ASA International Stroke Conference

San Antonio hosted the American Stroke Association’s International Stroke Conference this week. I didn’t attend but my colleagues at Medpagetoday came through again, with extensive coverage, including video.

The conference reported hundreds of studies on stroke, but not one involved hyperbaric oxygen. Although academics are quick to demand more studies to prove the utility of hyperbaric oxygen for any role in the treatment of stroke, either acutely or for rehabilitation, no one is willing to fund the research. Main stream opinion about hyperbaric oxygen involves circular reasoning: hyperbaric oxygen for stroke treatment, though promising, is unproven, therefore, more research is needed before using it for stroke therapy. But, no funds are available for research because hyperbaric oxygen is unproven. As I’ve discussed previously, the decision to treat a patient should be based on a cost-benefit analysis of the available information and not on an arbitrary standard of proof. After all, there can never be enough data.

Although the favorite topic of Atlanta Hyperbaric never came up at the ASA meeting, researchers reported many important findings. Most of the studies would probably only interest professionals, but a few had more general appeal:

Anything more refreshing than a cup of coffee in the morning? If so, perhaps you should reconsider.

Maybe coffee helps prevent strokes: Based on a 12-year study of 9,978 men and 12,254 women from the U.K., the overall risk of stroke was 30% less in those who drank at least one cup of coffee a day. Making statistical adjustments for other stroke risk factors did not change the overall results.

Surgery versus stenting: The first report from the CREST study, which was a multi-center trial of carotid endarterectomy compared to angioplasty and stenting, came out about even for the two procedures. Much more analysis of the data will be forthcoming, but it looks like angioplasty with stenting is about as safe and effective as the older, better studied endarterectomy.

Stroke patients may be getting younger: In the greater Cincinnati area during 2005, the average age of patients presenting with a first stroke was 68.4, which had dropped from 71.3 in 1993 and the percentage of patients with stroke younger than 45 increased from 4.5% to 7.3%. The speculation may be that incidence of stroke risk factors such as diabetes, hypertension, and obesity is increasing among younger people.

Get married: In a 34-year follow up study of about 10,000 men, an Israeli researcher reported that single men had a 64% increased risk of stroke. But, men who reported unsuccessful marriages had strokes at just as high a rate as single men. Speculation ranged from the benefits of having someone remind you to take medicines or avoiding unhealthy food to having someone get you to the hospital in the event of symptoms.

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