAR DISEASES IN WOMAN OF REPRODUCTIVE AGE SUFFERING FROM MIGRAINE. CLINICAL REVIEW

A clinical case of the arterial hypertension in combination with migraine is considered in a woman of a reproductive age. The tactics of the antihypertensive therapy is discussed from the point of view of therapy of arterial hypertension and prevention of cardiovascular diseases and prevention of migraine attacks. Existing recommendations on prevention of cardiovascular and cerebrovascular diseases in women are analyzed and an algorithm of the drug therapy based on the available data about the general nature of pathophysiological mechanism of development of arterial hypertension and migraine is provided.

Mortality due to Cardiovascular Diseases in Women and Men in the Five Brazilian Regions, 1980-2012.

Background:Studies have shown different mortalities due to cardiovascular diseases (CVD), ischemic heart disease (IHD) and cerebrovascular diseases (CbVD) in the five Brazilian regions. Socioeconomic conditions of those regions are frequently used to justify differences in mortality due to those diseases. In addition, studies have shown a reduction in the differences between the mortality rates of the five Brazilian regions.Objective:To update CVD mortality data in women and men in the five Brazilian regions.Methods:Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and Ministry of Health. Risk of death was adjusted by use of the direct method, with the 2000 world standard population as reference. We analyzed trends in mortality due to CVD, IHD and CbVD in women and men aged ≥ 30 years in the five Brazilian regions from 1980 to 2012.Results:Mortality due to: 1) CVD: showed reduction in the Northern, West-Central, Southern and Southeastern regions; increase in the Northeastern region; 2) IHD: reduction in the Southeastern and Southern regions; increase in the Northeastern region; and unchanged in the Northern and West-Central regions; 3) CbVD: reduction in the Southern, Southeastern and West-Central regions; increase in the Northeastern region; and unchanged in Northern region. There was also a convergence in mortality trends due to CVD, IHD, and CbVD in the five regions.Conclusion:The West-Central, Northern and Northeastern regions had the worst trends in CVD mortality as compared to the Southeastern and Southern regions. (Arq Bras Cardiol. 2016; [online].ahead print, PP.0-0)

Mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium exposure of the polluted Jinzu River basin, Toyama, Japan; a 26-year follow-up

BackgroundWe aimed to investigate the mortality and causes of deaths of inhabitants with renal dysfunction induced by cadmium (Cd) exposure caused by heavy environmental contamination.MethodsWe conducted a 26-year follow-up survey targeting 7529 inhabitants of the Cd-polluted Jinzu River basin and 2149 controls from non-polluted areas who participated in urinary examinations for proteinuria and glucosuria conducted in 1979 to 1984. When the residents were divided into 4 groups, no finding group, glucosuria group, proteinuria group, glucoproteinuria group, mortality risk ratios for all and specific causes of these groups in the polluted area were compared with that of controls without glucosuria and/or proteinuria after adjustments for age at baseline, smoking status, and history of hypertension using Cox’s proportional hazard model.ResultsThe mortality risk ratios for all causes of proteinuria and glucoproteinuria in men and glucosuria, proteinuria, and glucoproteinuria in women of the polluted areas significantly increased compared with those of the controls with no urinary findings. Respiratory, renal, and cardiovascular diseases and diabetes in men, and all diseases except cerebrovascular diseases in women contributed toward an increased mortality of exposed glucoproteinuria groups, which involved chronic Cd toxicosis with renal tubular dysfunction. In women, the mortality risks for cancer of the colon and rectum, uterus and kidney and urinary tract were significantly higher in the exposed proteinuria and glucoproteinuria groups, suggesting associations between renal damage and cancer risk. In exposed women, the no finding group and glucoproteinuria group also showed increased mortality from ischemic heart diseases, indicating that all exposed women may be at risk for ischemic heart diseases. Although the control glucosuria and/or proteinuria group also showed high mortality for diabetes and renal diseases, the increased risk ratio for renal disease mortality was much higher in exposed subjects with urinary findings, particularly in women.ConclusionsThese findings indicate that inhabitants with renal effects caused by Cd exposure had a poor life prognosis over long-term observation in both genders. Particularly in women, renal tubular dysfunction indicated by glucoproteinuria may increase mortality from cancer, ischemic heart diseases, and renal diseases.

Physical Activity and Risk of Cerebrovascular Disease in the European Prospective Investigation Into Cancer and Nutrition-Spain Study

Large-scale prospective epidemiological data testing the association between physical activity (PA) and cerebrovascular diseases (CVDs) are scarce, particularly in Europe. The objective was to assess the risk of CVD according to PA levels in adults. We included a total of 13 576 men and 19 416 women aged 29 to 69 years and participating in the European Prospective Investigation into Cancer and Nutrition cohort in Spain, recruited between 1992 and 1996 and followed-up until 2006 to ascertain incident CVD events. The validated European Prospective Investigation into Cancer and Nutrition PA questionnaire was used to assess metabolic equivalent × hours per week dedicated to different types of PA. Hazard ratios of CVD by PA levels were estimated using multivariate Cox regression. Extensive baseline data collected on diet, lifestyle habits, medical history, and anthropometry were available to adjust for. A total of 210 transient ischemic attacks and 442 stroke cases (80% ischemic, 10% hemorrhagic, 7% subarachnoid hemorrhage, and 3% mixed or unspecified) were registered after 12.3 years of mean follow-up. Recreational activity was inversely associated with risk of CVD in women but not in men. Women walking for ≥3.5 hours per week were at lower risk of stroke than those who did not engage in regular walking. No significant associations were found for other leisure time activities or vigorous PA with CVD in either sex. Recreational PA of moderate intensity was inversely associated with stroke incidence in women, whereas PA showed no effect on CVD risk in men. Increasing time dedicated to activities such as walking would be expected to help to reduce the stroke burden in women.

Temporal trends in the incidence and recurrence of hospitalised atherothrombotic disease in an Australian population, 2000–07: data linkage study

ObjectivesTo examine temporal trends in the incidence and recurrence of hospitalised coronary heart disease (CHD), cerebrovascular disease (CeVD) and peripheral arterial disease (PAD) separately and combined, and by the history...

CEREBROVASCULAR DISEASE AND PREGNANCY

Approximately 12%–27% of cerebrovascular disease in women of childbearing age is associated with pregnancy. The reported incidence of stroke in pregnancy ranges from 0.01%–0.05%. While these events are uncommon, they are often clinically devastating. The Center for Disease Control's (CDC) review of death certificates in all 50 states and the District of Columbia found that neurologic or neurovascular problems are one of the leading causes of mortality in pregnancy.