It seems stroking out and one of the symptoms of increased red blood
cell production which ALSO .. strokes .. you .. out .. are common to
each other.
So .. IS it the increased red blood cell production .. ?
Mini Strokes Linked to Uric Acid Levels
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STROKE URIC ACID ALLOPURINOL OBESITY HYPERTENSION NEUROLOGY
Newswise - Researchers at Johns Hopkins have found that high-normal
uric acid (UA) levels may cause barely detectable mini strokes that
potentially contribute to mental decline in aging adults.
Diet, exercise and drugs like allopurinol (all of which lower UA
levels) could eventually be of value in reducing this risk, especially
for those with additional risk factors such as diabetes, obesity and
hypertension, the researchers say. But they caution that it would be
premature to try this now.
In a study published in the Oct. 2 issue of Neurology, lead author
David Schretlen, Ph.D., of the Department of Psychiatry at The Johns
Hopkins University School of Medicine, linked UA levels to high
volumes of so-called white matter hyperintensities (WMH), which are
small dead areas of the brain that occur when brain cells are deprived
of oxygen. Lack of oxygen due to clots or burst blood vessels in the
brain are hallmarks of classic large strokes.
"Over a lifetime, it is common to have a small number of these mini
strokes and not even notice," says Schretlen, "but as the overall
volume of WMH increases, the damage can seriously disrupt how quickly
we think and how effectively we learn and remember information."
The role of UA is best known in gout, where buildup of the fatty acid
creates pain and disability in the feet and toes. However, UA appears
to play contradictory roles in the brain, says Schretlen. For example,
UA is a powerful antioxidant that might even protect against Parkinson
disease and Alzheimer disease, possibly because antioxidants destroy
oxygen free radicals that damage tissue. On the other hand, elevated
UA accompanies diabetes, obesity and heart disease, and it is a well-
known risk factor for stroke. One possible explanation of its
seemingly contradictory nature is that, like a double-edged sword, UA
is beneficial, but processes leading to its production can be harmful
under some circumstances, says Schretlen.
In the study, Schretlen and his team obtained and analyzed brain MRI
scans of 85 men and 92 women between 20 and 92 years of age. All
participants had normal levels of UA. However, those with high-normal
levels showed 2.6 times the volume of WMH than those with average or
low UA. Among subjects 60 years of age or older, those with high-
normal levels of UA had four to five times the volume of WMH than
others.
Gender differences exist in normal UA ranges. The blood UA
concentrations of men are typically about 1 milligram per deciliter
(mg/dL) higher than those of women. In this study UA levels ranged
from 1.6 to 8.2 mg/dL for men and from 1.5 to 7.2 mg/dL for women.
Within these ranges, concentrations greater than or equal to 5.75 mg/
dL for men and 4.8 mg/dL for women were classified as high normal.
In a previous study, Schretlen and colleagues examined the
relationship between serum UA and cognitive functioning in adults age
60 and older. In that study, elderly adults with high-normal levels of
UA were 2.7 to 5.9 times more likely to score in the lowest 25 percent
of the group on measures of thinking speed and memory.
"Having found that UA levels are linked to both mild cognitive decline
and mini strokes," says Schretlen, "we need to learn how these are
related. We have to find out which of these factors steers the boat."
Schretlen says clinical trials with drugs like allopurinol, which have
been used safely for decades to treat gout, may be warranted if
further research confirms his hypothesis.
Additional authors of this study, all from The Johns Hopkins
University School of Medicine, are Anjeli B. Inscore, Psy.D., Tracy D.
Vannorsdall, Ph.D., and Godfrey D. Pearlson, M.D., of the Department
of Psychiatry and Behavioral Sciences; Barry Gordon, M.D., Ph.D., and
H.A. Jinnah, M.D., Ph.D., of the Department of Neurology, and Michael
Kraut, M.D., Ph.D., of the Department of Radiology and Radiological
Sciences.
© 2007 Newswise. All Rights Reserved.
--------------------------------------------------------------------------------
Am J Kidney Dis
Vol.39 (2002) pp. 1135-1142
Bibliography
Hyperuricemia, hypertension, and proteinuria associated with high-
altitude polycythemia
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