Tag Archives: stroke

Stroke Falls to 5th Leading Cause of Death in U.S.

Posted on December 6, 2015 | Comments Off on Stroke Falls to 5th Leading Cause of Death in U.S.

For most of my medical career, stroke was the third leading cause of death in the U.S., behind heart disease and cancer. Just a few years ago, chronic lower respiratory tract disease surpassed stroke.

Stroke continues to fall in rank and fell recently to fifth place, overtaken by accidents (unintentional injuries).

Even non-fatal strokes can be devastating.

Reduce your risk of stroke by maintaining normal blood pressure, not smoking, exercise regularly, living at a healthy weight, limiting your alcohol consumption, don’t get diabetes, and limit your age to 55. It’s also important to seek medical attention if you have a TIA (transient ischemic attack).

I also think the Mediterranean diet helps.

Steve Parker, M.D.

Steve Parker MD, Advanced Mediterranean Diet

Two diet books in one

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Mediterranean Diet Linked to Lower Stroke Risk in Women

Posted on February 14, 2015 | Comments Off on Mediterranean Diet Linked to Lower Stroke Risk in Women

…but we knew that already. A new study involving California teachers confirmed prior findings. The Mediterranean diet reduced ischemic stroke risk by up to 18%. Ischemic strokes are your typical strokes, much more common than bleeding in the brain (hemorrhagic strokes).

Stroke is the 4th or 5th leading cause of death in the U.S. Why not lower your risk by following the Mediterranean diet?

MedPageToday has the details.

Steve Parker, M.D.

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Mediterranean Diet Prolongs Life Even If You Have Existing Cardiovascular Disease

Posted on November 16, 2013 | 2 comments
More evidence in favor of the Mediterranean diet as the healthiest around

More evidence in favor of the Mediterranean diet as the healthiest around

We’ve known for years that the Mediterranean diet helps prolong life and prevent heart attacks, cancer, and strokes in folks who start out healthy.

What about patients with existing cardiovascular disease? I’m talking about history of heart attacks, strokes, angina, and coronary artery disease.

Yep. The Mediterranean diet helps them live longer, too.

Details of the study are at the American Journal of Clinical Nutrition. The research was done at Harvard.

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Taking Care of Your Gums May Help Your Heart

Posted on November 3, 2013 | Comments Off on Taking Care of Your Gums May Help Your Heart

…according to an article at University Herald.

The idea is that nasty bacteria around your gums somehow cause arterial inflammation in your heart arteries, which could lead to heart attacks. I’ve written about this before.

A quote from the article:

The researchers followed 420 adults as part of the Oral Infections and Vascular Disease Epidemiology Study (INVEST), a randomly sampled prospective cohort of Northern Manhattan residents. Participants were examined for periodontal infection. Overall, 5,008 plaque samples were taken from several teeth, beneath the gum, and analyzed for 11 bacterial strains linked to periodontal disease and seven control bacteria. Fluid around the gums was sampled to assess levels of Interleukin-1β, a marker of inflammation. Atherosclerosis in both carotid arteries was measured using high-resolution ultrasound.

Over a median follow-up period of three years, the researchers found that improvement in periodontal health-health of the gums-and a reduction in the proportion of specific bacteria linked to periodontal disease correlated to a slower intima-medial thickness (IMT) progression, and worsening periodontal infections paralleled the progression of IMT. Results were adjusted for potential confounders such as body mass index, cholesterol levels, diabetes, and smoking status.

Thickening of the arterial lining is linked to higher rates of heart attack and stroke.

It remains to be seen whether alteration of gum bacteria and periodontal disease via oral self-care and dental care will reduce cardiovascular risk going forward. Stay tuned.

Read more at http://www.universityherald.com/articles/5322/20131101/brushing-your-teeth-could-prevent-heart-disease.htm#rvx294vC7VKJ6Qu3.99

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Arsenic Linked to Heart Disease and Stroke

Posted on September 23, 2013 | Comments Off on Arsenic Linked to Heart Disease and Stroke

…according to an article at MedPageToday. What kind of heart disease? Coronary artery disease.

The quote the president-elect of the American Heart Association: 

But, he cautioned, “it’s very important to realize that the absolute level of risk is still far lower than what has been seen with high blood pressure, diabetes, cigarette smoking, or cholesterol elevation.”

