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Obese with better chances of survival after a stroke
A stroke is less likely to be fatal in obese and obese people than in normal people, according to a study by the research team led by Professor Wolfram Döhner from the Center for Stroke Research at the Berlin Charité. The physicians had examined the correlations between the body mass index (BMI) and the health consequences of a stroke using the data of 1,521 patients from "a multicentre stroke study from 2003 to 2005", reports the Charité in a current press release.
The researchers' result is surprising. While overweight and obese people have a stroke more often than normal people, the long-term consequences are often less dramatic for them. "Patients with overweight or obesity die less frequently after a stroke and have fewer disabilities than those with ideal weight," according to the Berlin Charité. The researchers also found that although fat people have a first stroke more often, the risk of a second stroke for overweight patients who have already had a stroke is by no means higher than that of normal weight people. Professor Döhner and colleagues published the results of the study in the European Heart Journal.
Strokes in overweight and obese people more common, but less severe The analysis of the data from stroke patients has shown that "people with underweight are most severely affected by a stroke", reports the Berlin Charité. The risk of dying from a stroke was 14 percent lower in those who were overweight than in people with a supposed ideal weight (BMI 18.5 to 25). Obese (BMI over 30) patients even had a 24 to 45 percent lower risk of mortality after a stroke. The apparently contradictory relationships are called “obesity paradox” by the doctors. This has "been observed in the past with other chronic diseases, such as heart failure," according to the Charité. The current study now shows "for the first time that the obesity paradox also applies to stroke." This is expressed in the fact that overweight people die less from a stroke, suffer less disabilities and are less in need of care than normal people.
Treatment guidelines for stroke patients need to be adapted According to the researchers, one possible reason for the better chances of survival for those who are overweight after a stroke is that the fat deposits are available as reserves for the metabolism in stressful situations. Basically, "the knowledge for stroke patients is new", because "the treatment guidelines for strokes in Germany, Europe and the USA all recommend weight reduction after a first stroke, provided that they are overweight or obese," reports the Berlin Charité. According to Prof. Döhner, the current study results are in contrast to "the popular recommendation for patients to lose weight after a first stroke." Weight management in patients with existing illnesses must be fundamentally realigned. However, this finding contradicts “our hammered mantra of slimming down as a universal health guarantee.” With regard to the primary prevention of a stroke, it is still true that if you are overweight, weight loss can significantly reduce the risk of a first stroke. (fp)
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