Tag Archives: stroke

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

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.

Mediterranean Diet Prolongs Life Even If You Have Existing Cardiovascular Disease

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.

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

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.

Heart-Healthy Lifestyle Also Cuts Cancer Risk By Half

…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.

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.