Main Article Content
Abstract
Background: Ischemic stroke more commonly occurs in hypocalcemic patients and presented with more severe clinical symptoms.
Objective: We sought to observe the correlation of serum calcium with blood pressure and BMI among stroke patients in Bangladesh.
Methods: We performed a case-control study using the Department of Biochemistry at Dhaka Medical College, Dhaka, Bangladesh from January 2014 to December 2014. The case were defined as patients diagnose with an acute ischemic stroke, and controls were defined as healthy subjects. In this identified population, 15 cases were matched on age and sex to 50 control subjects. The information regarding age, serum calcium level, height and weight of both cases and controls were taken to calculate BMI. Systolic and diastolic blood pressure (SBP and DBP) from the subject are taken to investigate the history of hypertension.
Result: Serum calcium has statistically significant with a negative correlation with DBP (r =-0.335, p=0.017) and BMI (r =-0.426, p=0.002). A negative correlation between serum calcium and SBP also can be observed (r= - 0.194, p= 0.176).
Conclusion: Findings of this study concludes that hypocalcemia is found to be negatively correlated with blood pressure and BMI among ischemic stroke patients in Dhaka, Bangladesh.
Keywords
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References
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- Rajput MR, Lakhair MA, Shaikh MA, Saleem RM, Zafarullah RB. C-reactive protein (CRP) and other risk factors in acute ischemic stroke patients. Journal of the Liaquat University of Medical and Health Sciences. 2011;10(3):131–3.
- Kaur J, Prabhu KM, Thakur LC, Studies D, Road D, Nagar M. Serum magnesium levels in ischaemic cerebrovascular disorders?: A case - control pilot study in north Indian population. Journal of Pharmaceutical and Biomedical Sciences. 2012;17(17):15–8.
- Darvishi L, Hariri M, Hajishafiei M, Ghasemi S, Maghsoudi Z, Askari G, et al. Comparison of fat intake between patients with stroke and normal population. Journal of Research in Medical Sciences. 2013;18(1):1–50.
- Morris DL, Schroeder EB. Stroke Epidemiology [Internet]. 2001 [cited 2014 June 13]. Available from: https://www.uic.edu/com/ferne/pdf/strokeepi0501.pdf
- Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update. Circulation. 2012;125(1):2–220.
- MacKay J, Mensah GA. Global burden of stroke [Internet]. 2013 [cited 2014 May 7]. Available from:http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_ stroke.pdf
- Jauch EC. Ischemic stroke [Internet]. 2014 [cited 2014 Sep 10]. Available from:http://emedicine.medscape.com/article/1916852-overview#a0156
- Elyas DM, Rahman A, Mohammad QD, Mondol BA, Hossain S, Islam SS, et al. Comparative study of risk factors between lacunar and non-lacunar ischemic strokes. Bangladesh Journal of Neuroscience. 2013;28(2):88–95.
- Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Bennett DA, Moran AE, et al. Global and regional burden of stroke during 1990-2010: Findings from the Global Burden of Disease Study 2010. 2014;383(9913):245–54.
- Donnan GA, Fisher M, Macleod M, Davis SM. Stroke. Lancet. 2008;371(9624):1612-1623.
- Ovbiagele B, Starkman S, Teal P, Lyden P, Kaste M, Davis SM, et al. Serum calcium as prognosticator in ischemic stroke. Stroke. 2008;39(8):2231–6.
- Guven H, Cilliler AE, Koker C, Sarikaya SA, Comoglu SS. Association serum calcium level with clinical severity in acute ischemic stroke. Acta Neurologica Belgica. 2011;111(1):45–9.
- Darwin M. The pathophysiology of ischemic injury [Internet]. 1995 [cited 2014 March 23]. Available from: http://www.alcor.org/Library/html/ischemicinjury.html
- John PW, Mark LD, Mathew WK. Plasma calcium as a predictor of cardiovascular disease in community based cohort. Clinical Endocrinology (Oxf). 2013;78(6):852–7.
- Schieszer J. High calcium levels at admission linked to better stroke outcomes [Internet]. 2007 [cited 2014 August 1]. Available from: http://www.hcplive.com/publications/internal-medicine-world-report/2006/2006-07/2006-07_40
- Iso H, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH, Colditz GA, et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke [Internet]. 1999;30(9):1772–9. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L29411813
- MacMahon S, Rodgers A. The epidemiological association between blood pressure and stroke: Implications for primary and secondary prevention. Hypertension Research. 2008;17(Supplement I):S23–32.
