Hypertension and Stroke
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.
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.
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.
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.
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.
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.
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.
Most doctors and nurses measure blood pressure in one arm. A new British study published in The Lancet suggests that measuring it in both arms may be better. A difference in the arm-to-arm readings of 10 points or more can signal circulatory problems that may lead to stroke, peripheral artery disease, or other cardiovascular problems. In older people, an arm-to-arm difference in blood pressure is usually due to a blockage arising from atherosclerosis, the artery-clogging disease process that is at the root of most cardiovascular conditions. Next time you have your blood pressure checked, ask the doctor or nurse to do it on both arms. If there’s a difference greater than 10 point, another test called the ankle-brachial index might be in order to check for peripheral artery disease.
A bold initiative called Million Hearts aims to prevent one million heart attacks and strokes from happening over the next five years. As explained in the Harvard Heart Letter, the initiative is spearheaded by the federal Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services. Its main focus is to encourage more widespread and appropriate use of simple, effective, and inexpensive heart-protecting actions, dubbed the ABCS. These include taking daily low-dose Aspirin, if prescribed; managing Blood pressure and Cholesterol levels; quitting Smoking. The Harvard Heart Letter adds D for Diet and E for Exercise.
“Limit salt” has been a key part of dietary advice for decades. Once aimed at individuals, the FDA is hoping to persuade food companies to cut back on salt added to prepared foods. That’s probably a good idea, since the average American gets more salt—and thus sodium—than needed, most of it from prepared foods. But the question of how low we should go with sodium hasn’t been answered. Two studies suggest that getting too little sodium could pose problems, just as eating too much does. Trials to determine the safest range for sodium aren’t in the offing. What to do in the interim? Aiming for the recommended target of 2,300 milligrams per day from all sources is probably good for most people.