In the News
Oxford Times: Stroke Research Team Wins Top Award (23 November 2013)
The three new studies published by the Oxford Stroke Prevention Research Unit in The Lancet add to mounting evidence of the drug's anti-cancer effects.
Taking a low (75-300mg) daily dose of the drug appeared to cut the total number of cancer cases by about a quarter after only three years - there were nine cancer cases per 1,000 each year in the aspirin-taking group, compared with 12 per 1,000 for those taking dummy pills. It also reduced the risk of a cancer death by 15% within five years (and sooner if the dose was higher than 300mg) And if patients stayed on aspirin for longer, their cancer death risk went down even further - by 37% after five years.
Low-dose aspirin also appeared to reduce the likelihood that cancers, particularly bowel, would spread (metastasise) to other parts of the body, and by as much as half in some instances. In absolute numbers, this could mean for every five patients treated with aspirin one metastatic cancer would be prevented. [full text with video]
In a study published in the journal Circulation: Cardiovascular Genetics, scientists at the University of Oxford in England showed that people are more likely to inherit the risk of having a heart attack than the risk of having a stroke.
Senior author Dr. Peter Rothwell, a professor of clinical neurology at Oxford University, said "Currently, most risk models lump a patient's family history of stroke and heart attack together. We probably should model family history of stroke and heart attack separately in the future." [full text]
A mother's history of stroke can help predict a daughter's chances of not only having a stroke but also her chances of having a heart attack, new research shows. "Our new study shows that stroke in mothers is associated with heart attacks in daughters," said Dr. Amitava Banerjee, a clinical research associate at the Stroke Prevention Research Unit at the University of Oxford, in England. [full text]
A small daily dose of aspirin - 75mg - substantially reduces death rates from a range of common cancers, a study suggests. Research at Oxford University and other centres found that it cut overall cancer deaths by at least a fifth. The study, published in the Lancet, covered some 25,000 patients, mostly from the UK. Experts say the findings show aspirin's benefits often outweighed its associated risk of causing bleeding.
Professor Rothwell said he was not urging healthy middle-aged adults to immediately start taking aspirin, but said the evidence on cancer "tips things towards it being well worth it". [full text]
A daily aspirin tablet may help prevent bowel cancer, a study suggests. Oxford University found it cut cases by a quarter and deaths by more than a third in a review of 14,000 patients. They found it reduced the risk of the incidence of bowel cancer by 24% and of dying from the disease by 35%.
Lead researcher Professor Peter Rothwell said the screening would provide the perfect opportunity for doctors to discuss with their patients about whether to take aspirin. "To date, for healthy middle-aged people it has been a fine balance as to whether to take aspirins, but this tips it in my view." [full text]
(Reuters Health) - Three out of 10 people who suffer a minor stroke or a "mini-stroke" don't get medical help in time, upping their likelihood of going on to have a major stroke, new research shows. While the importance of rapid treatment for stroke is now widely recognized, less is known about whether people who suffer mini-strokes get prompt care.
People who have these mini-strokes -- what doctors call transient ischemic attacks, or TIAs - are now known to be at high risk of full-fledged strokes in the following hours and days, Dr. Arvind Chandratheva of the University of Oxford in the UK and colleagues point out in the journal Stroke. What's more, it's fairly easy to identify who among these patients is at highest risk, and starting preventive treatments early is "highly effective." [full text]
A fundamental change in the way GPs monitor high blood pressure is being urged, as experts say fluctuations in readings may be a better indicator of the risk of strokes and heart attacks than relying on single recordings showing high blood pressure, otherwise known as hypertension.
Patients with the most variation - measured over seven visits to a clinic - were six times more likely to have a stroke. That compared to patients with the highest blood pressure, over the same number of visits, who were 15 times more likely to have a stroke [full text]
People with occasionally high blood pressure are more at risk of stroke than those with consistently high readings, research suggests. Professor Peter Rothwell of the Department of Clinical Neurology at the University of Oxford, who led the research, said the findings have major implications for how GPs spot and treat people at high risk of stroke.
"At the moment, the guidelines for GPs say not to believe a one-off unusual reading, to bring the patient back and measure again, and as long as it's not consistently high, there is no need to treat. What we're saying is don't discount that one-off high blood pressure reading." [full text]
Women are at higher inherited risk for the most common type of stroke than men, a British study finds. The study of 806 men and women who suffered ischemic strokes or the minor artery blockages called transient ischemic attacks showed women were more likely to have at least one close relative who suffered a stroke, and that was due entirely to an excess of affected female relatives.
