Cardiovascular Journal of Africa: Vol 35 No 3 (SEPTEMBER/OCTOBER 2024)

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 35, No 3, September – October 2024 AFRICA 159 4. Hopman J, Allegranzi B, Mehtar S. Managing COVID-19 in low- and middle-income countries. J Am Med Assoc 2020; 323(16): 1549–1550. 5. Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Biondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol 2020; 75(18): 2352–2371. 6. Aluga MA. Coronavirus disease 2019 (COVID-19) in Kenya: Preparedness, response and transmissibility. J Microbiol Immunol Infect Wei Mian Yu Gan Ran Za Zhi 2020; 53(5): 671–673. 7. Gilbert M, Pullano G, Pinotti F, Valdano E, Poletto C, Boëlle P-Y, et al. Preparedness and vulnerability of African countries against importations of COVID-19: a modelling study. Lancet 2020; 395(10227): 871–877. 8. Welt FG, Shah PB, Aronow HD, Bortnick AE, Henry TD, Sherwood MW, et al. Catheterization laboratory considerations during the coronavirus (COVID-19) pandemic: from the ACC’s Interventional Council and SCAI. J Am Coll Cardiol 2020; 75(18): 2372–2375. 9. Gupta T, Nazif TM, Vahl TP, Ahmad H, Bortnick AE, Feit F, et al. Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter. Catheter Cardiovasc Interv 2021; 97(2): 201–205. 10. Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol 2020 9; 75(22): 2871–2872. 11. Rodríguez-Leor O, Cid-Álvarez B, Ojeda S, Martín-Moreiras J, Rumoroso JR, López-Palop R, et al. Impacto de la pandemia de COVID-19 sobre la actividad asistencial en cardiología intervencionista en España. REC Interv Cardiol 2020; 2: 82–89. 12. Al-Benna S. Impact of COVID-19 on surgical registrars’ education and training. S Afr J Surg 2020; 58(2): 55–58. 13. Sneyd JR, Mathoulin SE, O’Sullivan EP, So VC, Roberts FR, Paul AA, et al. Impact of the COVID-19 pandemic on anaesthesia trainees and their training. Br J Anaesth 2020; 125(4): 450–455. 14. Kanmounye US, Esene IN. Letter to the Editor: COVID-19 and neurosurgical education in Africa: making lemonade from lemons. World Neurosurg 2020; 139: 732–733. 15. Rwebembera J, Jeilan M, Ajijola OA, Talle M, Sani MU, Karaye KM, et al. Cardiac pacing training in Africa: endorsed by the Africa Heart Rhythm Association (AFHRA): JACC International. J Am Coll Cardiol 2020; 76(4): 465–472. 16. DeFilippis EM, Schmidt ACS, Reza N. Adapting the educational environment for cardiovascular fellows-in-training during the COVID-19 pandemic. J Am Coll Cardiol 2020; 75(20): 2630. … continued from page 139 Using normal weight as a reference, researchers found that the risk for ischaemic stroke was more than twice as high for women who had been overweight at 14 (HR 2.49; 95% CI 1.44–4.31) and 31 (HR 2.13; 95% CI 1.14–3.97) years. The risk was also considerably higher for women who had obesity at 14 (HR 1.87; 95% CI 0.76–4.58) and 31 years (HR 2.67; 95% CI 1.26–5.65) years. The risk for haemorrhagic stroke was even higher, both among women (HR 3.49; 95% CI 1.13–10.7) and men (HR 5.75; 95% CI 1.43–23.1) who had obesity at 31 years. No similar associations were found among men, and the findings were independent of earlier or later BMI. The risk for any cerebrovascular disease related to overweight at age 14 years was twice as high among girls than boys (HR 2.09; 95% CI 1.06–4.15), and the risk for ischaemic stroke related to obesity at age 31 years was nearly seven times higher among women than men (HR 6.96; 95% CI 1.36–35.7). ‘Stroke at a young age is rare, so the difference of just a few strokes could have an outsized impact on the risk estimates,’ Mikkola said. ‘Also, BMI relies solely on a person’s height and weight; therefore, a high BMI may be a misleading way to define obesity, especially in muscular people who may carry little fat even while weighing more.’ Caveats In an accompanying editorial, Larry Goldstein, MD, chair of the Department of Neurology, University of Kentucky, US, and co-director of the Kentucky Neuroscience Institute, said the study ‘provides additional evidence of an association between overweight/obesity and stroke in young adults.’ ‘However,’ he added, ‘while it is tempting to assume reductions in overweight/obesity in younger populations would translate to lower stroke rates in young adults, this remains to be proven. Moreover, it is always important to acknowledge that associations found in observational studies may not reflect causality.’ Source: MedicalBrief 2024

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