Brain health Archive

It’s happened to all of us: a hand or leg temporarily “falls asleep,” usually from being in one position for too long. Why does it happen? Are there times when you should be concerned about it?

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.

When people with dementia start exhibiting agitated behaviors, doctors often prescribe medications, but these have risks of serious side effects. A new study found that nondrug interventions were more effective than medications in reducing agitation.

When it comes to understanding this link, the devil is in the details.

When we talk about LDL cholesterol, it's always described as bad or harmful — and with good reason. High blood levels of this artery-clogging substance boost the risk of heart disease, the nation's leading cause of death. The more you can lower your LDL cholesterol (through diet, exercise, or medications), the lower your risk of a heart attack. For heart attack survivors, national guidelines recommend aiming for an LDL cholesterol level of less than 70 milligrams per deciliter to prevent a second heart attack.

In the past year, however, two studies in the journal Neurology reported a higher risk of hemorrhagic (bleeding) stroke in people with LDL levels of 70 and lower. While that sounds worrisome, a closer look at the findings can put these results into perspective.

Research we're watching

Younger adults who use marijuana appear to face a higher risk of stroke compared with those who don't use the drug, according to a report published Nov. 11, 2019, in the journal Stroke.

Researchers pooled data from a nationally representative survey from the CDC that included nearly 44,000 participants ages 18 to 44. About 14% reported using marijuana within the past month. Young adults who recently used marijuana were 1.8 times more likely to experience a stroke compared with nonusers. The risk was 2.5 times higher among frequent users (more than 10 days a month). Frequent marijuana users who also smoked regular cigarettes had three times the risk for nonusers.

Chronic stress is associated with an increased risk of heart disease, heart attacks, and strokes. These strategies can help you manage it.

People often complain about stress, but it's actually a natural reaction with an essential purpose.

When the body senses danger, it starts its fight-or-flight response. Your nervous system releases hormones like adrenaline and cortisol, which jolt the body into a protective mode. Your heart pounds faster, muscles tighten, blood pressure rises, breathing quickens, and your senses sharpen.

Taking these medications at bedtime rather than in the morning may make them more effective.

Many people take their medications as part of their morning ritual, along with a cup of coffee and the daily newspaper. But for blood pressure drugs, evening may be a better option. Last year, a large study found that taking blood pressure drugs before bed may lower the risk of serious heart-related complications more than taking the drugs in the morning (see "Benefits of bedtime blood pressure dosing").

The concept of chronotherapy, or adjusting medication dosing to a specific time of day, isn't new. There's not a great deal of evidence to support the practice with cardiovascular drugs, but it makes sense, says Dr. Naomi Fisher, director of the Hypertension Specialty Clinic at Harvard-affiliated Brigham and Women's Hospital.

A sense of dizziness or spinning associated with migraine headache is called vestibular migraine. A small study found that a type of nerve stimulation treatment improved symptoms of vestibular migraine in study participants.

News briefs

We've reported before that heavy drinking is tied to an increased risk for developing dementia. A Harvard-led study published online Sept. 27, 2019, by JAMA Network Open suggests that the risk is even worse if you have mild cognitive impairment (MCI). Researchers analyzed the data of more than 3,000 dementia-free adults (average age 78, some with MCI) who reported their alcohol use and underwent psychological testing for six years. People with MCI who drank heavily (more than 14 drinks per week) had a 72% higher risk for dementia than people who drank less than one drink per week. However, people without MCI who drank moderately (seven to 14 drinks per week) didn't appear to have an increased risk for dementia, and even seemed to have a 37% lower risk for dementia compared with people who consumed less than one drink per week. The bottom line: "Our results suggest that moderation is the healthiest approach if you drink. And if you have mild cognitive impairment, you may want to reconsider drinking alcohol at all," says Dr. Kenneth Mukamal, a study author and researcher with the Harvard T.H. Chan School of Public Health.

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Research we're watching

If you suffer from migraine headaches, there's a new option available to relieve your pain. In October 2019, the FDA approved lasmiditan (Reyvow) to treat migraine pain in adults. Taken as a pill, it works for migraines either with or without an aura (a visual disturbance within the hour before migraine pain starts). Lasmiditan is not designed to prevent migraines. Lasmiditan is the first migraine treatment in a class of drugs known as serotonin (5-HT) 1F receptor agonists. In studies, researchers found that it could relieve pain and other migraine symptoms within two hours.

Migraines affect an estimated 28 million women in the United States, according to the American Migraine Foundation, and the World Health Organization ranks them among the top 10 disabling conditions. Pain and other symptoms, which may include nausea, sensitivity to light and temporary vision changes, result in lost work days, reduced productivity, and diminished quality of life for many people.