Cirrhosis could increase stroke risk in older people

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Cirrhosis is the eighth leading cause of death by disease, killing about 25 000 people each year according to a Health24 article.

Cirrhosis – a stiffening of liver tissue that's often tied to excessive alcohol use – may also raise an older person's odds for a stroke, a new study suggests.

A stroke is the result of a burst blood vessel or because a blood vessel has become blocked by a blood clot, depriving the area of oxygen. 

"In a nationally representative sample of elderly patients with vascular risk factors, cirrhosis was associated with an increased risk of stroke, particularly haemorrhagic stroke," wrote a team led by Dr Neal Parikh, of Weill Cornell Medicine and New York-Presbyterian Hospital in New York City.

Prevalence of stroke

Haemorrhagic or "bleeding" stroke comprises about 13% of strokes and occurs when a blood vessel ruptures, according to the American Stroke Association. The majority of strokes (87%) are ischaemic – meaning they are caused by clots.

In the new study, Parikh's team tracked 2008–2014 data for more than 1.6 million Medicare patients older than 66.

Medicare is an American government health insurance programme administered by the Centers for Medicare & Medicaid Services (CMS).

The research showed that while just over 1% of people who did not have cirrhosis suffered a stroke during the average year, that number jumped to just over 2% for people with the liver disease.

Stroke

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Like a heart attack, a stroke requires immediate medical attention when symptoms begin to surface. Health24 reports that in certain cases, specific treatment can reduce the number of permanently damaged brain cells caused by a stroke.

No causal link

The study couldn't prove that the cirrhosis actually caused any of the strokes. According to the authors, possible explanations for the association between cirrhosis and increased stroke risk include impaired clotting ability.

Or, patients' heart risk factors may be exacerbated by cirrhosis and the underlying causes of cirrhosis, such as alcohol abuse, hepatitis C infection and metabolic disease, they said.

Degree of cirrhosis important

The findings were published in the journal JAMA Neurology.

Dr Ajay Misra is chair of neurosciences at NYU Winthrop Hospital in Mineola, New York. He said that, in the past, doctors had thought that cirrhosis somehow helped lower a person's risk for clot-linked, ischaemic stroke, but the new study "dispels" that myth.

And Dr Anand Patel, a neurologist at Northwell Health's Neuroscience Institute in Manhasset, New York, noted that the degree of cirrhosis was important.

"The risk of stroke appears to [rise] in proportion to the severity of cirrhosis," he said.

Patel also pointed out that the study offers little information on how helpful blood thinner medications might be in helping people with cirrhosis avoid strokes.

Parikh's team said further research is needed to help "yield opportunities for stroke risk reduction and prevention" in these types of patients.

Read more:

Coffee protects livers of drinkers

A drink a day may raise the risk of liver cirrhosis

Alcoholic cirrhosis

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