- WebMD. High Blood Pressure and Stroke [Internet]. 2013 [cited 2014 June 01]. Available from: http://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-high-blood-pressure-stroke
- Chaudhuri JR, Mridula KR, Alladi S, Anamika A, Umamahesh M, Balaraju B, et al. Serum 25-hydroxyvitamin D deficiency in ischemic stroke and subtypes in Indian patients. Journal of Stroke. 2014;16(1):44-50.
- Buck BH, Liebeskind DS, Saver JL, Bang OY, Starkman S, Ali LK,et al. Association of higher serum calcium levels with smaller infarct volumes in acute ischemic stroke. JAMA Neurology. 2007;64(9):1287–98.
- Kristián T, Gidö G, Kuroda S, Schütz A, Siesjö BK. Calcium metabolism of focal and penumbral tissues in rats subjected to transient middle cerebral artery occlusion. Experimental Brain Research. 1998;120(4):503–9.
- Yenari MA. Pathophysiology of acute ischemic stroke. Cleveland Clinic Journal of Medicine. 2004;71(suppl 1):25–7.
- Lipton P. Ischemic cell death in brain neurons. Physiological Reviews. 1999;79(4):1431–568.
- Mattson MP, Culmsee C, Zai FY. Apoptotic and antiapoptotic mechanisms in stroke. Cell and Tissue Research. 2000;301(1):173–87.
- Farhangi MA, Ostadrahimi A, Mahboob S. Serum calcium, magnesium, phosphorous and lipid profile in healthy Iranian premenopausal women. Biochemia Medica (Zagreb). 21(3):312–20.
- Lindsberg PJ, Roine RO. Hyperglycemia in acute stroke. Stroke. 2004;35(2):363–4.
- Abu-Odah H, Abed Y A-HB. Risk factors of stroke in patients admitted in European Gaza Hospital, Gaza Strip: A case control study in medical unit setting. Journal of Neurological Disorders & Stroke. 2014;2(4):1–5.
- Kesteloot H, Joossens JV. Relationship of dietary intake of sodium, potassium, calcium and magnesium to blood pressure. Japanese Journal of Public Health. 1995;42(2):95–103.
- Alharbi AS, Al-Omery A, Hedaib S. Prevalence of vitamin D deficiency among healthy Saudi men. Scholars Journal of Applied Medical Sciences. 2013;1(6):863–6.
- Lin PH, Yeh WT, Svetkey LP, Chuang SY, Chang YC, Wang C, et al. Dietary intakes consistent with the DASH dietary pattern reduce blood pressure increase with age and risk for stroke in a Chinese population. Asia Pacific Journal of Clinical Nutrition. 2013;22(3):482–91.
References
Colledge NR, Walker BR, Ralston S. Davidson’s principles and practice of medicine. 21st ed. London: Churchill Livingstone; 2010.
Rajput MR, Lakhair MA, Shaikh MA, Saleem RM, Zafarullah RB. C-reactive protein (CRP) and other risk factors in acute ischemic stroke patients. Journal of the Liaquat University of Medical and Health Sciences. 2011;10(3):131–3.
Kaur J, Prabhu KM, Thakur LC, Studies D, Road D, Nagar M. Serum magnesium levels in ischaemic cerebrovascular disorders?: A case - control pilot study in north Indian population. Journal of Pharmaceutical and Biomedical Sciences. 2012;17(17):15–8.
Darvishi L, Hariri M, Hajishafiei M, Ghasemi S, Maghsoudi Z, Askari G, et al. Comparison of fat intake between patients with stroke and normal population. Journal of Research in Medical Sciences. 2013;18(1):1–50.
Morris DL, Schroeder EB. Stroke Epidemiology [Internet]. 2001 [cited 2014 June 13]. Available from: https://www.uic.edu/com/ferne/pdf/strokeepi0501.pdf
Roger VL, Go AS, Lloyd-Jones DM, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2012 update. Circulation. 2012;125(1):2–220.
MacKay J, Mensah GA. Global burden of stroke [Internet]. 2013 [cited 2014 May 7]. Available from:http://www.who.int/cardiovascular_diseases/en/cvd_atlas_15_burden_ stroke.pdf
Jauch EC. Ischemic stroke [Internet]. 2014 [cited 2014 Sep 10]. Available from:http://emedicine.medscape.com/article/1916852-overview#a0156
Elyas DM, Rahman A, Mohammad QD, Mondol BA, Hossain S, Islam SS, et al. Comparative study of risk factors between lacunar and non-lacunar ischemic strokes. Bangladesh Journal of Neuroscience. 2013;28(2):88–95.
Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Bennett DA, Moran AE, et al. Global and regional burden of stroke during 1990-2010: Findings from the Global Burden of Disease Study 2010. 2014;383(9913):245–54.
Donnan GA, Fisher M, Macleod M, Davis SM. Stroke. Lancet. 2008;371(9624):1612-1623.
Ovbiagele B, Starkman S, Teal P, Lyden P, Kaste M, Davis SM, et al. Serum calcium as prognosticator in ischemic stroke. Stroke. 2008;39(8):2231–6.
Guven H, Cilliler AE, Koker C, Sarikaya SA, Comoglu SS. Association serum calcium level with clinical severity in acute ischemic stroke. Acta Neurologica Belgica. 2011;111(1):45–9.
Darwin M. The pathophysiology of ischemic injury [Internet]. 1995 [cited 2014 March 23]. Available from: http://www.alcor.org/Library/html/ischemicinjury.html
John PW, Mark LD, Mathew WK. Plasma calcium as a predictor of cardiovascular disease in community based cohort. Clinical Endocrinology (Oxf). 2013;78(6):852–7.
Schieszer J. High calcium levels at admission linked to better stroke outcomes [Internet]. 2007 [cited 2014 August 1]. Available from: http://www.hcplive.com/publications/internal-medicine-world-report/2006/2006-07/2006-07_40
Iso H, Stampfer MJ, Manson JE, Rexrode K, Hennekens CH, Colditz GA, et al. Prospective study of calcium, potassium, and magnesium intake and risk of stroke in women. Stroke [Internet]. 1999;30(9):1772–9. Available from: http://www.embase.com/search/results?subaction=viewrecord&from=export&id=L29411813
MacMahon S, Rodgers A. The epidemiological association between blood pressure and stroke: Implications for primary and secondary prevention. Hypertension Research. 2008;17(Supplement I):S23–32.
WebMD. High Blood Pressure and Stroke [Internet]. 2013 [cited 2014 June 01]. Available from: http://www.webmd.com/hypertension-high-blood-pressure/guide/hypertension-high-blood-pressure-stroke
Chaudhuri JR, Mridula KR, Alladi S, Anamika A, Umamahesh M, Balaraju B, et al. Serum 25-hydroxyvitamin D deficiency in ischemic stroke and subtypes in Indian patients. Journal of Stroke. 2014;16(1):44-50.
Buck BH, Liebeskind DS, Saver JL, Bang OY, Starkman S, Ali LK,et al. Association of higher serum calcium levels with smaller infarct volumes in acute ischemic stroke. JAMA Neurology. 2007;64(9):1287–98.
Kristián T, Gidö G, Kuroda S, Schütz A, Siesjö BK. Calcium metabolism of focal and penumbral tissues in rats subjected to transient middle cerebral artery occlusion. Experimental Brain Research. 1998;120(4):503–9.
Yenari MA. Pathophysiology of acute ischemic stroke. Cleveland Clinic Journal of Medicine. 2004;71(suppl 1):25–7.
Lipton P. Ischemic cell death in brain neurons. Physiological Reviews. 1999;79(4):1431–568.
Mattson MP, Culmsee C, Zai FY. Apoptotic and antiapoptotic mechanisms in stroke. Cell and Tissue Research. 2000;301(1):173–87.
Farhangi MA, Ostadrahimi A, Mahboob S. Serum calcium, magnesium, phosphorous and lipid profile in healthy Iranian premenopausal women. Biochemia Medica (Zagreb). 21(3):312–20.
Lindsberg PJ, Roine RO. Hyperglycemia in acute stroke. Stroke. 2004;35(2):363–4.
Abu-Odah H, Abed Y A-HB. Risk factors of stroke in patients admitted in European Gaza Hospital, Gaza Strip: A case control study in medical unit setting. Journal of Neurological Disorders & Stroke. 2014;2(4):1–5.
Kesteloot H, Joossens JV. Relationship of dietary intake of sodium, potassium, calcium and magnesium to blood pressure. Japanese Journal of Public Health. 1995;42(2):95–103.
Alharbi AS, Al-Omery A, Hedaib S. Prevalence of vitamin D deficiency among healthy Saudi men. Scholars Journal of Applied Medical Sciences. 2013;1(6):863–6.
Lin PH, Yeh WT, Svetkey LP, Chuang SY, Chang YC, Wang C, et al. Dietary intakes consistent with the DASH dietary pattern reduce blood pressure increase with age and risk for stroke in a Chinese population. Asia Pacific Journal of Clinical Nutrition. 2013;22(3):482–91.