Firstly we NeuroAiD™ team, are happy to share with you our pride: Moleac has been granted the Emerging Company of the Year by BioSpectrum, the leading integrated media platform for the Life Science Industry in Asia Pacific. Secondly we would like to talk about dementia, a stroke related disease and blood pressure drugs. At last we will turn our attention again onto the aspirins, if they are really effective in prevention for cerebrovascular diseases.

We would like to assist you in your return to daily life while recovering from stroke. As you are probably already aware, making the best use of time is of vital importance in your stroke recovery. Therefore, please allow us to call you at a number, day and time of your convenience, to hear your questions and explain our answers. If you agree, kindly email us the table below at info@neuroaid.com :

• Number :
• Date :
• Location / time zone :
• Person to ask for :

If you choose to contact us yourself instead, call us on our US toll free number:
1-800-882-4046 / +65-6478-9430 or email us at info@neuroaid.com

The NeuroAiD™ Team at Moleac

On the 14^th March 2010, in Singapore, Moleac has been granted the Emerging Company of the Year by BioSpectrum, the leading integrated media platform for the Life Science Industry in Asia Pacific. BioSpectrum is the most authoritative and influential information on healthcare industry in the Asia Pacific region. The recognition comes as another prestigious award, after being named by Frost and Sullivan the Entrepreneurial Company of the Year 2009. We are happy to share with you our pride. We brought a first innovative medicine to market within four years with limited resources. NeuroAiD™ has been identified in Traditional Medicines and has been carefully selected for its efficacy and absence of side effects. The first treatment for post stroke recovery has addressed the therapeutic gaps and has helped thousands of patients including you.

The latest breakthrough pharmacology data may be able to pave way for new indications of NeuroAiD™ in stroke prevention, cognitive impairments and dementia. It is good news for our patients who are in need of treatments in this under-served therapeutic area. NeuroAiD™ team thanks you for your support and continues working together with the academic partners, to keep making meaningful contribution and accompanying you in the long recovery journey after stroke.

Sources:
www.moleac.net
www.biospectrumasia.com

A recent study made by researchers from Boston University in the United States has shown that there is a positive relationship between taking blood pressure drugs and dementia. Millions of older people who take drugs for high blood pressure or heart problems can lessen their risk of developing Alzheimer’s disease and dementia. It was also reported that people suffering already from dementia are less likely to get worse. The research showed that people who are taking angiotensin receptor blockers (ARBs) were up to 40% less likely to develop dementia than people taking other blood pressure drugs. The researchers from Boston University found that older people taking ARBs were less likely to experience dementia and Alzheimer’s disease.

Dementia

As stated in the United States National Library of Medicine of the National Institutes of Health, “dementia which, is also called senility, is a word for a group of symptoms caused by disorders that affect the brain. It is not a specific disease. People with dementia may not be able to think well enough to do activities of daily living such as getting dressed or eating and that they may lose their ability perform problem solving as well as controlling their emotions. People with dementia may experience personality changes. They may become agitated or may experience visual hallucinations.”

The United States' National Institute of Health cites memory loss as the most common symptom of dementia. However, experiencing memory loss does not guarantee that you have dementia. They said that people with dementia will experience serious problems with two or more brain functions, such as memory and language.

There are a number of causative factors that may predispose a person to dementia. These may include diseases and infections, strokes, head injuries, drugs and nutritional deficiencies.

Angiotensin Receptor Blockers (ARBs)

Angiotensin II is a very potent vasoconstrictor. It results in the contraction of muscles surrounding blood vessels. This leads to constriction of the blood vessels which results to hypertension or high blood pressure.

ARBs are medications that inhibit the action of angiotensin II. This results in vasodilation or dilation of the blood vessels and eventually would lead to a decreased blood pressure. They are used to treat or improve conditions such as hypertension and heart failure.

Number of people with Dementia

It is estimated by the US Congress Office of Technology Assessment that the number of people affected by dementia in the United States alone is 6.8 million. They added that at least 1.8 million of those surveyed people are severely affected. In the United Kingdom, people with dementia are expected to increase to 1.7 million over the next twenty years.

The illness affects around 35 million worldwide and is expected to increase greatly as the number of older people around the globe also increases.

Hypertension and Dementia

Hypertensive episodes over long periods would eventually lead to blood vessel damage. This phenomenon predisposes a hypertensive person to a possible stroke, heart disease and also dementia.

High blood pressure is a risk factor for vascular dementia, which is a type of dementia. It is where brain function is diminished due to a series of “small” strokes. Also, a person’s blood vessels are negatively affected by these hypertensive episodes. These episodes may lead to people contracting the illness since arteries supplying the brain are also affected.