 

“I would not want folks to say if we simply reduced the arsenic in our drinking water, we’d get rid of coronary heart disease,” he told MedPage Today. “It’s not that simple.”

 

The article is based on a study of 3,500 American Indians in three states. Whether results apply to other ethnic groups is unknown.

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Heart-Healthy Lifestyle Also Cuts Cancer Risk By Half

Posted on March 19, 2013 | 1 comment

…according to a report in MedPageToday.

I'm still not convinced that severe sodium restriction is necessary or even possible for most people

I’m still not convinced that severe sodium restriction is necessary or even possible for most people

The American Heart Association has published guidelines aiming to reduce premature death and illness caused by cardiovascular diseases such as heart attacks, high blood pressure, and strokes.

The guidelines focus on seven factors critical to cardiovascular health:

  • smoking
  • blood sugar
  • blood pressure
  • physical activity
  • total cholesterol
  • body mass index (BMI)
  • ideal diet

Using data from the Atherosclerosis Risk In Communities study (almost two decades’ follow-up), researchers found that those who maintained goals for six or seven of the American Heart Association critical factors had a 51% lower risk of cancer compared with those meeting no goals.

For detailed information about the specific goals, click here.

As you might expect, I was curious about what the American Heart Association considered a heart-healthy diet.  I quote the AHA summary:

The recommendation for the definition of the dietary goals and metric, therefore, is as follows: “In the context of a diet that is appropriate in energy balance, pursuing an overall dietary pattern that is consistent with a DASH [Dietary Approaches to Stop Hypertension]-type eating plan, including but not limited to:

  • Fruits and vegetables: ≥ 4.5 cups per day
  • Fish: ≥ two 3.5-oz servings per week (preferably oily fish)
  • Fiber-rich whole grains (≥ 1.1 g of fiber per 10 g of carbohydrate): ≥ three 1-oz-equivalent servings per day
  • Sodium: < 1500 mg per day
  • Sugar-sweetened beverages: ≤ 450 kcal (36 oz) per week

Intake goals are expressed for a 2000-kcal diet and should be scaled accordingly for other levels of caloric intake. For example, ≤ 450 calories per week represents only up to one quarter of discretionary calories (as recommended) coming from any types of sugar intake for a 2000-kcal diet.

Diet recommendations are more complicated than that; read the full report for details.  Only 5% of study participants ate the “ideal diet.”  The Mediterranean diet easily meets four out of five of those diet goals; you’d have to be extremely careful to reach the sodium goal on most any diet.

Cardiovascular diseases and cancer are among the top causes of death in Western societies.  Adhering to the guidelines above may kill two birds with one stone.

Steve Parker, M.D.

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Posted in Cancer, Coronary Heart Disease, Diet-Heart Hypothesis, Exercise, Heart Disease, High Blood Pressure

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High Adiponectin May Not Protect Against Stroke and Heart Disease After All

Posted on March 19, 2013 | Comments Off on High Adiponectin May Not Protect Against Stroke and Heart Disease After All

I’ve written in the past about adiponectin, a hormone-like protein that may help protect against disease.  Obese folks have less of it.  However, a new study published in Obesity Reviews found no protection against stroke and coronary heart disease (like heart attacks) in people with higher levels of adiponectin.

Read the abstract.

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Berry Science, or Berriology

Posted on September 18, 2012 | 2 comments

Mmm, mm, good! And they’re low carb

The Mediterranean diet was originally found to be a healthy diet by comparing populations who followed the diet with those who didn’t.  The result?  Mediterranean dieters enjoyed longer lifespans and less heart disease, cancer, strokes, diabetes, and dementia.

Over the last 15 years, researchers have been clarifying exactly how and why this might be the case.  A study from Finland is a typical example.

The traditional Mediterranean diet provides an abundance of fresh fruit, including berries.  Berries are a rich source of vitamin C and polyphenols, substances with the potential to affect metabolic and disease processes in our bodies.

The Finnish researchers studied 72 middle-aged subjects, having half of them consume moderate amounts of berries, and half consume a placebo product over 8 weeks.  Compared with the placebo group, the berry eaters showed inhibited platelet funtion, a 5% increase in HDL cholesterol (the “good” cholesterol), and a 7-point drop in systolic blood pressure.

