Stroke Archive

Ask the doctor

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Q. Is there something stronger than aspirin I can take for peripheral artery disease in my legs?

A. People with peripheral artery disease (PAD) in the legs have blockages (plaques of atherosclerosis) in the arteries that impair the flow of blood. Based on large scientific studies involving over 5,000 people with PAD, authorities recommend taking a daily aspirin tablet. For people with PAD, smoking cessation, regular exercise, and often other medicines such as statins, can help prevent further plaque buildup and decrease symptoms.

Common mental health disorders are linked to a higher risk of heart attack and stroke. Learn to spot the warning signs.

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Heart disease and mental health issues are both common. So it's not surprising that these problems often occur together. But are people with depression or anxiety more prone to developing cardiovascular disease?

Teasing out the answer to that question has proved tricky. Some factors known to contribute to a higher risk of heart disease (for example, an unhealthy diet, lack of exercise, and smoking) are also common in people with mental health issues. Now, new research that adjusts for those potentially confounding factors suggests the answer is yes.

Ask the doctor

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Q. The Harvard Health Letter has often said that it is generally healthy for women to have one alcoholic drink per day. Yet I hear a recent study showed no benefit. What's the truth?

A. Before answering your question, let's define "one drink": it's 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor. And it means having one drink each day of the week, not having seven drinks on Saturday night, sleeping it off Sunday, and begging off until next Saturday night. Now, despite the recent study, we stick with what we've said, which reflects the research of outstanding nutrition scientists at Harvard and elsewhere.

Vitamins don't seem to reduce cardiovascular risks, according to a new report.

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There may be reasons to take a multivitamin, but improving your cardiovascular health is not one of them, says a report in the July 10 issue of Circulation: Cardiovascular Quality and Outcomes. The authors found that for the average person, taking a multivitamin supplement didn't help prevent cardiovascular problems, such as heart attacks and strokes.

The findings were based on a review of general population studies conducted from 1970 to 2016, involving more than two million people. Researchers looked for associations between multivitamin supplementation and cardiovascular outcomes. But they weren't able to find any links.

Research we're watching

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About one in 10 people has eczema, a chronic inflammatory condition that leaves skin dry and itchy. People with more severe forms may experience a scaly rash or skin that cracks and oozes. These people may also be at greater risk for heart attack and stroke, according to a study in the May 23 issue of The BMJ.

For the study, researchers analyzed data from more than 385,000 adults with eczema, which was classified as mild, moderate, or severe. Each was matched with up to five people of similar age and sex who didn't have eczema.

Research we're watching

Episodes of atrial fibrillation (afib) — a chaotic, irregular heart rhythm — can last for minutes, hours, days, or much longer. The condition encourages blood clots to form in the heart; the clots can then escape and lead to a stroke. New research suggests that even intermittent bouts of afib (which were previously considered to be low risk) may increase a person's risk of stroke.

The study included nearly 2,000 people who wore a small skin patch that continuously monitored their heart rates for 14 days. All of them had paroxysmal (intermittent) afib and were not taking anti-clotting medications. Researchers then tracked the participants' incidence of stroke over the following five years. They found that afib that lasted more than 11% of the total monitoring time was associated with a threefold increase in stroke risk.

Research we're watching

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Eating an egg a day may help protect against cardiovascular disease, according to a study published online May 21 by the journal Heart. Researchers found that people who ate an egg every day had an 18% lower risk of dying from cardiovascular disease and a 28% lower risk of experiencing a deadly hemorrhagic stroke, compared with people who didn't eat eggs.

The study included more than 400,000 adults ages 30 to 79. Participants were from 10 survey sites in China. Researchers looked at how often study subjects reported eating eggs and then tracked their health for nearly nine years using registries and other methods.

Ask the doctors

Q. I recently read about the decision by the state of California to require cancer warnings on coffee. I drink a cup a day. Should I be concerned?

A. The recent decision by a California judge to require cancer warning labels on coffee stemmed from concerns about a specific substance found in coffee, acrylamide, which is a chemical that is produced when coffee is roasted. Coffee isn't the only food or beverage that contains acrylamide. Acrylamide is produced during the high-temperature cooking process used for numerous common foods, including cookies, crackers, and potato chips, according to the American Cancer Society (ACS). But before you panic, while there definitely is acrylamide in coffee, scientists have yet to conclusively prove that this chemical causes cancer, according to the ACS. Most of the research on humans hasn't found any increased risk of cancer in people who eat foods containing acrylamide. Other studies looking at specific types of cancers have produced mixed results but found no conclusive links, according to the ACS. In addition, there is evidence that drinking coffee can bring some health benefits, such as reductions in the risks for stroke and liver disease. A 2015 study in Circulation also found that moderate coffee drinkers (defined as those having less than five cups a day) had lower risks for heart disease and neurological disease, according to the American Heart Association. So, the final message is this: if you are healthy and drink coffee moderately, there is no evidence that it's going to raise your risk of developing cancer.

Research we're watching

It seems the old adage "everything in moderation" might have an exception — smoking. A study in the January 24 issue of The BMJ found that smoking even one cigarette a day carries significant health consequences, namely a higher risk of heart attack and stroke.

Using data from 141 different studies, involving millions of participants, researchers compared people who smoked either one, five, or 20 cigarettes each day. They found, counter to what many people assume, that rates of heart disease and stroke were not reduced as much as expected in casual smokers compared with pack-a-day smokers.

This heart rhythm disorder is linked to thinking and memory problems. But anti-clotting drugs may lower the risk.

Bouts of atrial fibrillation, or afib — a rapid, chaotic heartbeat — make some people feel lightheaded and dizzy, while others don't notice any symptoms. But the most serious threat of this condition is the higher risk of stroke among people with afib compared with those without the disorder (see "Blood clot dangers, large and small"). Now, there's a growing recognition that people with afib also face an increased risk of thinking and memory problems — even if they do not experience a stroke.

Known as cognitive impairment, these problems include trouble remembering, learning new things, concentrating, or making routine decisions. The presumed underlying cause? Tiny blood clots that cause "silent" (that is, unrecognized) strokes and gradually injure parts of the brain involved with cognition.