The Study

The study made at Boston University looked into the records of around 6 million people who were treated for high blood pressure. It collated data starting from 2001 and 2006. Doctor Benjamin Wolozin and his colleagues from Boston University studied 819,491 people in the United States aged over 65 who had heart disease. The total population of the study showed that 98% were men.

The study showed the benefits from taking ARBs. The drugs which aid in preventing vasoconstriction also helped in preventing or delaying the arrival of the symptoms of dementia and also slowed down progress of the disease.

The study showed that people taking ARBs were less likely to be diagnosed with dementia as compared to people taking other high blood pressure medications. It also showed that people who had dementia during those times would less likely to develop delirium, be admitted to a nursing home or even die prematurely by as much as 45%. Men who were taking ARBs had a 24% lower risk of developing dementia than men taking other cardiovascular drugs. Men who were taking ACE inhibitors, on the other hand, had a 19% lower incidence of the illness. The risk of having the illness for people taking both angiotensin-targeting drugs was lessened by as much as 50%.

Admission to nursing homes by men with Alzheimer’s disease who took ARBs was trimmed down by as much as fifty percent while combined angiotensin medication therapy cut down the admission to nursing homes by as much as two-thirds.

Dr. Benjamin Wolozin, a professor of pharmacology and neurology at Boston University and senior author of a report on the findings said that "We think it [angiotensin] is one of the most important factors determining healthy blood vessels and also acts in the brain to help neurons to be a little more resilient."

Wolozin added that it is still not yet clear why the ARBs have a positive effect on the brain. He added that the increase in blood flow to the brain probably plays a role.

As stated by Wolozin if blood does not reach the brain, brain function such as thought processes are diminished. He added that there is more than one type of angiotensin receptors in the brain. ARBs block only the bad receptors leaving only the good receptors. This eventually makes the neurons more resilient thus increasing thought processes.

Professor Clive Ballard of the Alzheimer’s Society said that full clinical trials, following a smaller number of patients over a longer period, were now needed. He stated that hypertension increases both the risk of having Alzheimer’s disease by as much as 50% and also increases the risk of having a stroke. He added that it is now important to investigate drugs used to control high blood pressure as a possible treatment for dementia. Dr. Susanne Sorensen who heads the research team of the Alzheimer’s Society said that it had been known that it is important to control hypertension starting from mid-life to reduce the risk of developing dementia. She added that the using existing drugs to help in the fight against dementia are very attractive.

Wolozin, on the other hand, stated that it is not yet sufficient to support routine use of ARBs in preventing Alzheimer’s disease. He said that the study was lacking in strict control which is needed for a convincing proof. He said that “Any study like this is hypothesis-generating.” “You only know for sure when you have done clinical prospective trials,” Wolozin added.

Wolozin then advised people who are thinking of using ARBs to reduce the risk of dementia should first consult with their physicians. He added that use of the ARBs entail risks such as falling due to low blood pressure or hypotension.

Sources:
Guardian.co.uk
Msnbc.msn.com
News.bbc.co.uk
Nlm.nih.gov
Nhs.uk
Medicinenet.com
Emedicinehealth.com

The Daily Telegraph of the United Kingdom reported that "Healthy people who are taking aspirin in the hope of preventing a stroke or a heart attack are doing themselves more harm than good." It added that these healthy people who take a low dose of daily aspirin in order to prevent or reduce the occurrence of a cerebrovascular accident (stroke) or a myocardial infarction (heart attack) are also increasing their risk of internal bleeding. It also stated that "Millions of people take a low dose of aspirin daily, as it is known to reduce the risk of having a stroke or the incidence of a second heart attack."

This state of altered sensation can lead to the development of pressure ulcers (formerly known as decubitus ulcers, bed sores or pressure sores). It is a painful localized lesion caused by unrelieved pressure to body tissues. This unrelieved pressure will eventually result to the damage of the underlying tissues. Since stroke patients experience altered sensations, pressure ulcers can be a major problem during their care. This problem persists in all types of care settings: acute care, long-term care settings and stroke patients cared for in their very own homes.

Aspirin

People see aspirin as a prophylaxis, a “just in case” measure. Since its discovery, aspirin has been hailed as a cure all and considered safe by majority of the people. But there are also side-effects associated with this miracle drug. One of the major side-effect of aspirin is bleeding which may occur in the brain, stomach or anywhere in the body. Experts have given out warnings about weighing its beneficial effects against the risk of harm.

The US National Library of Medicine stated that aspirin is in a group of medications called salicylates. It works by stopping the production of certain natural substances that cause fever, pain, swelling, and blood clots.

