Stroke Archive

Most strokes are caused by a clot that blocks a blood vessel in the brain. Those that damage small areas of brain tissue that don't control any vital functions are known as silent strokes because they don't cause any noticeable symptoms.

In the journals

Age may not be a factor when it comes to who can benefit from statins. A study published online July 7, 2020, by JAMA found that people who started taking the cholesterol-lowering medication in their mid-70s or later had fewer heart-related problems and lived longer than non-users.

Researchers looked at 326,981 mostly male veterans, ages 75 and older, who were free of cardiovascular disease and did not take statins. Over the next 10 years, more than 57,000 began statin therapy.

In the journals

Not only can regular leg stretching help reduce cramps and muscle strains, it also may be another way to protect against heart disease and stroke. A study published online July 1, 2020, by The Journal of Physiology found that performing simple leg stretches can help improve blood flow throughout the body.

Researchers split 39 healthy people into two groups. One group didn't do any stretching. The other group performed four types of leg stretches five times a week for 12 weeks. The stretches focused on the hip, knee, and ankle. Each stretch was done for 45 seconds with a 15-second recovery. Afterward, the researchers found that the arteries in the lower legs of the stretching group had better blood flow and less stiffness. The stretching group also had lower blood pressure at the end of the study compared with their initial readings.

People who take frequent saunas or hot baths may lower their risk of heart problems. But be cautious if you have low blood pressure.

Soaking in a bathtub or basking in a sauna can be a pleasant way to relax. Done on a regular basis, both habits may also help prevent heart attacks and strokes, according to several studies.

"The high temperatures in a warm tub or sauna cause your blood vessels to dilate, which lowers blood pressure," says Dr. Adolph Hutter, professor of medicine at Harvard Medical School. The volume of blood your heart pumps will also rise, especially in a hot tub. That's a result of the pressure of the water on the body, which increases the heart's workload, he explains.

For monitoring conditions that contribute to heart attack and stroke, virtual doctor visits are much more convenient than in-person appointments. Where is this trend headed?

Virtual doctor visits — when you talk to a physician on a video call instead of during an in-person office exam — have been available in certain places for years. But they never really caught on until the pandemic hit earlier this year. Almost overnight, virtual care became an indispensable tool for managing coronavirus infections and other health conditions during the crisis.

In 2019, virtual visits accounted for fewer than 1% of the appointments at Mass General Brigham, a large health care system founded by Harvard-affiliated Brigham and Women's Hospital and Massachusetts General Hospital (MGH). "But during the peak of the coronavirus surge in Boston, 80% of all visits were done virtually," says Dr. Lee Schwamm, director of the Center for TeleHealth at MGH and vice president of virtual care at Mass General Brigham.

Research we're watching

Ticagrelor (Brilinta), a drug that helps prevent blood clots, was approved in 2011 for treating people who had experienced a heart attack or acute coronary syndrome (a sudden loss of blood flow to the heart). Now, the drug can be prescribed to a broader group of people. In June 2020, the FDA expanded ticagrelor's approval to reduce the likelihood of first heart attack or stroke among high-risk people with coronary artery disease.

The expansion is based on results from a multiyear study of more than 19,000 people with coronary artery disease and diabetes at high risk for a heart attack. Participants who took aspirin plus ticagrelor were less likely to experience a heart attack, stroke, or death from heart disease compared with those who took aspirin alone.

Research we're watching

People with chronic pain may be more likely to have a heart attack or stroke than those without chronic pain, according to a study published online May 7, 2020, by the journal Pain Medicine.

From 2001 to 2005, researchers identified 17,614 Taiwanese people who had used pain relievers for at least three months. The most common causes of pain were spinal disorders, arthritis, and headaches; the pain relievers included both over-the-counter drugs and prescription opioids. For the comparison group, researchers used 35,228 people without chronic pain who were matched by age and sex to those in the first group.

News briefs

Eating a diet high in foods tied to inflammation — such as processed meat, sweets, and refined grains — is associated with many health problems, including an increased risk for colon cancer, heart disease, stroke, or diabetes. A Harvard study published online May 7, 2020, by Gastroenterology found another potential risk: Crohn's disease, a condition characterized by areas of inflammation throughout the large and small intestines. Researchers evaluated 30 years' worth of self-reported diet information from more than 208,000 men and women. Diets were scored based on foods that promote inflammation. Compared with people who had the lowest inflammatory diet scores, people with the highest scores had a 51% higher risk for developing Crohn's disease. The risk for Crohn's doubled among people who went from a low- to a high-inflammatory diet during the study. The study is observational and doesn't prove that an inflammatory diet causes Crohn's disease. But with so many other risks associated with foods that promote inflammation, it's important to eat as many foods that fight inflammation as possible. In other words, focus on whole, unprocessed foods with no added sugar — such as vegetables, fruits, whole grains, legumes (beans, lentils), fish, poultry, nuts, seeds, a little bit of low-fat dairy, and olive oil.

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News briefs

Here's a finding worth toasting if you're partial to a tipple: a study published online June 29, 2020, by JAMA Network Open linked low-to-moderate alcohol drinking in middle age with better cognitive (thinking) skills in older age. Researchers analyzed the health data of about 20,000 adults (average age 61) who took part in cognitive screenings every few years during a nine-year period and reported how much alcohol they drank each week. Men who had fewer than 15 drinks per week, and women who had fewer than eight drinks per week, were considered moderate drinkers. And they're the ones who appeared to have better word recall and vocabulary over time, and slower rates of cognitive decline, compared with people who never drank. The study is observational and doesn't prove that drinking alcohol protects the brain. In fact, the subject is debated: some studies have suggested that moderate alcohol drinking is associated with better cardiovascular health compared with heavy alcohol intake, but other studies have found that drinking any amount of alcohol increases the risk for high blood pressure and stroke. The takeaway: if you're going to raise a glass, do so only in moderation.

Image: © Ridofranz/Getty Images

Researchers are beginning to better understand if, when, and how to address this condition, which is linked to a newly recognized type of stroke.

In the womb, all fetuses have a foramen ovale (Latin for "oval hole") between the heart's right and left upper chambers (atria). This opening allows blood to take a shortcut within the heart rather than following a longer path through the lungs, which cannot work until they are exposed to air. After birth, when a newborn baby takes his or her first breath, the foramen ovale begins to close. Most of the time, it seals completely within a few months.

But in about a quarter of people, that doesn't happen. This anatomical variation is called a patent foramen ovale (patent means open) or PFO. Most people never know they have it, because a PFO doesn't cause any signs or symptoms. For the most part, the condition is harmless.