Stroke Archive

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.

People monitor their cholesterol levels, but they should also watch their triglycerides.

Most people have heard of the two main kinds of cholesterol: the "good" HDL and the "bad" LDL. Doctors focus on controlling LDL, as high levels can lead to a buildup of fatty deposits in the arteries and block blood flow, which can trigger a heart attack or stroke.

A blood test called a lipid profile measures your HDL, LDL, and total cholesterol levels. But within that test is another number you should not ignore: your triglyceride levels.

Research we're watching

Late in 2019, the FDA approved a new use for icosapent ethyl (Vascepa), a drug that is a highly purified form of eicosapentaenoic acid (EPA), an omega-3 fatty acid found in fish.

The drug was originally approved in 2012 for treating people with very high levels of triglycerides, a type of fat in the blood. Now, icosapent ethyl is approved for people with triglyceride levels greater than or equal to 150 milligrams per deciliter who also have an elevated risk of cardiovascular disease despite taking the highest tolerable dose of a cholesterol-lowering statin. A large trial found that the drug decreases the risk of heart attack, stroke, and death from cardiac causes by 26% when compared with a placebo.

There is a lot you can do to lower your chances of having a stroke. Even if you've already had a stroke or TIA ("mini-stroke"), you can take steps to prevent another.

Controlling your weight is an important way to lower stroke risk. Excess pounds strain the entire circulatory system and can lead to other health conditions, including high blood pressure, diabetes, high cholesterol, and obstructive sleep apnea. But losing as little as 5% to 10% of your starting weight can lower your blood pressure and other stroke risk factors.