It added that prescription aspirin is used to relieve symptoms of rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus (SLE) and other rheumatologic conditions. It added that nonprescription aspirin may be used to relieve mild to moderate pain, prevention of a second heart attack, angina, ischemic stroke (strokes that occur when a blood clot blocks the flow of blood to the brain) or mini-strokes (strokes that occur when the flow of blood to the brain is blocked for a short time) in people who have had this type of stroke or mini-stroke in the past. It also stated that aspirin does not prevent hemorrhagic strokes (strokes caused by bleeding in the brain).

The Study

The study tried to answer the question “who should be given an aspirin to prevent a stroke or a heart attack.” This led the research ream to test the efficacy of aspirin against cardiovascular events in people who are at risk of atherosclerosis and cardiovascular events thru screening. The study was made within a ten year period starting from 1998 until 2008. The researchers tried to verify whether strokes, fatal or non-fatal heart attacks or deaths were reduced by aspirin. They were also interested in monitoring the side effects of aspirin, such as bleeding.

The study included screening of the ankle brachial index (ABI). It is a simple, inexpensive test to determine the ratio of the blood pressure of the legs from the blood pressure of the arms.

The ABI required participants to lie down for five minutes, during which the blood pressure (BP) in their feet were compared to the BP in their arms. Their blood pressure were measured using a typical blood pressure cuff and an ultrasound probe to detect the pulse in two arteries of the feet. And the ratio of blood pressures were recorded (above 0.95 is thought to be normal and below 0.95 is thought to indicate narrowing of the arteries to the legs).

The research involved inviting 165,795 people from central Scotland who are aged 50 to 75 for screening. Of this total number of invitations, 28,980 men and women were screened. The study team then narrowed the population by excluding people who already had been diagnosed with vascular disease, who were already taking medication such as aspirin or warfarin, or were unwilling or unable to participate. A total of 3,350 people with an ABI of 0.95 or less were left after the population was trimmed down.

The remaining participants were split into two equal groups of 1,675 people. The study team followed all but 10 participants for an average of eight years. The participants were seen at intervals of three months, one year and five years in the clinic and were then contacted annually by telephone. They also received a mid-year letter, inquiring generally about any problems, and an end-of-year newsletter.

During this time, the study team observed for strokes, fatal or non-fatal heart attacks or revascularization (such as angioplasty or bypass grafts). The researchers also monitored for all deaths, angina, intermittent claudication (pain in the legs on walking due to narrowing of the arteries) and warning strokes (transient ischemic attacks).

The research team found out that there was no statistically significant difference between the two groups. They added that there were 13.7 events per 1,000 person-years in the aspirin group compared to 13.3 events per 1,000 person-years in the placebo group. The results showed that “the administration of aspirin compared with placebo did not result in a significant reduction in vascular events.” It showed that taking of daily aspirin did not prevent or reduce the risk of a stroke or a heart attack. The study illustrated the increased risk of having the side-effects of the drug for people taking aspirin as a prophylaxis.

Although the result of the study showed that there was “no statistical significance,” it is still an important result. The research suggests that the perceived benefits from taking daily aspirin are likely to be small.

The study stated that “daily aspirin does not appear to be of benefit in preventing cardiovascular disease in this group of patients at least, and suggests it could even increase bleeding.” It added that “there are other groups of patients at higher vascular risk, for example, those with high blood pressure, cholesterol and diabetes who may benefit from aspirin.” In hindsight, the research pointed out that “people taking aspirin following a stroke or a heart attack should continue to do so, and others should consider being assessed for vascular risk.”

According to Professor Peter Weissberg, Medical Director of the British Heart Foundation, “We know that a small daily dose of aspirin can reduce the risk of a heart attack in people with angina and in those who've had a heart attack. In these cases, this potential benefit outweighs the risk of internal bleeding, which is a side effect of aspirin.”

He added that the study sought to determine if people with evidence of artery disease in their legs - which raises the risk of having a heart attack in future - would also benefit from taking daily aspirin. Weissberg stated that the results showed that people do not gain any heart-protective benefit from taking a daily dose of aspirin and were more prone to internal bleeding complications than people who took a placebo.

Weissberg stated that the findings agree with their current advice that people who do not have symptomatic or diagnosed artery or heart disease should not take aspirin because the risk of bleeding outweighs the benefits.

Dr. Jeffrey Berger, of the New York University School of Medicine, wrote that “The trial supports findings of a recent meta-analysis that failed to demonstrate a benefit of aspirin therapy for patients with peripheral artery disease.” He added that the study made by Fowkes et al showed that aspirin have marginal benefits for reducing initial cardiovascular events when used for patients without clinically evident cardiovascular disease and is associated with higher rates of bleeding events in these patients. Nevertheless, aspirin remains an effective therapeutic agent for secondary prevention of cardiovascular events. We strongly advise you to consult your doctor before taking any medication.

References:
www.telegraph.co.uk
www.nhs.uk
Bedsores.org
www.nlm.nih.gov