Stroke Archive

For young people with autism spectrum disorder, the transition from adolescence to adulthood is marked by changes in many areas of their lives. Healthcare providers and caregivers can make this transition smoother and help their patients meet these challenges.

There is evidence that antidepressants are not effective in older people with dementia. Emerging research suggests that nondrug, psychosocial interventions are the most effective treatments for depression or anxiety in older adults with cognitive impairment.

Ask the doctor

Q. I've taken blood pressure medicines every morning for many years, and they keep my pressure under control. Recently, my doctor recommended taking them at bedtime, instead. Does that make sense?

A. It actually does make sense — based on recent research. For many years, there have been at least three theoretical reasons for taking blood pressure medicines before bedtime. First, a body system that strongly affects blood pressure, called the renin-angiotensin system, has its peak activity during sleep. Second, circadian rhythms cause differences in the body chemistry at night compared with daytime. Third, most heart attacks occur in the morning, before medicines taken in the morning have a chance to "kick in."

People monitor their cholesterol levels, but they should also watch their triglycerides.

Most people have heard of the two main kinds of cholesterol: the "good" HDL and the "bad" LDL. Doctors focus on controlling LDL, as high levels can lead to a buildup of fatty deposits in the arteries and block blood flow, which can trigger a heart attack or stroke.

A blood test called a lipid profile measures your HDL, LDL, and total cholesterol levels. But within that test is another number you should not ignore: your triglyceride levels.

Ask the doctors

Q. I recently started experiencing a lot of pain in my hand from osteoarthritis. Can I reverse this condition?

A. You can't reverse osteoarthritis, but there are things you can do to manage your pain and improve your symptoms. Osteoarthritis occurs when the protective cartilage that acts as cushioning between your bones starts to fray and wear down over time. Eventually this enables the bones to rub together, which causes the pain you are experiencing as well as swelling and stiffness that makes it difficult to move your hand freely. Typically, when you have arthritis, the pain and symptoms will be worse at some times than at others. You may experience a flare-up one day and feel better the next. To help reduce the discomfort of a flare-up, talk to your doctor about medication to relieve pain. She or he may recommend an over-the-counter pain reliever. Some people also get symptom relief using a topical pain reliever that is rubbed into the skin. Other strategies that can ease pain are splints or braces, heat or cold therapy, activity modification, and exercises or physical therapy to increase flexibility and strengthen your hand muscles.

Research we're watching

Late in 2019, the FDA approved a new use for icosapent ethyl (Vascepa), a drug that is a highly purified form of eicosapentaenoic acid (EPA), an omega-3 fatty acid found in fish.

The drug was originally approved in 2012 for treating people with very high levels of triglycerides, a type of fat in the blood. Now, icosapent ethyl is approved for people with triglyceride levels greater than or equal to 150 milligrams per deciliter who also have an elevated risk of cardiovascular disease despite taking the highest tolerable dose of a cholesterol-lowering statin. A large trial found that the drug decreases the risk of heart attack, stroke, and death from cardiac causes by 26% when compared with a placebo.

In older people, the majority of falls occur when someone is standing or walking while also performing a separate cognitive or motor task. These tasks require more cognitive effort as we age, but focus and awareness can prevent falls from happening.

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.