MEDICINE - UP TO THE MINUTE

by

Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina

OBESITY, WEIGHT GAIN AND STROKE- IN WOMEN

Many people are familiar with the word `'"stroke"" but don't really know what it means. A stroke is an interruption ~ the flow of arterial blood to the brain. This interruption in blood supply is "used either by a clot in the artery or by a hemorrhage through the arterial wall. In the first and most common type (called an "ischemic" stroke), the blood flow is blocked the way a stream is dammed. In the second type (a "hemorrhagic" stroke), the blood flow is diverted from its course. In both types, the result is damage to the brain. Brain damage is often accompanied by obvious signs - weakness or paralysis of an arm or leg, partial paralysis of the face, loss of speech. Sometimes the symptoms are more subtle - brief loss of consciousness or loss of memory, for example. For many years, doctors have assumed that obesity enhanced the likelihood of a stroke; but treatment can't be based on mere assumption. So researchers at Harvard decided to use a massive ongoing study to determine the relationship between excessive weight and strokes.

This study, the Nurses' Health Study, was begun in 1976. The number of women enrolled was enormous - a total of 116,759, ages 30 to 55. All were nurses, and they filled out questionnaires every two years for 20 years. In order to determine the relationship, if any, between obesity and stroke, medical researchers, led by Dr. Kathryn Rexrode, focused on a 16 year period After analyzing the questionnaire, they published their findings in "A Prospective Study of Body Mass Index, Weight Change, and Risk of Stroke in Women", (Journal of the American Medical Association' Vol. 277, No. 19, pp. 1539-1545).

The Rexrode team calculated obesity in terms of the body mass index (BMI) - self-reported weight in kilograms divided by the square of self-reported height in meters. From this calculation, they measured adiposity - a fancy name for being overweight. The researchers also studied weight increase and focused on those women who gained between 11 and 19 kilograms or more (one kilogram equals 2.2 pounds). The study covered 1,722,163 years in the lives of their subjects.

So, is there good news for overweight women? Did the researchers dispel the old medical superstition that being overweight heightens the likelihood of a stroke? Or, to put it in practical terms, can you go to the kitchen tonight and eat a whole German chocolate cake without worrying about your circulatory system? Unfortunately, for those who live to eat, the study demonstrated conclusively that obesity and weight gain contribute substantially to the incidence of strokes in women.

In the period under study, there were 403 ischemic strokes among nurses and 269 hemorrhagic strokes. The incidence among obese women and those who had reported substantial weight areas was significantly higher than those not obese.

No doubt about it. Overeating can contribute to the onset of a stroke, as can smoking, high blood pressure, and the eating of fat-filled foods. It's no longer merely an educated guess among doctors. Women who are overweight have more strokes. If you want a stroke, keep on eating and gaining weight. It you want to help avoid a stroke, lose weight in a sensible way, preferably under the direction of your physician. Preventive medicine is the best medicine.

This article is for general information purposes only. Readers with specific problems should consult a physician.



The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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