What does platelet function have to do with anything?  Platelets are critical components of blood clots.  Blood clots can stop life-threatening bleeding, but also contribute to life-threatening strokes and heart attacks.  Inhibition of platelet function can decrease the occurence of blood clots that cause heart attacks and strokes.  That’s why millions of people take daily aspirin, the best known platelet inhibitor.

Cardiovascular disease is a group of conditions that include high blood pressure, heart attacks, poor circulation, and strokes.  Berry consumption in this small Finnish study resulted in favorable changes in blood pressure, HDL cholesterol, and platelet function.  These changes would tend to reduce the occurence and severity of cardiovascular disease.

So berries don’t just taste good, they’re good for us.  If price is a concern, focus on the berries that are in season or use frozen berries.

Steve Parker, M.D.

Reference: Erlund, I., et al, Favorable effects of berry consumption on platelet function, blood pressure, and HDL cholesterol.  American Journal of Clinical Nutrition, 87 (2007): 323-331.

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Fat or Fit: Which Is Healthier?

Posted on August 25, 2012 | Comments Off on Fat or Fit: Which Is Healthier?

Men live longer if they improve or maintain their fitness level over time, according to research out of the Cooper Clinic in Dallas, Texas. Part of that improved longevity stems from reduced risk of death from cardiovascular disease such as heart attack and stroke.

Compared with men who lose fitness with aging, those who maintained their fitness had a 30% lower risk of death; those who improved their fitness had a 40% lower risk of death. Fitness was judged by performance on a maximal treadmill exercise stress test.

Body mass index over time didn’t have any effect on all-cause mortality but was linked to higher risk of cardiovascular death. The researchers, however, figured that losses in fitness were the more likely explanation for higher cardiovascular deaths. In other words, as men age, it’s more important to maintain or improve fitness than to lose excess body fat or avoid overweight.

Steve Parker, M.D.

Reference: Lee, Duck-chul, et al. Long-term effects of changes in cardiorespiratory fitness and bodly mass index on all-cause and cardiovascular disease mortality in men. Circulation, 124 (2011): 2,483-2,490

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Mediterranean Diet Cuts Stroke Risk In Women

Posted on May 24, 2012 | Comments Off on Mediterranean Diet Cuts Stroke Risk In Women

The journal Circulation in 2009 reported that the Mediterranean diet reduces risk of stroke in women by 13%. This supplements our prior knowledge that the healthy diet is associated with lower risk of coronary heart disease in both men and women.

Researchers in Boston analyzed the records of 74,886 middle-aged women in the Nurses’ Health Study to deteremine how closely they followed a Mediterranean diet pattern. They followed participants’ health status for 20 years, noting how many women developed stroke, coronary heart disease, and “cardiovascular death” (fatalities from strokes and coronary heart disease combined).

Compared with the women who adhered minimally to the Mediterranean diet pattern, the women with highest compliance had 13% fewer strokes. Consistent with earlier studies, the Mediterranean dieters had 39% lower risk of cardiovascular death and 29% lower risk for coronary heart disease (again, comparing the women with highest and lowest compliance).

Take-Home Points

To gain the health benefits of the Mediterranean diet, consider making changes to the way you eat.

Here are the characteristics of the traditional Mediterranean diet:

  • It maximizes natural whole foods and minimizes highly processed ones
  • Small amounts of red meat
  • Less than four eggs per week
  • Low to moderate amounts of poultry and fish
  • Daily fresh fruit
  • Seasonal locally grown foods with minimal processing
  • Concentrated sugars only a few times per week
  • Wine in low to moderate amounts, and usually taken at mealtimes
  • Milk products (mainly cheese and yogurt) in low to moderate amounts
  • Olive oil as the predominant fat
  • Abundance of foods from plants: vegetables, fruits, beans, potatoes, nuts, seeds, breads and other whole grain products

Steve Parker, M.D.

Reference: Fung, Teresa, et al. Mediterranean diet and incidence of and mortality from coronary heart disease and stroke in women. Circulation, 119 (2009): 1,093-1,100.

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