A compound in citrus fruits may reduce your stroke risk, according to research reported in Stroke: Journal of the American Heart Association. Eating higher amounts of a compound in citrus fruits, especially oranges and grapefruit, may lower ischemic stroke risk. Women who ate high amounts of the compound had a 19 percent lower risk of ischemic stroke than women who consumed the least amount.

This prospective study is one of the first in which researchers examine how consuming flavonoid subclasses affects the risk of stroke. Flavonoids are a class of compounds present in fruits, vegetables, dark chocolate and red wine.

"Studies have shown higher fruit, vegetable and specifically vitamin C intake is associated with reduced stroke risk," said Aedín Cassidy, Ph.D., the study's lead author and professor of nutrition at Norwich Medical School in the University of East Anglia in Norwich, United Kingdom.

"Flavonoids are thought to provide some of that protection through several mechanisms, including improved blood vessel function and an anti-inflammatory effect."

Cassidy and colleagues used 14-years of follow-up data from the Nurse's Health Study, which included 69,622 women who reported their food intake, including details on fruit and vegetable consumption every four years. Researchers examined the relationship of the six main subclasses of flavonoids commonly consumed in the U.S. diet -- flavanones, anthocyanins, flavan-3-ols, flavonoid polymers, flavonols and flavones -- with risk of ischemic, hemorrhagic and total stroke.

As expected, the researchers didn't find a beneficial association between total flavonoid consumption and stroke risk, as the biological activity of the sub-classes differ. However, they found that women who ate high amounts of flavanones in citrus had a 19 percent lower risk of blood clot-related (ischemic) stroke than women who consumed the least amounts.

In the study, flavanones came primarily from oranges and orange juice (82 percent) and grapefruit and grapefruit juice (14 percent). However, researchers recommended that consumers increase their citrus fruit intake, rather than juice, due to the high sugar content of commercial fruit juices.

A previous study found that citrus fruit and juice intake, but not intake of other fruits, protected against risk of ischemic stroke and intracerebral hemorrhage. Another study found no association between yellow and orange fruits and stroke risk, but did link increased consumption of white fruits like apples and pears with lower stroke risk. An additional study found that Swedish women who ate the highest levels of antioxidants -- about 50 percent from fruits and vegetables -- had fewer strokes than those with lower antioxidant levels.

More studies are needed to confirm the association between flavanone consumption and stroke risk, and to gain a better understanding about why the association occurs, the authors said.

If you are continuously exposed to traffic noise your risk of stroke is higher if you are over 65 years of age, Danish researchers wrote in the European Heart Journal. They also found a clear association between stroke risk and decibel levels - the louder the noise, the higher the risk.

The authors inform that theirs is the first study to examine a link between stroke risk and traffic noise. In a study involving 51,485 individuals, the scientists worked out that the risk of stroke rose by 14% for every 10 decibel rise in noise levels.

On closer examination, they found that the risk of focused on individuals aged over 65 years. There was no statistically significant increased risk for those under 65, but a 27% higher risk of stroke for over 65s for every 10 decibel rise in noise.

The risk of stroke among the elderly rose at a much higher rate when decibel levels were over 60.

Study leader, Dr Mette Sørensen, at the Institute of Cancer Epidemiology, Danish Cancer Society, said:

"Our study shows that exposure to road traffic noise seems to increase the risk of stroke. Previous studies have linked traffic noise with raised blood pressure and heart attacks, and our study adds to the accumulating evidence that traffic noise may cause a range of cardiovascular diseases. These studies highlight the need for action to reduce people's exposure to noise.

"This is the first study ever to investigate the association between exposure to road traffic noise and risk of stroke, and, therefore, more research is needed before any firm conclusions can be made."

They had based their study on the Diet, Cancer, and Health cohort study, which included individuals aged from 50 to 64 (1993-1997). Of the 57,053 people on the database, they gathered medical and residential histories on 51,485 of them. They were followed up, on average, for ten years. 1,881 of them suffered a stroke during that ten-year period.