"The main implication for clinical practice is that when you consider who is at risk for stroke, it looks like family history in particular is more important in women than men, particularly if there is a family history of stroke in female relatives," said study author Dr. Peter M. Rothwell, director of the Stroke Prevention Research Unit at the Radcliffe Infirmary in Oxford. [full text]
NEW YORK (Reuters Health) - Mini-strokes lead to a major stroke within one week in 1 out of 20 people and should be treated as a medical emergency, British doctors said on Sunday. They said patients who are immediately treated for small strokes, called transient ischemic attacks (TIAs) had almost no risk of a major stroke soon afterward.
But people who did nothing about a TIA had an 11-percent risk of a major stroke within one week, Dr. Matthew Giles and Peter Rothwell of the Stroke Prevention Research Unit at the University of Oxford reported. [full text]
Rapid treatment following a mini stroke (a transient ischaemic attack, or TIA) reduces the risk of a major stroke occurring by 80%. It is a fact recognised by medical professionals, that diagnosis and treatment following TIAs and strokes should be carried out as early as possible to prevent further events from occurring. This large and reliable study adds some measure of the extent of this benefit.
Professor P.M. Rothwell and colleagues of the Stroke Prevention Research Unit, Radcliffe Infirmary, Oxford, carried out this research. The Oxford Vascular Study was funded by UK Medical Research Council, Dunhill Medical Trust, Stroke Association, Bupa Foundation, National Institute for Health Research, and Thames Valley Primary Care Research Partnership. The study was published in the peer-reviewed medical journal The Lancet. [full text]
The way to reduce the chances of developing dementia such as Alzheimer's disease after a stroke is to prevent a second stroke by concentrating on all the known stroke risk factors, a new British study suggests.
Two major findings emerged from an analysis of 30 previous studies that involved more than 7,500 people who had suffered a stroke, said Dr. Sarah Pendlebury, a senior clinical fellow at the Stroke Prevention Research Unit of John Radcliffe Hospital in Oxford and lead author of a report published online Sept. 23 in The Lancet Neurology. [full text]
About half the people who have a major stroke soon after a less serious brain event, such as a transient ischemic attack or "mini-stroke," do so within 24 hours of the minor event, a new study finds. The message here for people who have a TIA is to "seek medical attention immediately, particularly if you have either weakness or speech disturbance that lasts more than 10 minutes," said the study's senior author, Dr. Peter M. Rothwell, a professor of clinical neurology at the University of Oxford in England. "Don't wait until the next day -- it may be too late," he said. [full text]
A GTC Fellow whose work has changed national and international clinical practice into the treatment of stroke has won the inaugural BMJ Group Award for outstanding achievement in evidence-based health care.
Professor Peter Rothwell's work on transient ischaemic attack, TIA or 'mini-stroke', and minor stroke, has established the need for acute preventive treatment and shown that such treatment reduces the early risk of major stroke by 80 per cent. [full text]
Professor Peter Rothwell FMedSci has been awarded the 2009 Foulkes Foundation Medal. Awarded every two years, the Foulkes Foundation Medal brings recognition to an individual for excellence in research in the biomedical sciences and inspires and encourages others to pursue a career in biomedical research.
Professor Rothwell is Professor of Clinical Neurology and founding Director of the Stroke Prevention Research Unit at the University of Oxford. He gained his PhD in 1999 after working for Professor Charles Warlow in Edinburgh on secondary prevention of stroke, particularly the risks and benefits of carotid endarterectomy. He was subsequently Lecturer in Clinical Neurology in Oxford and was awarded an MRC Senior Clinical Fellowship in 2000, allowing him to set up the Stroke Prevention Research Unit, which now employs over 30 staff and is widely considered to be one of the most successful stroke research groups in the world. His work has revolutionised the treatment of TIA and minor stroke, and his recent findings on the link between variability in blood pressure and risk of stroke and on the effects of aspirin on risks of cancer, infection and other non-vascular outcomes promises to have a similar impact. [full text]
Strokes occur when blood flow to the brain is interrupted, usually due to a clot, narrowed or abnormal blood vessels or a haemorrhage. The consequences can include slurred speech, impaired mobility or paralysis, diminished sight and concentration. It is also the third commonest cause of death in Britain. Yet most of us assume it is an old person's disease, affecting mainly men.
