Stroke Archive

For people at high risk of diabetes who also have (or are prone to) heart disease, a daily walk may lower their risk of cardiovascular events, according to a study in The Lancet.

The findings are based on data from 9,306 people who took part in a larger study to evaluate two medications. Participants were required to follow a low-fat diet, get regular exercise, and track their steps with a pedometer at the beginning of the study (the baseline) and after one year.

The grief of losing a spouse or partner affects not just emotional and mental health, but physical health as well. The surviving spouse or partner often develops health problems in the weeks and months that follow. A study published this week in JAMA Internal Medicine found that individuals who had lost a spouse or partner were more likely to have a heart attack or stroke within the next 30 days. Grief activates the sympathetic nervous system, which is responsible for revving up the body’s fight-or-flight response. That can lead to stress-induced changes in blood pressure, heart rate, and blood clotting. There is also a tendency after such a profound loss for the surviving spouse or partner to disregard his or her own health. It can take several months to a year to work through grief and grieving. If it lasts much longer, and is interfering with daily life—seeing friends, doing once-pleasurable activities—it’s possible that grief has morphed into something more serious, like depression.

Over the past decade, ads touting testosterone therapy to treat low energy and a flagging libido in men have fueled a rapid rise in prescriptions for the hormone. Short-term studies suggest that testosterone therapy boosts bone mass, strength, and sexual function and improves some markers of heart disease risk. But concerns about the long-term safety of testosterone treatment (available as a gel, patch, or shot) linger, particularly after a 2010 study of testosterone in frail, older men was stopped early because of cardiovascular problems among the testosterone users.

Now, findings from a study of 8,700 male veterans with low testosterone add to the concern. Men who used testosterone therapy had a 30% higher risk of heart attack, stroke, or death over a three-year period than men who didn't use testosterone. The men, who were in their early 60s on average, had all undergone a heart imaging test, and most had risk factors for heart problems. Testosterone might boost heart risks by encouraging the formation of dangerous blood clots, say the authors, whose article appeared in The Journal of the American Medical Association.

The science leans toward more aggressive use of statin drugs to prevent heart problems, but medication is not a "must do."

Doctors have a new roadmap for preventing heart attacks, strokes, and other harmful outcomes of cardiovascular disease. The guidelines, released by experts with the American Heart Association and American College of Cardiology in November 2013, are the first update in more than a decade. "The guidelines provide a simplified approach to reducing cardiovascular risk," says Dr. Joanne Foody, an expert in preventive cardiology at Harvard-affiliated Brigham and Women's Hospital.

Key treatments for both diseases—exercise and medications—demand extra attention and planning

Many people with heart disease—nearly 60%—also deal with painful joint damage due to arthritis. Coping with both conditions together poses some special challenges, especially with regard to exercise and medications.

Should you be taking it? If so, when, how much, and what kind?

New guidelines may expand female candidates for these cholesterol-lowering drugs.

Statins are potent cholesterol-lowering drugs. However, they also have other effects that protect against heart attack and stroke. For that reason, new Guidelines released November 12 from the American College of Cardiology and the American Heart Association have broadened recommendations for use of these medicines. Cholesterol levels no longer are the main factor. As a result, if you're not taking a statin drug now, you may be advised to start.

Q. I'm a healthy 58-year-old man recently diagnosed with high blood pressure. My doctor prescribed metoprolol, and my blood pressure is now in the normal range. But I've started having trouble getting an erection. Could the medication be causing this problem, and if so, is there anything I can do about it?

A. Metoprolol belongs to a class of drugs known as beta blockers, which make the heart beat slower and with less force. In the past, doctors prescribed beta blockers as a first-choice treatment for high blood pressure.

Q. During a recent appointment, my cardiologist heard a sound in my neck and sent me for an ultrasound, which showed a narrowing in my carotid artery. The doctor said this means I'm at risk for a stroke. Because I'm already taking all the right medicines, his only recommendation was getting another ultrasound in a year. But if the narrowing gets worse and I have a stroke, won't that be too late?

A. The carotid arteries, found on either side of the neck, are the main supply route for blood to reach the brain. If cholesterol-laden plaque clogs one of these arteries, it sometimes produces a distinctive sound (called a bruit [BROO-ee]) that a doctor can detect with a stethoscope. That finding usually prompts an ultrasound.

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