Prediction of cerebral apoplexy - Survey results / 日本農村医学会雑誌

Cerebrovascular disease is still considered a serious health problem in Japanese rural areas. The rate of death from the disease is very high. Many clinical and epidemiological studies have been conducted so far. However, they have failed to come up with answers effective for prediction and prevention of the scourge.<BR>As part of the agricultural coop commissioned research project entitled “Study of Cerebral Apoplexy: Its Prediction and Prevention, ” we took a questionnaire survey in 1985-86, to obtain data as regards patients' subjective symptoms, electrocardiographic observations, hematological findings and many others before the onset of cerebral apoplexy. Five medical research institutes affiliated with the national welfare federation of agricultural cooperatives responded to our questionnaire.<BR>As a result, the subjective symptoms that showed stochastically significant increases from one year to three months before the onset of the disease as a whole were fatigue, forgetfulness and insomnia. When it comes to cerebrovascular infarction, shortness of breath, angina, forgetfulness, and nocturia were particularly notable.<BR>All these symptoms are not peculiar to cerebral apoplexy, but it should be noted that these are the warning signals of the killer disease.

Prediction of ischemic cerebrovascular disorders / 日本農村医学会雑誌

It has been reported by many workers that the patients with atrial fibrillation have risk factors that give rise to cerebral infarction. Nonetheless, no report has been made on whether or not there can be a difference in the development of ischemic cerebrovascular disorders, depending on the actual condition at the onset of atrial fibrillation, particularly a varying degree of ventricular pause and heart rate, etc.<BR>Investigations were made on 318 patients with continuous atrial fibrillation and 114 with paroximal atrial fibrillation in a total of 432 patients, ranging in age from 22 to 89 years in a ratio of 2: 1 between male and female with a mean of 65.1±11.2 years, who were included in the current study.<BR>The results have proved to be worthwhile when ventricular pause was studied by Holter's ECG. When ischemic cerebrovascular disorders were observed at varying intervals longer than 2.5, 3 and 4 seconds, a significant difference was noted between the intervals longer than 2.5 and 4 seconds in the incidence of ischemic cerebrovascular disorders (p<0.05). Lone atrial fibrillation showed a similar tendency in this aspect, regardless of the presence or absence of basic diseases.<BR>The duration of ventricular pause remained unchanged in the therapy combined with digitalis, but significantly extended when Ca-antagonist, and Beta-blocker were used. Thus, it may be important to be carafau in the selection of medications.