"In fact, it's a significant risk in younger people," says Peter Rothwell, professor of clinical neurology and head of the stroke prevention unit at Oxford University. "There's a long-standing misapprehension that younger men are more prone to heart attacks [than strokes], and that strokes affect the elderly, but actually the risks of a stroke affect a broad age range. A quarter of victims are under 65, and men and women are equally prone." The Stroke Association says 1,000 people under the age of 30 have a stroke in Britain each year. [full text]
A review of research found one in 20 patients who have a transient ischaemic attack (TIA) will go on to have a stroke within a week. The lowest risk of stroke was reported among patients treated as emergency cases in specialist stroke units. The research, by the Oxford University Stroke Prevention Unit, is published by Lancet Neurology. [full text]
The risk of a major stroke occurring in the first month after a minor stroke - a transient ischaemic attack (TIA) - is currently 10%. But a team at Oxford's Radcliffe found the risk was transformed by prompt drug treatment. Such actions, if universally applied, could prevent almost 10,000 strokes per year in the UK alone, they say. [full text]
ive years of daily, full-dose aspirin cuts colon cancer risk by as much as 74 percent, a U.K. study suggests. The finding contradicts earlier U.S. studies that saw no effect of aspirin on a person's risk of getting colon cancer. University of Oxford researchers Enrico Flossman, MRCP; Peter M. Rothwell, MD, PhD; and colleagues studied the effects of aspirin by combining data from two large clinical trials. Neither trial was specifically designed to study colon cancer.
However, pooled data from the studies suggests that people who took a full-dose aspirin tablet every day for at least five years had as much as a 74 percent lower risk of colon cancer 10 to 14 years later. In the U.S., a full-dose aspirin tablet contains 325 milligrams of the drug. [full text]
People with cardiovascular disease, who have a high risk of blood clot, are prescribed drugs like aspirin to thin the blood and reduce the risk of a heart attack or stroke. But many healthy older people also take a regular aspirin in an attempt to ward off a stroke. Study leader, Professor Peter Rothwell, said the increasing use of drugs such as aspirin may soon take over high blood pressure as the leading cause of intracerebral haemorrhagic stroke in the over 75s. He warned than in healthy older adults the risks of taking aspirin may outweigh any benefits. [full text]
The Dunhill Medical Trust has awarded the University of Oxford ?1.5 million for stroke research, prevention and treatment. The money will go towards clinical projects that work directly with stroke patients, taking world-leading research to the hospital.
The grant will help fundthe Oxford Stroke Programme, an ambitious project that will bring together different strands of stroke research from across the University to develop a research-driven care programme for stroke patients within Oxford's John Radcliffe Hospital. The Programme will be led by internationally-renowned stroke researchers working in prevention, brain imaging and acute stroke care to create a powerful multi-disciplinary stroke research programme. It is hoped that the model for prevention and treatment it develops will become a template for nationwide care.
Every year, over 130,000 people in the UK suffer a stroke - one person every five minutes. It is the third largest cause of premature death in the developed world, the single biggest cause of neurological disability, and a major cause of epilepsy, depression, and dementia. More than 250,000 people in the UK live with disabilities caused by stroke. The majority of people affected are over 65, but about 25% are of working age and stroke can affect children and even babies. By the age of 80, one in four people will have had a stroke.
The world-class stroke experts at Oxford leading the programme are Peter Rothwell, Professor of Clinical Neurology; Alastair Buchan, Professor of Clinical Geratology; and Peter Jezzard, Herbert Dunhill Professor of Neuroimaging. [full text]
According to the American Stroke Association, signs of a TIA can include all or some of the following: sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion; trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden severe headache with no known cause. "We looked at the characteristics of the event in patients who had a TIA, and predicted the risk of a major stroke within the next seven days," said study author Dr. Peter Rothwell, a professor of clinical neurology at the University of Oxford.[full text]
Results of a study in this week’s issue of THE LANCET highlight how improved treatment and management of risk factors have reduced the incidence of stroke by 40% in a region of the UK over the past 20 years ... Dr Rothwell comments: “Although we cannot prove conclusively that the major fall in stroke incidence is a direct result of the measured increase in use of preventive medication, a causal link is highly likely. There remains significant under-treatment of individuals at risk of stroke in the community and so further major reductions in stroke incidence should be possible.” (Quote by e-mail, does not appear in published paper). In an accompanying Commentary (p 1920), Valery Feigin and Stephen Vander Hoorn (University of Auckland, New Zealand) conclude ‘ Rothwell and colleagues’ state-of-the-art study makes an important contribution to knowledge about stroke epidemiology.’ [full text]
Stroke research is severely underfunded and needs more than charity support to combat a disease which costs the health service more than £2bn a year, according to research. An investigation funded by the Stroke Association shows that money spent on stroke research falls way behind those of heart disease and cancer - up to 50 times less... [full text]