The scientists explained that they factored out several variables which had the potential to distort their findings, such as air pollution, aircraft and railway noise, smoking status, eating habits, and alcohol and caffeine consumption.

They linked a noise calculation program to study participants and their addresses. The program had been mapping noise levels in several Scandinavian areas for a number of years. The program takes into account traffic speed, composition, road type, road surface, building polygons and where exactly people's homes were in relation to the roads (height, position, etc.).

35% of individuals were exposed to noise levels of at least 60 decibels at time of joining. 72% of them remained at their same address throughout the whole study period. Noise exposure in this study ranged from 40 to 82 decibels.

Dr Sørensen said: "If we assume that our findings represent the true risk, and the association between traffic noise and stroke is causal, then an estimated eight percent of all stroke cases, and 19% of cases in those aged over 65, could be attributed to road traffic noise. The population in this study, however, lived mainly in urban areas and is, therefore, not representative of the whole population in terms of exposure to road traffic noise. However, if we take the exposure distribution of all dwellings in Denmark into account, we find that about 600 new cases of stroke could be attributed to road traffic noise in Denmark each year. There are 5.5 million inhabitants in Denmark and a total of 12,400 new cases of stroke each year."

This is an epidemiological study, and cannot therefore demonstrate that the cause of higher stroke risk is traffic. All it can do is reveal a link. Epidemiology examines the patterns of health and disease and associated factors at population level.

The authors say that they are not certain why this link exists.

Dr Sørensen said: "The mechanisms involved are probably the same mechanisms believed to be involved in noise-induced hypertension and heart attacks, namely that noise acts as a stressor and disturbs sleep, which results in increased blood pressure and heart rate, as well as increased level of stress hormones. Taken together, all of these could increase the risk for cardiovascular disease.

In addition, older people tend to have more fragmented sleep patterns and are more susceptible to sleep disturbances. This could explain why the association between road traffic noise and risk of stroke was seen mainly in the oldest participants."

While fewer Americans are dying from heart disease and stroke than a decade ago, these conditions continue to burden society by their prevalence and increased medical costs, according to a new report from the American Heart Association.

Between 1997 and 2007, the death rate from heart disease fell by 27.8 percent, the report shows. The death rate from stroke dropped by 44.8 percent.

At the same time, the number of operations and procedures performed to treat cardiovascular disease increased by 27 percent. The cost of treating heart disease and stroke — including both health care costs and lost productivity — was estimated at $286 billion in 2007, the researchers said. That even exceeds  expenditures on cancer, which totaled $228 billion in 2008.

The mortality drop is likely due to improved quality of care for patients, said Dr. Véronique Roger, a professor of medicine and epidemiology at the Mayo Clinic College of Medicine in Rochester, Minn., and the report’s lead researcher. People are getting the treatment and operations they need to live longer. But at the same time, cardiologists and health care professionals are either treating more people or performing more procedures per patient, leading to increased costs.

"While this is indeed a success story in the sense that it’s the success of medical care, it represents a huge burden on all of us," Roger said.
And it's a problem that's unlikely to go away anytime soon, Roger told MyHealthNewsDaily. She pointed to the large number of people living with known risk factors for cardiovascular disease. For example:

• About a third of adults over age 20 have high blood pressure, also called hypertension. Although most are aware of their condition, less than half have it under control, Roger said.
• About two-thirds of adults are overweight.
• Around 18 percent of women and 23 percent of men smoke.
• Eight percent of adults have diabetes, and close to 37 percent have "prediabetes," in which a person's blood glucose levels are elevated, but not enough to warrant a diagnosis of diabetes.
• Over the last three decades, the number of obese children ages 6 to 11 has increased from 4 percent to more than 20 percent.

Roger said the American Heart Association has set two goals it hopes to achieve by 2020: reduce deaths from cardiovascular disease by 20 percent, and improve the cardiovascular health of Americans by 20 percent — based on several factors, including exercise rates, smoking rates and cholesterol levels.

