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Last Updated: Saturday, 21 June, 2003, 22:58 GMT 23:58 UK
Artery disease 'triggers strokes'
The discovery could lead to better treatments for patients
People with damaged arteries have long been considered to be at high risk of having a heart attack.

But now researchers in the United States have found they are also more likely to have a stroke.

The findings could lead to changes in the way patients with damaged arteries or coronary endothelial dysfunction (CED) are treated.

This condition occurs when arteries that supply blood to the heart do not dilate as they should.

Artery cells

The disorder affects the vascular endothelium - the smooth layer of cells lining the walls of arteries throughout the body.

A healthy vascular endothelium is supposed to expand and contract according to the body's blood flow needs.

We have associated this disorder with both heart attack and stroke
Dr Amir Lerman

Failure of these cells to expand and contract properly can trigger chest pain in people with the condition.

It is regarded as an early indicator of heart disease.

But Dr Amir Lerman and colleagues at the Mayo Clinic in Minnesota believe it may also be an early warning sign for stroke.

They examined the records of 503 people who had been tested for CED.

They found patients with the disorder were five times more likely to suffer a stroke compared to people without the condition.

They said the findings highlight the need to diagnose and treat patients with the condition early.

Writing in Circulation, the journal of the American Heart Association, they said the research may have "important implications in identifying people at risk for heart attack and stroke before they have significant symptoms".

The problem, however, is that testing patients for CED is expensive and complex as it requires invasive surgery.

As a result, doctors are unable to routinely screen patients for the condition.

Simpler tests

Doctors at the Mayo Clinic are hoping to overcome this problem by developing a simple test for the condition.

Their test would screen for the condition by analysing vessels in fingertips.

"Screening for endothelial dysfunction could potentially identify patients who would benefit from aggressive treatment," said Dr Lerman.

"Now that we have associated this disorder with both heart attack and stroke, finding ways to identify it earlier in patients is even more important."

Doctors in Britain are also working on alternative tests.

Researchers at the Cardiovascular Research Initiative at the University of Edinburgh are carrying out a study to see if the condition can be diagnosed using pulse wave analysis.

This involves measuring the stiffness of arteries by analysing the force with which blood is pumped around the body.

This can be done easily with a special type of machine.

They believe the test if proved to be effective could be widely used by doctors to diagnose the condition.

Meanwhile, in a second study doctors in Canada and the UK confirmed MRI scans can be used to identify patients at risk of an impending stroke or heart attack.

Their study found the scans, normally used to assess patients with a range of problems including cancer or fractures, can identify the build-up of fatty deposits in arteries that can trigger a heart attack or stroke.

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