Browsing by Author "Muntner, Paul"

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    Association of Prediabetes and Diabetes With Stroke Symptoms The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study
    (2012-09) Carson, April P; Muntner, Paul; Kissella, Brett M; Kleindorfer, Dawn O.; Howard, Virginia J; Meschia, James F; Williams, Linda S.; Prineas, Ronald J; Howard, George; Safford, Monika M
    OBJECTIVE Stroke symptoms among individuals reporting no physician diagnosis of stroke are associated with an increased risk of future stroke. Few studies have assessed whether individuals with diabetes or prediabetes, but no physician diagnosis of stroke, have an increased prevalence of stroke symptoms. RESEARCH DESIGN AND METHODS This study included 25,696 individuals aged ≥45 years from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study who reported no history of stroke or transient ischemic attack at baseline (2003–2007). Glucose measurements, medication use, and self-reported physician diagnosis were used to categorize participants into diabetes, prediabetes, or normal glycemia groups. The presence of six stroke symptoms was assessed using a validated questionnaire. RESULTS The prevalence of any stroke symptom was higher among participants with diabetes (22.7%) compared with those with prediabetes (15.6%) or normal glycemia (14.9%). In multivariable models, diabetes was associated with any stroke symptom (prevalence odds ratio [POR] 1.28 [95% CI 1.18–1.39]) and two or more stroke symptoms (1.26 [1.12–1.43]) compared with normal glycemia. In analyses of individual stroke symptoms, diabetes was associated with numbness (1.15 [1.03–1.29]), vision loss (1.52 [1.31–1.76]), half-vision loss (1.54 [1.30–1.84]), and lost ability to understand people (1.34 [1.12–1.61]) after multivariable adjustment. No association was present between prediabetes and stroke symptoms. CONCLUSIONS In this population-based study, almost one in four individuals with diabetes reported stroke symptoms, which suggests that screening for stroke symptoms in diabetes may be warranted.
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    Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension
    (Wolters Kluwer, 2021) Parati, Gianfranco; Stergiou, George S.; Bilo, Grzegorz; Kollias, Anastasios; Pengo, Martino; Ochoa, Juan Eugenio; Agarwal, Rajiv; Asayama, Kei; Asmar, Roland; Burnier, Michel; De La Sierra, Alejandro; Giannattasio, Cristina; Gosse, Philippe; Head, Geoffrey; Hoshide, Satoshi; Imai, Yutaka; Kario, Kazuomi; Li, Yan; Manios, Efstathios; Mant, Jonathan; McManus, Richard J.; Mengden, Thomas; Mihailidou, Anastasia S.; Muntner, Paul; Myers, Martin; Niiranen, Teemu; Ntineri, Angeliki; O'Brien, Eoin; Octavio, José Andres; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, Paul; Palatini, Paolo; Pellegrini, Dario; Postel-Vinay, Nicolas; Ramirez, Agustin J.; Sharman, James E.; Shennan, Andrew; Silva, Egle; Topouchian, Jirar; Torlasco, Camilla; Wang, Ji Guang; Weber, Michael A.; Whelton, Paul K.; White, William B.; Mancia, Giuseppe; Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension; Medicine, School of Medicine
    The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.
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    Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension
    (Wolters Kluwer, 2021) Parati, Gianfranco; Stergiou, George S.; Bilo, Grzegorz; Kollias, Anastasios; Pengo, Martino; Ochoa, Juan Eugenio; Agarwal, Rajiv; Asayama, Kei; Asmar, Roland; Burnier, Michel; De La Sierra, Alejandro; Giannattasio, Cristina; Gosse, Philippe; Head, Geoffrey; Hoshide, Satoshi; Imai, Yutaka; Kario, Kazuomi; Li, Yan; Manios, Efstathios; Mant, Jonathan; McManus, Richard J.; Mengden, Thomas; Mihailidou, Anastasia S.; Muntner, Paul; Myers, Martin; Niiranen, Teemu; Ntineri, Angeliki; O'Brien, Eoin; Octavio, José Andres; Ohkubo, Takayoshi; Omboni, Stefano; Padfield, Paul; Palatini, Paolo; Pellegrini, Dario; Postel-Vinay, Nicolas; Ramirez, Agustin J.; Sharman, James E.; Shennan, Andrew; Silva, Egle; Topouchian, Jirar; Torlasco, Camilla; Wang, Ji Guang; Weber, Michael A.; Whelton, Paul K.; White, William B.; Mancia, Giuseppe; Working Group on Blood Pressure Monitoring and Cardiovascular Variability of the European Society of Hypertension; Medicine, School of Medicine
    The present paper provides an update of previous recommendations on Home Blood Pressure Monitoring from the European Society of Hypertension (ESH) Working Group on Blood Pressure Monitoring and Cardiovascular Variability sequentially published in years 2000, 2008 and 2010. This update has taken into account new evidence in this field, including a recent statement by the American Heart association, as well as technological developments, which have occurred over the past 20 years. The present document has been developed by the same ESH Working Group with inputs from an international team of experts, and has been endorsed by the ESH.
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    Racial differences in recurrent ischemic stroke risk and recurrent stroke case fatality
    (Wolters Kluwer, 2018) Albright, Karen C.; Huang, Lei; Blackburn, Justin; Howard, George; Mullen, Michael; Bittner, Vera; Muntner, Paul; Howard, Virginia; Health Policy and Management, School of Public Health
    Objective: To determine black-white differences in 1-year recurrent stroke and 30-day case fatality after a recurrent stroke in older US adults. Methods: We conducted a retrospective cohort study using a 5% random sample of Medicare beneficiaries with fee-for-service health insurance coverage who were hospitalized for ischemic stroke between 1999 and 2013. Hazard ratios for recurrent ischemic stroke and risk ratios for 30-day case fatality comparing blacks to whites were calculated with adjustment for demographics, risk factors, and competing risk of death when appropriate. Results: Among 128,789 Medicare beneficiaries having an ischemic stroke (mean age 80 years [SD 8 years], 60.4% male), 11.1% were black. The incidence rate of recurrent ischemic stroke per 1,000 person-years for whites and blacks was 108 (95% confidence interval [CI], 106-111) and 154 (95% CI 147-162) , respectively. The multivariable-adjusted hazard ratio for recurrent stroke among blacks compared with whites was 1.36 (95% CI 1.29-1.44). The case fatality after recurrent stroke for blacks and whites was 21% (95% CI 21%-22%) and 16% (95% CI 15%-18%), respectively. The multivariable-adjusted relative risk for mortality within 30 days of a recurrent stroke among blacks compared with whites was 0.82 (95% CI 0.73-0.93). Conclusion: The risk of stroke recurrence among older Americans hospitalized for ischemic stroke is higher for blacks compared to whites, while 30-day case fatality after recurrent stroke remains lower for blacks.