Meeting these goals won't be easy, Roger said, because they require people to make a commitment — health care professionals can only do so much.

"Improving cardiovascular health and wellness is really an agenda that we all own, it's certainly not confined to the health care profession," she said.
"If you come to my office, I can tell you not to smoke and to exercise every day, but…the responsibility lies with the individual, not with the physician," she said.

The report, Heart Disease and Stroke Statistics — 2011, is published online today (Dec. 15) in the journal Circulation.

Pass it on: Heart disease and stroke cause fewer deaths in Americans than they did 10 years ago, but still burden the country financially.

A survey released by National Stroke Association shows that 53 percent of stroke survivor respondents suffer from symptoms of another neurologic condition called pseudobulbar affect (PBA), a condition thought to be caused by structural damage in the brain due to injury or disease. PBA causes involuntary and unpredictable outbursts of laughing or crying, often in socially inappropriate situations. Even though a significant proportion of stroke survivors suffer from PBA, fewer than one in five are familiar with the condition.

Survey results demonstrated that of the total National Stroke Association respondents, over half (304 of 578 respondents) had symptoms of PBA as determined by a score of 13 or greater on the Center for Neurologic Study Lability Scale (CNS-LS), the standard, self-report tool used to assess the presence and severity of PBA symptoms. Of these respondents, approximately 27 percent had CNS-LS scores that indicated moderate-to-severe symptoms of PBA. More than one-quarter (27%) indicated that they experience PBA outbursts frequently or often.

In addition to the potential prevalence of PBA among stroke survivors, the results illustrated the negative effect on quality of life that PBA has on stroke survivors and their caregivers. About four in 10 respondents reported that PBA episodes interfere with their social activities including spending time with friends and family. Likewise, about one-third of the respondents indicate that PBA episodes have contributed to difficulty in maintaining relationships or becoming housebound.

"With more than six million stroke survivors in the United States, the prevalence and burden of pseudobulbar affect in the stroke community is significant," said James Baranski, CEO, National Stroke Association. "Not only are these survivors recovering from a serious neurologic injury, but they are also dealing with the anxiety, embarrassment and social isolation that results from PBA episodes -- all at a time when support from family and friends is needed most."

Other key findings from the National Stroke Association survey include:

• More than 50 percent of stroke survivors with PBA symptoms consider the episodes of involuntary crying and laughter to be burdensome.
• PBA interferes extremely, very or somewhat often with everyday activities such as spending time with friends and family (38%), talking on the phone (32%), interacting with nurses or other healthcare professionals (24%), and attending church or religious services (23%).
• Only about a third of those with PBA symptoms are treated for their episodes (38%), and only half of treated patients are satisfied with their treatment.
• Other involuntary emotional episodes frequently experienced include frustration, irritability, agitation and anger.

"The results of the National Stroke Association survey on PBA confirm what I see on a regular basis in my practice as it pertains to stroke survivors," said Richard Zorowitz, MD, Chief, Department of Physical Medicine and Rehabilitation, Johns Hopkins Bayview Medical Center. "This survey demonstrates that PBA is a common condition that stroke survivors must also manage. It can cause significant impairment in patients' and caregivers' quality of life. The findings also reinforce the need for effective treatment options that help patients reduce the involuntary outbursts of laughing or crying and allow them to regain more control over their daily lives."

National Stroke Association conducted the survey in conjunction with Avanir Pharmaceuticals, Inc. to learn more about the prevalence and impact of PBA among stroke survivors and the level of awareness of the condition among both patients and their caregivers.

More than 795,000 people experience a stroke, also known as a brain attack, each year, making it the third leading cause of death in the U.S. and a leading cause of adult disability.

Patients suffering from serious neurologic disease or brain injury may also suffer the added burden of pseudobulbar affect (PBA). PBA is a neurologic condition caused by underlying structural damage in the brain which triggers involuntary, unpredictable and disruptive outbursts of laughing or crying. More than a million Americans suffer from PBA.