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Inflammation Increases Chance of Stroke

New Swedish study tracked 6,000 men for almost 20 years

WEDNESDAY, Nov. 6, 2002 (HealthDayNews) -- Men with high blood pressure and inflammation are more than four times more likely than other men to suffer a stroke at some point in their lives, says a new Swedish study.

The researchers also found that inflammatory proteins in the blood play a major role in strokes, even 10 years after they are first detected. Testing for such proteins could help physicians prepare for strokes and act to prevent them, says lead author Dr. Gunnar Engstrom, of the Malmo University Hospital in Malmo, Sweden.

"It is possible to detect these proteins by a simple blood test. This has been done for many years, and is still done at our hospital," Engstrom says.

On average, every 3.3 minutes a person dies of stroke in the United States, according to the American Stroke Association.

Until recently, inflammatory proteins weren't associated with heart disease and strokes. Then two years ago, two European studies in The New England Journal of Medicine linked these proteins to heart attacks. However, this new study is much more extensive and argues that the proteins are almost as important as high blood pressure in determining strokes.

The study, published in the current online issue of Stroke, evaluated stroke risk, blood pressure and levels of the inflammatory proteins in 6,071 healthy Swedish men aged 28 to 61. Researchers tracked the men for an average of 18.7 years.

One-quarter of those in the study had high systolic blood pressure, making them 2.5 times more likely to have a stroke than men with normal blood pressure. However, those with both high blood pressure and inflammatory proteins in their blood -- about 10 percent of the group -- were 4.3 times more likely to have a stroke, Engstrom says.

"We know that smoking increase inflammation. There is maybe a hereditary component, too," he says. "It is possible that inflammation increases the risk of stroke through several different pathways."

An important question Engstrom plans to explore in future studies is whether inflammation actually triggers high blood pressure. It's a question shared by other doctors and researchers.

"If worsening blood pressure elevation over a period of years could be prevented or attenuated by anti-inflammatory treatments, a new window on primary prevention could be opened," says Dr. Keith W. Muir, a neurologist with the South Glasgow University Hospital in Scotland.

Because only 3 percent to 4 percent of those in the group had strokes during the study, Muir wonders whether a preventative treatment is worthwhile.

"Is an additional 1 in 25-to-30 chance of a stroke over a 20-year period justification for intensive drug treatment in a healthy middle-aged man?" Muir asks in an editorial that will run in next month's issue of Stroke.

Studies such as this one help doctors begin to answer that question, he says.

What To Do

To learn more about strokes, visit the National Stroke Association, or the Internet Stroke Center, run by the Washington University School of Medicine in St. Louis.

SOURCES: Gunnar Engstrom, M.D., Ph.D., Malmo University Hospital, Malmo, Sweden; Keith W. Muir, M.D., neurologist, South Glasgow University Hospital and the Institute of Neurological Sciences, Glasgow, Scotland; Nov. 1, 2002, online edition, Stroke
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