Stroke Archive

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 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.

In the journals

People who quit smoking decades ago are still at risk for lung diseases like chronic obstructive pulmonary disease (COPD), according to a study published online Oct. 9, 2019, by The Lancet Respiratory Medicine.

Researchers looked at lung capacity — the amount of air in your lungs after taking a deep breath — among more than 25,000 people and analyzed the results based on whether the individuals smoked, had quit smoking, or had never smoked. Previous research has suggested that the decline in lung capacity that occurs with smoking levels off within a few years after people quit.

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.

Infections aren't the only conditions that can cause discomfort.

Certain urinary symptoms are quite common, particularly in women: painful burning with urination, an urgent need to urinate like you can't hold it (urinary urgency), and urinating frequently (urinary frequency).

These symptoms can be caused by any of the following conditions.

News briefs

A research team from Harvard reports that it has harnessed the powerful gene editing tool called CRISPR to recognize and kill viruses. The findings were published online Oct. 2, 2019, by Molecular Cell. CRISPR can alter strands of both DNA and RNA (a molecule related to DNA), which are built like strings of beads. Each bead consists of one of four chemicals called bases. CRISPR can recognize a specific sequence of bases (such as one that is characteristic of a particular virus), latch on to that sequence and cut it, and change the sequence to a different one. This can scramble the genetic sequence of a virus in such a way that the virus no longer can make copies of itself. The Harvard team used this technique to kill several viruses that are made of RNA — including influenza virus — in a laboratory dish. The next step will be to see if the CRISPR technique can also be used to kill viruses in a living animal. That will be much harder. However, if it works, the technique might someday help humans fight viral infections.

Image: © Bill Oxford/Getty Images

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.

Research we're watching

Treating high blood pressure may do more than prevent heart attacks and strokes. In older adults, intensive blood pressure lowering may also conserve brain function, according to a new study.

Published online Oct. 14, 2019, by the journal Circulation, the study included 199 adults ages 75 and older, all with a systolic blood pressure value (the first number in a reading) of 150 or higher. Their brain scans also showed lesions in the brain's white matter, which contains nerve fibers that send signals from one part of the brain to another. The lesions, which reflect damaged small blood vessels, have been linked to a propensity for thinking and memory problems. About two-thirds of people over age 75 have white matter lesions, as do most people over age 90.