Rita Engelhardt

University of California, Los Angeles, Los Angeles, CA, United States

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Publications (3)12.43 Total impact

  • Samir H Shah · Rita Engelhardt · Bruce Ovbiagele
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    ABSTRACT: Americans are increasingly searching for complementary and alternative remedies. Some data suggest that persons who use Complementary and Alternative medicine (CAM) are at a higher risk for interactions with prescription medications. We assessed CAM use among American stroke survivors as little is known about CAM in this population. We compared CAM use in adults with and without stroke who participated in the most comprehensive national survey on CAM use to date, the 2002 National Health Interview Survey. Independent predictors of CAM use among stroke survivors were assessed with logistic regression. Of 30,992 adults, 2.6% indicated a history of stroke, with 46% of these stroke survivors reporting CAM use. Acupuncture was the only CAM therapy used more frequently in stroke survivors (OR 1.53, 95% CI=1.07-2.19, p=0.02). In multivariable analyses among stroke survivors, CAM use was more frequent among those who reported delays in seeking medical care due to cost (OR 2.28, 95% CI=1.28-4.07, p=0.005) or those with recent neck pain, (OR 2.28, 95% CI=1.48-3.52, p=0.002) and less frequent among those >65 years (OR 0.54, 95% CI=0.31-0.96, p=0.035), non-Hispanic Blacks (OR 0.57, 95%CI=0.33-1.0, p=0.049), and those with less than high school education (OR 0.33, 95% CI=0.22-0.51, p<0.001). Approximately half the stroke survivors in the United States engage in some form of CAM therapy, with those reporting delays in seeking medical care due to cost, or recent neck pain being more likely to pursue CAM treatment.
    No preview · Article · Aug 2008 · Journal of the Neurological Sciences
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    ABSTRACT: Data on recent stroke prevalence rates among middle-aged men in the United States indicate that men aged 55 to 64 years are 3 times more likely than men aged 45 to 54 years to have experienced a stroke. We aimed to determine potential risk factors that may contribute to this steep increase in late midlife stroke occurrence. We analyzed the National Health and Nutrition Examination Survey 1999 to 2004 data sets, assessing stroke prevalence, predictors of stroke occurrence, and vascular risk factors in men across their midlife years. Crudely, higher glycohemoglobin, history of hypertension, history of diabetes, and history of coronary artery disease significantly predicted stroke in 45- to 54- and 54-to 64-year-old men. Significant stroke risk factors unique to each age group were non-white race, lower ankle-brachial pulsatility index, and occurrence of recent severe headache in the 45- to 54-year age group, whereas elevated serum homocysteine (HCY) level predicted stroke in those aged 55 to 64 years. In multivariable regression analysis, lower ankle-brachial pulsatility index (odds ratio [OR] 1.69, 95% confidence interval [CI] 1.47-1.83, P < .001) and recent severe headache (OR 5.12, 95% CI 1.3-20.1, P = .019) were the only independent predictors of stroke in the 45- to 54-year age group, whereas only elevated HCY predicted stroke in the 55- to 64-year age group (OR 1.708, 95% CI -1.103-2.643, P = .0163). Elevated serum HCY level is the sole independent predictor of stroke among men aged 55 to 64 years in the United States. Further study to assess the efficacy of HCY-lowering treatment in mitigating a steep increase in late midlife stroke occurrence among men may be warranted.
    Preview · Article · Jul 2008 · Journal of stroke and cerebrovascular diseases: the official journal of National Stroke Association
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    ABSTRACT: We assessed sex differences in stroke prevalence among individuals of midlife age (35 to 64 years) in the United States and determined factors predicting stroke. Data from 1999 to 2004 (n = 17,061) from the National Health and Nutrition Examination Survey, a nationally representative sample of US adults, were used to assess sex differences in stroke prevalence and to identify independent predictors of stroke occurrence among middle-aged individuals. Women aged 45 to 54 years had significantly higher odds of having experienced a stroke vs men of the same age (odds ratio [OR] 2.39, 95% CI 1.32 to 4.32). No other significant midlife stroke differences between sexes were noted. A higher stroke trend was seen in 45- to 54-year-old women vs 35- to 44-year-old women (OR 2.13, 95% CI 0.95 to 4.80, p = 0.067), but no difference was seen in stroke rates in 55- to 64-year-old women vs 45- to 54-year-old women (OR 1.40, 95% CI 0.6912 to 2.8229, p = 0.352). Independent predictors of stroke in women aged 45 to 54 years were coronary artery disease (OR 12.790, 95% CI 1.901 to 86.063, p = 0.009) and waist circumference (OR 1.543, 95% CI 1.002 to 2.376, p = 0.049). Several vascular risk factors including systolic blood pressure and total cholesterol levels increased at higher rates among women compared with men in each successively older cohort from 35 to 64 years. A higher prevalence of stroke may exist among women aged 45 to 54 years compared with similarly aged men. This potential disparity could be due in part to inadequate stroke risk factor modification in women and is deserving of further study.
    Preview · Article · Dec 2007 · Neurology

Publication Stats

143 Citations
12.43 Total Impact Points


  • 2008
    • University of California, Los Angeles
      • Department of Biomathematics
      Los Angeles, CA, United States
  • 2007
    • Harbor-UCLA Medical Center
      Torrance, California, United States