Hypertension and Stroke

Reena Pande, M.D.

Getting more potassium and less salt may cut heart attack, stroke risk

Reena Pande, M.D., Instructor in Medicine, Harvard Medical School
Overflowing salt shaker

Salt is a cheap, easy way to turn on taste buds. That’s one reason why it’s in so many of the foods we eat. It’s so commonly used that most Americans consume more than double the recommended daily limit for it. Three new studies in BMJ (formerly the British Medical Journal) once again confirm the relationship between salt intake and health problems. They show that reducing salt intake can help lower blood pressure and lower the odds of having a heart attack or stroke or developing heart failure. They also show that consuming more potassium is also linked to lower blood pressure and lower risk of stroke. Current dietary guidelines recommend that Americans get no more than 1 teaspoon of salt a day. That’s the equivalent of 2,300 milligrams (mg) of sodium a day. Most Americans get much more than that. It’s possible to cut back by avoiding processed and packaged foods, using herbs and spices to season food instead of salt, and other strategies. It’s best to get potassium from food, especially fruits and vegetables. Green leafy vegetables, beans, and bananas have a lot of potassium.

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Patrick J. Skerrett

Studies explore global burden of disease and heart disease in the United States

Patrick J. Skerrett, Executive Editor, Harvard Health
Stethoscope and the Earth

If you like numbers and statistics, especially those about health, two reports released this week should keep you occupied for days: the massive Global Burden of Disease study was published in The Lancet, and the American Heart Association released its annual “Heart and stroke statistics” report. The Global Burden of Disease project found that average life expectancy continues to rise in most countries. It also found that infection and other communicable causes of disease no longer dominate deaths and disability. Today, so-called non-communicable causes like traffic accidents, violence and war, heart disease, cancer, and other chronic conditions account for two-thirds of world deaths and the majority of years lost to disability and death. According to the American Heart Association’s annual report, the percentage of deaths due to heart attack, stroke, and other cardiovascular diseases has fallen by nearly one-third since 1999, but don’t expect that to continue. Increases in high blood pressure, high cholesterol, diabetes, overweight, and inactivity threaten to reverse these gains.

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Patrick J. Skerrett

World Stroke Day: Emphasize prevention, early detection

Patrick J. Skerrett, Executive Editor, Harvard Health
World map

The term “stroke” conjures up a frightening bolt out of the blue. It certainly feels that way when it happens. But the sudden onset hides most strokes’ decades-long development stemming from slow but steady damage to blood vessels, the growth of artery-clogging plaque, or the erratic heart rhythm known as atrial fibrillation. This long gestation means it is often possible to avoid a stroke by fighting arterial corrosion. Today is World Stroke Day—a moment to pay close attention to stroke. Worldwide, this brain-damaging condition afflicts millions of people each year, and kills more than 6 million. In the United States, about 800,000 people have strokes each year, and about 140,000 die from them. There are two main messages of World Stroke Day: Stroke can be prevented. Stroke can be treated if detection and treatment happen quickly.

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Patrick J. Skerrett

Peripheral artery disease: often silent, sometimes deadly, potentially preventable

Patrick J. Skerrett, Executive Editor, Harvard Health
Cholesterol concept (old pipe)

Better attention to four common health factors could go a long way to preventing a stealth condition known as peripheral artery disease (PAD). That’s the upshot of a Harvard-based study published today in JAMA. PAD usually refers to blockages in the arteries that supply blood to the legs and other body parts below the heart. Such blockages can cause widespread damage, limit activity, and sometimes lead to death. In the new study, the factors that most strongly influenced the development of PAD were the same “big four” that are largely responsible for heart disease and stroke: smoking, diabetes, high blood pressure, and high cholesterol. Prevention is the best medicine. Quitting smoking and keeping blood pressure, cholesterol, and blood sugar under control can prevent PAD from getting established, or slow the disease process and possibly improve symptoms. Also important are exercise, a healthy diet, and taking medications as needed to protect the heart and arteries.

