Bold Voices - April 2014 - (Page 16)

AT THE BEDSIDE Link Between Shingles and Stroke Risk? People younger than 40 are less likely to be screened for stroke risk factors. They should be if they have shingles. 16 P eople younger than 40 who have had shingles may be at greater risk for a stroke, heart attack or transient ischemic attack (TIA), suggests a review of more than 300,000 patient histories. "Herpes Zoster as a Risk Factor for TIA: A Retrospective Cohort Study in the UK," published in Neurology, finds that after an average of six years, 0.21 percent of patients ages 18 to 40 with shingles had a stroke, compared with 0.12 percent of those who never had shingles. A TIA was 2.4 times more likely for patients with shingles, and a heart attack was 50 percent more likely, according to a related article in The Huffington Post. The review examined the records of 106,601 patients with shingles and 213,202 similar-aged patients without shingles, all from a United Kingdom database. People older than 40 who had shingles were 15 percent more likely to have a TIA and 10 percent more likely to have a heart attack, but not more likely to have a stroke. The review notes that people younger than 40 are less likely to be screened for stroke risk factors in general and suggests that, in particular, patients with shingles should be screened. Future studies are recommended to determine the effectiveness of shingles vaccines in reducing risk of stroke and heart attack. "[F]actors that increase the risk of stroke also increase the risk of shingles, so we do not know if vaccinating people can reduce the risk of stroke per se," lead author Judith Breuer, University College London, says in the article. "The current recommendations are that anyone 60 years and older should be vaccinated. The role for vaccination in younger individuals with vascular risk factors needs to be determined." In Utero Exposure to Dyslipidemia Heightens High LDL Risk in Offspring When mothers have a high LDL level during pregnancy, their youngadult offspring are five times more likely to have the same. W omen with a lowdensity lipoprotein (LDL) cholesterol level greater than 130 mg/ dL at their prebirth assessment are five times more likely to have young-adult offspring with an elevated LDL, according to a multivariate analysis from the Framingham Heart Study. "In Utero Exposure to Dyslipidemia Magnifies LDL Risk in Offspring," in Clinical Endocrinology News, states that, in contrast, high paternal LDL before pregnancy was not associated with increased odds of dyslipidemia in young-adult offspring. "In utero exposure to maternal dyslipidemia appears to have lasting adverse consequences in terms of cardiovascular disease risk," reported Michael Mendelson, Boston Children's Hospital, at an American Heart Association conference. If the findings are confirmed, the implications are very significant, given that an estimated 25 percent of U.S. women of childbearing age have elevated LDL. Mendelson presented data at the conference on 343 maternal-child pairs enrolled in the study. Parental serum lipids were measured three years before childbirth and again 20 years later, when the young-adult offspring also had serum lipids measured during their first assessment as Framingham participants. "We postulate that identifying young women of childbearing age with dyslipidemia and reducing abnormal LDL with lipid-specific healthy lifestyle interventions may further reduce the transgenerational cycle of dyslipidemia and cardiovascular disease risk," Mendelson adds in the article. The Framingham Heart Study is funded by the National Institutes of Health.

Table of Contents for the Digital Edition of Bold Voices - April 2014

Another Angle
President’s Note (Teaser)
NTI2014: You Have to Come! An Unmatched Experience in the Mile High City
AACN Clinical Priorities 2014: Clinical Topics for Bedside Clinicians
NTI Network: Connect Online to Plan Your Week
Step Forward! Vote in AACN’s Election 2014
You May Inherit Atherosclerosis From Your Mummy
Pain, Agitation, Delirium Guidelines Expand Nurses’ Toolkit
Pediatric Flu Deaths Still a Concern, Expanded Vaccinations Advised
Are Senior-Specific EDs Worth the Investment?
‘Stop Sepsis’ Program Reduces Mortality Rate 40 Percent
Better Relationships Between Nurses, Cleaning Staff Can Improve Patient Care
Patient Outcomes Improve With Surgeon-Led Mortality Reviews
Reducing Cross-Contamination from Healthcare Personnel Attire
New Biomarker Could Improve Outlook in Esophageal Cancer
Long-Term Survival of Kids After Out-of-Hospital Cardiac Arrest
Tight Glycemic Control Could Shorten Children’s Hospital Stay
Web-based Patient Portals Improve Self-Management
In Our Journals
Nurse-Patient Communication Enhanced in AACN CSI Academy Projects
Link Between Shingles and Stroke Risk?
In Utero Exposure to Dyslipidemia Heightens High LDL Risk in Offspring
Palliative Care: Conversations Matter
Improving Communication About Chronic Critical Illness
Certification Capsules
April 16: National Healthcare Decisions Day
New Editorial Consults, Other Publishing Events at NTI 2014
AACN Scholarships for August EBP, Research Methods Institutes
Early-Bird Registration Ends April 3
Attend the Chapter Leadership Development Workshop at NTI 2014
Vote Now!
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - April 2014