Stroke Archive

Research we're watching

Think you're doing your heart a favor by drinking diet instead of regular soda? That may be wishful thinking, according to a research letter published Nov. 3, 2020, in the Journal of the American College of Cardiology.

Researchers studied nearly 105,000 people who filled out three 24-hour dietary recall surveys every six months. During a 10-year follow-up, researchers tracked the participants' cardiovascular health.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

Research we're watching

A drug made from a highly purified form of EPA (an omega-3 fatty acid found in fish) appears to help reduce plaque in the heart's arteries, according to a study published online Aug. 29, 2020, by the European Heart Journal. The findings may explain why the drug, icosapent ethyl (Vascepa), lowers the risk of heart attack and stroke by 26% in people at high risk for those serious problems.

The study included 80 people with fatty plaque in the arteries of the heart (coronary artery disease). Most of them had diabetes and were taking a statin. Their trigly­cerides were elevated, ranging from 135 to 499 milligrams per deciliter. Half were randomly assigned to take 4 grams of icosapent ethyl daily; the other half received a placebo.

In the journals

Scientists continue to explore the right balance of carbohydrates and fat in people's diets. But for overweight or obese older adults, a recent study found that a low-carbohydrate, high-fat diet might offer special health benefits. The results were published online Aug. 12, 2020, by Nutrition and Metabolism.

Researchers asked 40 obese adults, ages 60 to 75, to follow an eight-week diet in which 10% of calories came from carbs, 25% from protein, and 65% from fat. Carb sources included leafy greens, non-starchy vegetables, some fruit, and high-fiber grains. Protein intake consisted of eggs, fish, pork, and poultry. Fat-containing foods included olive oil, coconut oil, nut oils, nut butter, cheese, coconut milk, and avocados.

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.