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Heidi Godman

Lycopene-rich tomatoes linked to lower stroke risk

Heidi Godman, Executive Editor, Harvard Health Letter
Tomatoes

Succulent tomatoes are far more than just a delicious fruit. Eating them may also help lower your risk of stroke, likely due to the lycopene they contain. Lycopene is a powerful antioxidant that eliminates dangerous free radicals that can damage DNA and other fragile cell structures. Past research has shown that a diet rich in lycopene-containing foods may help lower the risk of prostate and other cancers. Now, in a report just published in the journal Neurology, a team of Finnish researchers has linked higher lycopene levels in the blood to protection against stroke. The researchers suggested that lycopene, in addition to its ability to attack free radicals, may also reduce inflammation and cholesterol, improve immune function, and prevent blood from clotting. All of these may help reduce ischemic strokes, which are caused by clot-caused blockages in blood flow to the brain. It’s best to get lycopene from food—tomatoes and watermelon are excellent sources—not supplements.

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Heidi Godman

Non-alcoholic red wine may lower blood pressure

Heidi Godman, Executive Editor, Harvard Health Letter
Glass of red wine

Scientific studies, the media, and even some doctors tout the heart health benefits of red wine. But if controlling blood pressure is important to you, consider this the next time you raise your glass: A new study published online in Circulation Research suggests that non-alcoholic red wine may be better at lowering blood pressure than regular red wine. Powerful antioxidants in red wine called polyphenols may be more effective when there’s no alcohol to interfere with them. Spanish researchers compared the effects of regular wine, non-alcoholic red wine, and gin on blood pressure. Non-alcoholic red wine lowered blood pressure and boosted levels of nitric oxide, which helps relax blood vessels. What the study doesn’t tell us is how non-alcoholic red wine stacks up against regular red wine for preventing heart attacks or other cardiovascular problems.

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Reena Pande, M.D.

Yoga may aid stroke recovery

Reena Pande, M.D., Instructor in Medicine, Harvard Medical School
Hand in yoga pose

Thanks to medical advances in detecting and treating stroke, the risk of dying from one is now lower than it used to be. Unfortunately, many stroke survivors are left with a disability. In fact, stroke is the leading cause of serious long-term disability in the United States. A new study from Indianapolis suggests that yoga may benefit some stroke survivors. In this study, 47 stroke survivors were divided into three groups. Some took part in a twice weekly group yoga session for eight weeks, and others received standard follow-up but no yoga. There were several benefits in the yoga group, including improved balance, improved quality of life, reduced fear of falling, and better independence with daily activities. Although small, this study adds to findings from other research that yoga may help stroke survivors in several ways.

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Howard LeWine, M.D.

Blood pressure goals may need to change with age

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Older-persons-hand-holding-a-cane

Controlling high blood pressure is a good thing—unless you are a frail older person. Then it might be harmful. That’s the surprising finding of a study of more than 2,000 seniors published online in the Archives of Internal Medicine. In the study, high blood pressure was linked to an increased risk of dying only among older adults who were relatively fit. Among those who couldn’t walk 20 feet, those with high blood pressure were less likely to have died. It’s possible that frail older adults benefit from having higher blood pressure. It’s also possible that using multiple medications drive down blood pressure in older, frail adults may do more harm than good.

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Howard LeWine, M.D.

Pregnancy-related high blood pressure, diabetes linked to later heart disease

Howard LeWine, M.D., Chief Medical Editor
Internet Publishing, Harvard Health Publications
Pregnancy

Most of the changes that come with pregnancy—growing a belly “bump,” being tired, mood swings, cravings for particular foods, and the like—are normal, temporary, and harmless. Two other changes, pregnancy-related high blood pressure and diabetes, may have long-lasting implications for heart health. The development of high blood pressure during pregnancy is known as preeclampsia; pregnancy-related diabetes is called gestational diabetes. They are different from “regular” high blood pressure and diabetes because both are “cured” by delivery. A new study published this week in the journal Circulation suggests that these complications boost a woman’s risk of cardiovascular disease during middle age.

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Patrick J. Skerrett

Everyday foods are top 10 sources of sodium

Patrick J. Skerrett, Executive Editor, Harvard Health
Pretzel

A new report from the Centers for Disease Control and Prevention (CDC) shows that just 10 types of deliver almost half of the average American’s daily sodium. Topping the list are breads and rolls, cold cuts, pizza, poultry, and soups. Almost two-thirds of our daily sodium comes from food bought in stores, and one-quarter comes from food bought in restaurants (which includes fast-food shops and pizza places).The report also showed that Americans take in an average of 3,266 milligrams of sodium a day (about 1½ teaspoons of salt), well above the healthy target of 2,300 milligrams a day. As a nation, cutting back on salt by an average of 400 milligrams a day could prevent 28,000 deaths a year and save $7 billion in health care costs.

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