TPA and Exercise

No, these two aren't really related, but today I read about two different studies that had two different outcomes - one I was surprised with, the other was always obvious to me.

First, the TPA study. Here in Canada, I assume, when you're admitted into the Emergency Room having just suffered a stroke, the administration of TPA (tissue-type plasminogen activator) or the "clot buster" drug was pretty much automatic. Turns out, in this US-based study anyways, that's not true. Researchers did a survey of Neurology Residents - those that had completed their training in 2010, and those that had finished in 2000. Here are the results of this survey:

• 2010 - 94% comfortable administering TPA independently
• 2000 - 73% comfortable administering TPA independently
• 2010 - 95% personally administered TPA
• 2000 - 80% personally administered TPA

Although current (US) practice guidelines recommend the administration of TPA for ischemic stroke, fewer than 1 in 10 actually get the treatment! I was shocked when I read that. It seems that experience performing the TPA therapy was directly related to how comfortable you were doing it. The more you do it, the easier it is for you. Some more interesting data on the administering of the drug:

• 78% of Neurologists who had administered TPA without supervision were comfortable administering it for new patients
• 52% of Neurologists who had only administered TPA under supervision were comfortable using it with new patients.

So the bottom line for me - if ever caught in the USA with another stroke - seek out the freshest intern you can find, and whether he's comfortable with it or not - ask to get the TPA.

Next, the exercise thing. Over the years, all of us have been told that leading a sedentary lifestyle comes with a higher risk of coronary heart disease (CHD). Well, now researchers have quantified this .. they've taken the US guidelines for physical activity and measured them for CHD risk.

If you moderately exercise (brisk walk) 150 minutes a week - 22 minutes a day - you reduce your chances of having a CHD event by 14%.

If you moderately exercise 300  minutes a week - 45 minutes a day - you reduce your chances of having a CHD event by 20%.

So - the biggest bang for your buck is simply getting off the couch for a few minutes a day and doing something physical. You get even more return if you do more physical. This isn't strenuous exercise at all - just walking.