Stroke Archive

Researchers are beginning to better understand if, when, and how to address this condition, which is linked to a newly recognized type of stroke.

In the womb, all fetuses have a foramen ovale (Latin for "oval hole") between the heart's right and left upper chambers (atria). This opening allows blood to take a shortcut within the heart rather than following a longer path through the lungs, which cannot work until they are exposed to air. After birth, when a newborn baby takes his or her first breath, the foramen ovale begins to close. Most of the time, it seals completely within a few months.

But in about a quarter of people, that doesn't happen. This anatomical variation is called a patent foramen ovale (patent means open) or PFO. Most people never know they have it, because a PFO doesn't cause any signs or symptoms. For the most part, the condition is harmless.

Lifestyle improvements, such as quitting smoking and exercising more, can reduce your risk of a stroke.

A stroke may seem like a sudden, uncontrollable event — a lightning strike out of the blue. But in reality, stroke risk often builds over time, and many strokes are preventable. A study published in the May 2020 issue of Stroke found not only that lifestyle changes can help you head off a potential stroke, but also that you can still reduce your risk even if you don't make these changes until later in life.

"What is novel about our study is that we found that even in middle-aged women, changing lifestyle has a large effect on preventing stroke," says Dr. Goodarz Danaei, senior author of the study and the Bernard Lown Associate Professor of Cardiovascular Health at the Harvard T.H. Chan School of Public Health. "Even in the sixth decade of life, lifestyle changes can still prevent up to a quarter of all strokes." The average age in women for a first stroke is 75.

Do you struggle with decisions? These strategies can help you make good choices more efficiently.

We make countless choices every day. Most are the mundane variety: what to eat, what to wear, what movie to watch. But often our decisions (or lack thereof) have a significant impact on our well-being.

Poor decision making is often a consequence of natural cognitive decline. This can cloud people's judgment about what is the right course of action or make it harder to weigh multiple options. The result is that people make questionable choices, or they feel overwhelmed and don't make any decision, which is sometimes even worse.

If you haven't made a video call yet, give it a try to fight isolation.

When much of the world began lockdowns to battle coronavirus in March 2020, many people turned to video calls to fight off the loneliness that often accompanies social isolation. Tech companies reported that the use of video calls for socializing surged by as much as 80%, enabling people to "see" family and friends. But it doesn't take a lockdown to warrant the use of this technology.

The epidemic of loneliness and isolation

Loneliness affects more than a third of older Americans. Another third of older adults feel isolated: they may be living alone, lack transportation, or live far from loved ones. Or they may have outlived a spouse or friends.

An analysis of multiple studies looking at the relationship between high blood pressure and cognitive health –– abilities like thinking, memory, and attention –– found that older people who lower high blood pressure are slightly less likely to develop cognitive impairment or dementia.

Research we're watching

Eating a vegetarian diet may lower your risk of stroke, according to a study in the March 17 issue of Neurology.

The study included two groups of people from Buddhist communities in Taiwan, where vegetarian diets are encouraged. About 30% of the more than 130,000 participants were vegetarian, meaning they didn't eat any meat or fish. Their average age was 50, and none had a prior stroke.

Research we're watching

People with clogged arteries in their hearts (coronary artery disease) or legs (peripheral artery disease) face a high risk of having a heart attack or stroke, particularly if they also have diabetes. For such people, a combination of clot-preventing drugs lowers the risk of those dangerous outcomes, according to a study published online March 28 by the journal Circulation.

The study included just over 18,300 people with coronary or peripheral artery disease; about 38% also had diabetes. They all took low-dose aspirin daily, but half also took 2.5 milligrams of rivaroxaban (Xarelto) twice daily while the others took a placebo. Like aspirin, rivaroxaban helps discourage blood clots, but through a different mechanism.

In the journals

Bleeding is a common side effect of anticoagulants (blood thinners). However, people with atrial fibrillation (afib) who take the drug for stroke prevention should not ignore any bleeding from their lower gastrointestinal (GI) tract, as it may signal colon cancer. That study finding was published online Feb. 7, 2020, by the European Heart Journal.

Researchers analyzed 125,418 patients who took anticoagulants for afib. Only 2,576 had lower GI bleeding during the first six months of treatment, regardless of age. Yet those who did experience bleeding had 10 times the risk of being diagnosed with colon cancer during the subsequent year compared with those who hadn't had any bleeding.

Here's what the numbers mean — and strategies to lower your cholesterol if it's too high.

For some women who've had normal cholesterol readings all their lives, that changes at menopause. "Going through menopause often results in lipid and cholesterol changes for the worse," says Dr. Samia Mora, an associate professor of medicine at Harvard Medical School and a specialist in cardiovascular medicine the Brigham and Women's Hospital. Drops in the female hormone, estrogen, are associated with a rise in total cholesterol levels due to higher amounts of low-density lipoprotein (LDL), the "bad" cholesterol, and another blood lipid (fat) known as triglyceride. Over time this can raise heart risks, which is a reason for concern, as cardiovascular disease is the No. 1 cause of death in postmenopausal women, says Dr. Mora.

"So, it's especially important to track the numbers in perimenopause and the early years after menopause, as LDL cholesterol and total cholesterol tend to increase," she says.

New studies shed light on the role of aspirin for people without a previous heart attack or stroke.

 Image: © dszc/Getty Images

It costs just pennies per pill, doesn't require a prescription, and may be lifesaving for some people. But daily low-dose aspirin doesn't make sense for everyone. Now, three major studies that examined the benefits and risks of this widely used drug may alter the advice about who should take aspirin.

"Aspirin remains a cornerstone of treatment after a heart attack or stroke. But the question of whether people with a low to moderate risk of heart disease should take aspirin is a really important one," says Dr. Christopher Cannon, a cardiologist at Brigham and Women's Hospital and professor of medicine at Harvard Medical School. Tens of millions of people in the United States fall into that low-to-moderate-risk category. But until now, there weren't many large trials that included those people, he notes.