Stroke Archive

In the journals

Even if you believe you're in excellent health, you could still be at risk for a heart attack or stroke, suggests a study of more than 6,800 people, average age 62, published Feb. 15, 2019, in JAMA Network Open. At the study's beginning, participants rated their health as excellent, very good, good, or poor/fair. (More than half the men reported being in very good or excellent health.)

Next, everyone had a coronary artery calcium (CAC) scan, which detects plaque buildup in the arteries of the heart. The scores range from zero to 100 and higher, with zero meaning no plaque buildup is present and cardio-vascular disease risk is at its lowest.

Research we're watching

Contrary to observations that moderate drinking (one or two drinks per day) protects against stroke, a new study finds that stroke risk may rise with increasing alcohol intake.

The findings, which were published online April 4 by The Lancet, come from a study involving 160,000 Chinese adults who reported their drinking habits. They also were tested for gene variants common in Asian populations that cause an unpleasant flushing reaction after drinking. Only 2% of women reported drinking alcohol, compared with 33% of men, so the findings focus mainly on men.

Even short-lived, subtle stroke symptoms should be evaluated.

Imagine trying to write a note, but it feels like you're moving the pen through wet concrete. Or you suddenly can't see normally — it's as if a black curtain has dropped over one of your eyes.

If these odd symptoms last for only a few minutes, you might be tempted to brush them off and blame muscle cramps or fatigue. Don't make that mistake, says Dr. Christopher Anderson, director of Acute Stroke Services at Harvard-affiliated Massachusetts General Hospital. Both of the above scenarios are examples of a possible transient ischemic attack (TIA), commonly referred to as a ministroke. Caused by a temporary lack of blood in part of the brain, a TIA is a warning sign that you are at risk for a stroke.

Learn how to recognize and prevent this dangerous condition, known as venous thromboembolism, or VTE.

When a blood clot blocks an artery supplying the heart or the brain, the result is a heart attack or stroke. Most Americans are familiar with these two serious health threats. But they're probably less familiar with the dangers of venous thromboembolism, or VTE — a clot that forms in a vein.

A clot in the leg or arm, known as deep-vein thrombosis, can cause pain, swelling, and redness in the affected limb. But the real threat occurs if the clot breaks off and travels to the lungs, causing a pulmonary embolism.

In the journals

People who have had a heart attack or a stroke are routinely prescribed a statin to reduce the risk of a repeat event. But by also following a Mediterranean-style diet, they can improve their chance of living longer, suggests a study in the Feb. 1, 2019, issue of the International Journal of Cardiology.

The study looked at 1,180 people, average age 68, who had at least one previous heart attack or stroke, and recorded their statin use and diet intake at the study's beginning. The researchers identified the people who faithfully followed a Mediterranean-style diet. A Mediterranean-style diet involves consuming medium to high amounts of whole fruits and vegetables, whole grains, legumes and nuts, olive oil, and poultry and fish, with limited amounts of red meat, alcohol, and dairy.

At 70 years and counting, the Framingham Heart Study continues to help doctors better understand stroke, dementia, and heart disease.

 Image: © BHPix/Getty Images

In 1948, more than 5,200 people living in a town just west of Boston volunteered for what has evolved into the longest running and best-known study of the causes of heart disease. But the multigenerational Framingham Heart Study has also revealed important clues about brain disorders — most notably stroke but also cognitive decline and dementia (see "Framingham's brain health findings").

In the early 1960s, Framingham researchers coined the term "risk factor," which refers to a characteristic or exposure that raises a person's odds of developing a disease. Over the following decades, they uncovered many such factors for heart disease, including cigarette smoking, obesity, lack of physical activity, and high blood pressure. These habits and conditions also turned out to predispose people to stroke and dementia, thereby establishing that what harms the heart is also bad for the brain.

In the journals

Vitamin D and omega-3 fatty acid supplements have had mixed results when it comes to preventing heart attacks, strokes, and cancer in people who have already developed these problems or are at high risk for them. Yet a new study published online Nov. 10, 2018, by The New England Journal of Medicine found they may actually prevent these conditions among people who have never had these problems before.

Researchers recruited almost 26,000 people, ages 50 and older, who had no history of heart disease or cancer. The participants were divided into four groups. People in one group were given daily doses of 2,000 international units of vitamin D (an amount found to be linked to lower disease risk in observational studies) and 1 gram of a drug called Lovaza, which contained 840 milligrams of omega-3s (two to four times the amount in two servings of fish per week). The second group took vitamin D and a placebo, the third group took the omega-3s and a placebo, and the final group took two placebos. After more than five years, the researchers found that those given omega-3s were 28% less likely to suffer a heart attack compared with those given a placebo. Those who ate fewer servings of fish (less than the average of 1.5 servings per week) appeared to have a greater benefit from the additional omega-3s while those with higher fish intake had minimal benefit.

 Image: © Hunterann/Thinkstock

Research we're watching

For years, many have speculated that taking vitamin D and omega-3 fatty acid supplements might help to prevent heart attacks, strokes, and certain cancers. But a study by Harvard researchers published online November 10, 2018, by The New England Journal of Medicine has found that the benefits may be more limited than originally hoped.

The results of the Vitamin D and Omega-3 Trial (VITAL), which enrolled more than 25,000 people and ran for more than five years, showed that while omega-3 supplements did appear to reduce the risk of heart attack, particularly among African Americans, they did not appear to be effective in preventing stroke or cancer. Vitamin D supplements also saw few benefits when it came to preventing heart attack, stroke, or cancer — but they were associated with a drop in cancer deaths in people who had taken the supplements for at least a year or two.

Research we're watching

 Image: © nehopelon/Getty Images

People whose daily diets include at least two servings per day of milk, yogurt, or cheese appear to have a lower risk of heart disease, stroke, or death than people who don't consume dairy products.

The findings, published Sept. 11, 2018, in The Lancet, were based on food questionnaires from more than 136,000 people from 21 countries. After a follow-up that lasted an average of nine years, researchers found that adults who consumed two or more servings of dairy each day had a 22% lower risk for heart disease, a 34% lower risk for stroke, and a 23% lower risk of heart-related death. Observational studies such as this one cannot prove cause and effect. But dairy-based foods contain vitamins D and K, calcium, and other nutrients thought to be good for cardiovascular health. The findings support the benefits of all types of dairy, including full-fat versions. However, current guidelines still recommend nonfat or low-fat milk, yogurt, and cheese, which contain fewer calories and less saturated fat.

Image: Valeriya/Thinkstock

In the journals

People with atrial fibrillation, or afib, a type of irregular heartbeat that is linked with stroke, also may have a greater risk of dementia than those without the condition, according to a study published online Oct. 10, 2018, by Neurology.

Researchers recorded medical data from 2,685 people, average age 73. None of them had dementia and 243 had afib. After nine years, another 279 people developed afib. The researchers found that people with afib showed a faster rate of decline in thinking and memory skills than those without the condition, and were 40% more likely to develop dementia.