Stroke Archive

Q. I'm 82 and a landscape painter. Lately the sight in my right eye seems to be affecting my painting, although I can still see well enough to read small print and drive. I have a cataract in that eye. Should I have cataract surgery?

A. A cataract is a thickening and cloudiness of the lens of the eye that is more common as we age. If your eye doctor has recommended that you have the cataract removed, then yes, you should have the surgery, especially if your vision is impaired. The surgery involves taking your lens out and replacing it with an artificial one. Being able to see more clearly will not only help your painting, but it will also reduce your risk of falling. There is even some evidence that people who have cataracts removed live longer than those who don't, possibly because their improved vision allows them to participate more fully in life.

Harvard scientists are getting international attention for their work with breakthrough technology that can edit genes in living cells. Five Harvard experts—Dr. George Church of Harvard Medical School, and Drs. Keith Joung, David Liu, Kiran Musunuru, and Derrick Rossi, all of Harvard University—were featured speakers in the first-ever CRISPR Congress, held in Boston in February 2015. CRISPR stands for clustered regularly interspaced short palindromic repeats. These are segments of genes that contain repeating sequences of DNA.

The Harvard experts spoke to other scientists about CRISPR, which holds the potential to repair gene mutations, fight disease, and improve food supplies. Harvard researchers have demonstrated that CRISPR may be able to lower cholesterol levels, correct gene mutations, and block HIV infection. "Suddenly anyone can edit any piece of any DNA a thousand times more easily and precisely than before, which is game-changing for gene therapies, organ transplantation, aging reversal, and malaria," says Dr. Church.

Hidden causes of shortness of breath can make the problem tricky to treat.

High blood pressure is one of the many health risks associated with not getting enough sleep, which is often caused by insomnia, or difficulty falling or staying asleep. Although often considered a nighttime problem, some people with insomnia may be in a state of "hyperarousal" that also makes it hard for them to nod off during the day. Now, new research suggests that people with chronic insomnia who also have trouble napping face a higher risk of high blood pressure.

The study, in the March 2015 issue of Hypertension, included more than 200 people with chronic insomnia (defined as insomnia that lasts more than six months) and almost 100 normal sleepers. All underwent daytime nap tests, which measures how quickly a person falls asleep in a quiet environment during the day. People with chronic insomnia who took longer than 14 minutes to fall asleep during the nap studies had three times the risk of high blood pressure compared with normal sleepers, the researchers found. Treatments such as medications and biofeedback to help dampen hyperarousal may be best for people with this type of insomnia, they suggest, although more research is needed.

Q. I'm 68, and I had the pneumonia vaccine a few years ago. Now I hear that I need to have two different ones. Do I really need to do this?

A. For many years, men who turned 65 were told that they needed a single pneumonia shot, called Pneumovax. Now the CDC suggests that older adults get an additional vaccination with a different vaccine, called Prevnar. The combination stimulates the immune system more effectively than either alone.

The two vaccines build immunity against different types of the bacterium, known as pneumococcus, that causes pneumonia. Pneumovax (PPSV23) protects against 23 common types of pneumococcus. Prevnar (PCV13) protects against 13 types.

Uncomfortable nighttime leg sensations can spoil your sleep, but you can take steps to relieve it.

Is restless legs syndrome (RLS) the cause of your restless sleep? This exasperating condition triggers abnormal sensations in the legs and an irresistible urge to move them. It can wreak havoc with sleep, leading to daytime fatigue.

Preventing stroke is the top priority if your heart is beating irregularly. A variety of options can control symptoms.

A flutter in the chest and a racing heartbeat could be just a passing cardiac blip, perhaps triggered by emotional stress or too much caffeine. But sometimes it's a sign of atrial fibrillation—the irregular quivering of the heart's upper chambers, or atria.

Many men consider taking a daily low-dose aspirin to reduce the chance of having a heart attack or stroke. You should do so only if the chance of being helped outweighs the chance of triggering unwanted bleeding, since aspirin interferes with normal clotting. But about one in 10 men who take protective aspirin may not really qualify, according to a national study in the Journal of the American College of Cardiology.

Experts recommend that aspirin might be considered in someone whose chance of experiencing a cardiovascular problem is at least 6% in the next 10 years. At that tipping point, the chance of being helped is great enough to justify the risk of unwanted bleeding.

High blood sugar may add to mental decline in people with cardiovascular disease.

A portable ultrasound device that detects plaque buildup in arteries may offer a simple, cost-effective way to detect heart disease before it causes any symptoms. A report in the December 2014 Global Heart journal describes findings from a large-scale test of the technology in India, the United States, and Canada.

The innermost layer of an artery's wall (the intima) provides a smooth surface for blood to flow through. The middle layer (the media) contains muscle and elastic fibers that let the vessel expand and contract with each heartbeat. The thicker the intima and the media, the more likely the artery is choked with cholesterol-filled plaque. Using ultrasound, a doctor can easily measure the intima-media thickness in the arteries of the neck and upper leg.