Stroke Archive

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.

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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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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.

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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.

Lifestyle improvements, such as quitting smoking and exercising more, can reduce your risk of a stroke.

A stroke may seem like a sudden, uncontrollable event — a lightning strike out of the blue. But in reality, stroke risk often builds over time, and many strokes are preventable. A study published in the May 2020 issue of Stroke found not only that lifestyle changes can help you head off a potential stroke, but also that you can still reduce your risk even if you don't make these changes until later in life.

"What is novel about our study is that we found that even in middle-aged women, changing lifestyle has a large effect on preventing stroke," says Dr. Goodarz Danaei, senior author of the study and the Bernard Lown Associate Professor of Cardiovascular Health at the Harvard T.H. Chan School of Public Health. "Even in the sixth decade of life, lifestyle changes can still prevent up to a quarter of all strokes." The average age in women for a first stroke is 75.

Do you struggle with decisions? These strategies can help you make good choices more efficiently.

We make countless choices every day. Most are the mundane variety: what to eat, what to wear, what movie to watch. But often our decisions (or lack thereof) have a significant impact on our well-being.

Poor decision making is often a consequence of natural cognitive decline. This can cloud people's judgment about what is the right course of action or make it harder to weigh multiple options. The result is that people make questionable choices, or they feel overwhelmed and don't make any decision, which is sometimes even worse.

If you haven't made a video call yet, give it a try to fight isolation.

When much of the world began lockdowns to battle coronavirus in March 2020, many people turned to video calls to fight off the loneliness that often accompanies social isolation. Tech companies reported that the use of video calls for socializing surged by as much as 80%, enabling people to "see" family and friends. But it doesn't take a lockdown to warrant the use of this technology.

The epidemic of loneliness and isolation

Loneliness affects more than a third of older Americans. Another third of older adults feel isolated: they may be living alone, lack transportation, or live far from loved ones. Or they may have outlived a spouse or friends.

An analysis of multiple studies looking at the relationship between high blood pressure and cognitive health –– abilities like thinking, memory, and attention –– found that older people who lower high blood pressure are slightly less likely to develop cognitive impairment or dementia.

Research we're watching

Eating a vegetarian diet may lower your risk of stroke, according to a study in the March 17 issue of Neurology.

The study included two groups of people from Buddhist communities in Taiwan, where vegetarian diets are encouraged. About 30% of the more than 130,000 participants were vegetarian, meaning they didn't eat any meat or fish. Their average age was 50, and none had a prior stroke.

Research we're watching

People with clogged arteries in their hearts (coronary artery disease) or legs (peripheral artery disease) face a high risk of having a heart attack or stroke, particularly if they also have diabetes. For such people, a combination of clot-preventing drugs lowers the risk of those dangerous outcomes, according to a study published online March 28 by the journal Circulation.

The study included just over 18,300 people with coronary or peripheral artery disease; about 38% also had diabetes. They all took low-dose aspirin daily, but half also took 2.5 milligrams of rivaroxaban (Xarelto) twice daily while the others took a placebo. Like aspirin, rivaroxaban helps discourage blood clots, but through a different mechanism.