Stroke Archive

In the journals

Blood pressure readings are usually done on only one arm, but a new analysis makes the case for checking both arms, as the difference between them may suggest an elevated risk for heart disease. The findings were published in the February 2021 issue of Hypertension.

Researchers examined 24 studies that measured blood pressure in both arms in 53,827 adults without high blood pressure. They found that a difference of more than five points between the left and right arm systolic readings (the top number) was linked with a 9% higher risk for a first-time heart attack or stroke and a 6% increase in cardiovascular death within 10 years. The greater the difference between the two readings, the higher the risk.

Listening to music may boost exercise ability, ease stress and anxiety, and enhance recovery from strokes.

 Image: © shironosov/Getty Images

Whether you prefer Stravinsky's symphonies or the Beatles' ballads, you probably listen mostly because you simply like how they sound. You might not realize that music engages not only your auditory system but many other parts of your brain as well, including areas responsible for movement, language, attention, memory, and emotion.

"There is no other stimulus on earth that simultaneously engages our brains as widely as music does," says Brian Harris, certified neurologic music therapist at Harvard-affiliated Spaulding Rehabilitation Hospital. This global activation happens whether you listen to music, play an instrument, or sing — even informally in the car or the shower, he says. And it helps to explain how and why music therapy works (see "Singing — and striding — stroke survivors").

On call

Q. What is the significance of mild narrowing of the carotid artery detected by an ultrasound? I have never had any symptoms of stroke.

A. "Mild" narrowing ranges from 15% to 49% blockage of the artery. Over time, this narrowing can progress and lead to a stroke. Even if it doesn't progress, mild narrowing is a sign of early blood vessel disease and calls for preventive measures.

Research we're watching

People with atrial fibrillation (afib) who consume more than 14 alcoholic beverages a week may face a higher risk of stroke and other blood clot-related problems, according to a new study.

The study included 9,411 people with afib, who were divided into four groups based on how much they typically drank per week: abstainers or rare drinkers (less than one), light drinkers (less than seven), moderate (seven to 14), and heavy (14 or more). Researchers then tracked the participants for a median follow-up period of 17.4 months, noting the incidence of strokes, transient ischemic attacks (ministrokes), blood clots in a limb or organ (embolisms), or hospitalization for management of either atrial fibrillation or heart failure.

These drugs actually help stop dangerous blood clots from forming. Here's when you may need them.

Nearly everyone has heard of "blood thinners." Maybe you or someone you know takes one. But these drugs don't "thin" blood at all.

"They are actually anti-clotting drugs," says Dr. Gregory Piazza, a cardiologist with Harvard-affiliated Brigham and Women's Hospital. "They prevent potentially dangerous blood clots from developing in people at high risk, like those who have atrial fibrillation or a stent in a blood vessel, or who are immobile after surgery."

About one in five people has high levels of lipoprotein(a), a fatty particle linked to premature heart disease.

Most people probably haven't heard of lipoprotein(a), although that's not surprising. Cardiologists have known for years that having high levels of these fatty particles circulating in the bloodstream poses a risk to the cardiovascular system. But there wasn't much they could offer in terms of therapy, so widespread testing for lipoprotein(a) — also known as Lp(a) — didn't make sense.

Recent progress means the landscape may soon be shifting. Earlier research showed that injectable cholesterol-lowering drugs known as PCSK9 inhibitors, such as evolocumab (Repatha) or alirocumab (Praluent), may lower Lp(a) by up to 25%. Until last year, however, it wasn't clear whether that reduction actually helped people with high Lp(a).

Bananas are one of the most popular fruits in the United States, perhaps because they're affordable (about 58 cents per pound, on average) and available year-round.

Among all fruits, bananas are one of best sources of potassium, with about 450 milligrams (mg) per banana. Healthy adults not on certain medications should aim for 4,700 mg of potassium daily, although few Americans meet this goal. A high potassium intake may help reduce high blood pressure and has also been linked to a lower risk of stroke and possibly heart disease.

A transient ischemic attack is a warning of a potential full stroke. Don't ignore it.

An estimated 795,000 people get a first-time stroke every year, and there is a good chance they were warned. Transient ischemic attacks (TIAs), also known as ministrokes, share many of the typical stroke symptoms. Yet they often are mild and brief, which is why they routinely get missed or ignored.

"A TIA is your body sounding a loud alarm that you're at high risk for a full stroke, and you need to listen," says Dr. Erica Camargo Faye, a stroke neurologist at Harvard-affiliated Massachusetts General Hospital.

In the journals

Two recent studies shined a new spotlight on how inflammatory foods and drinks can affect heart disease risk. One study, published Nov. 10, 2020, in the Journal of the American College of Cardiology, looked at the impact high- and low-inflammatory diets had among 210,000 people free of heart disease at the beginning of the study. High-inflammatory diets were defined as those with more red, processed, and organ meats; refined carbohydrates; and sweetened drinks. In contrast, anti-inflammatory diets emphasize leafy greens (kale, spinach), dark yellow and orange vegetables (yellow peppers, carrots), whole grains, fruits, tea, coffee, and moderate amounts of red wine.

Participants' eating habits were recorded every four years for up to 32 years. Those who followed a high-inflammatory diet ended up with a 38% higher risk of heart disease and a 28% higher risk of stroke than those who ate a low-inflammatory diet.

Your partner's flawed health behaviors may be harming your heart.

It's been said that the longer couples stay together the more they look alike. As it turns out, the resemblance may be more than skin-deep. A study published online Oct. 26, 2020, by JAMA Network Open found that couples' health behavior and heart disease risk factors also look alike — for better or worse.

"We know, even from personal experience, that couples share similar behaviors that can affect health, but it was surprising to find the high levels of shared unhealthy behaviors within couples," says the study's lead author, Dov Shiffman, a senior scientific fellow at the medical testing company Quest Diagnostics.