stroke
An Aspirin a Day for Older People Doesn’t Prolong Healthy Lifespan
Posted on by Dr. Francis Collins
Credit: iStock/thodonal
Many older people who’ve survived a heart attack or stroke take low-dose aspirin every day to help prevent further cardiovascular problems [1]. There is compelling evidence that this works. But should perfectly healthy older folks follow suit?
Most of us would have guessed “yes”—but the answer appears to be “no” when you consider the latest scientific evidence. Recently, a large, international study of older people without a history of cardiovascular disease found that those who took a low-dose aspirin daily over more than 4 years weren’t any healthier than those who didn’t. What’s more, there were some unexpected indications that low-dose aspirin might even boost the risk of death.
Wearable mHealth Device Detects Abnormal Heart Rhythms Earlier
Posted on by Dr. Francis Collins
Caption: Woman wearing a Zio patch
Credit: Adapted from JAMA Network Summary Video
As many as 6 million Americans experience a common type of irregular heartbeat, called atrial fibrillation (AFib), that can greatly increase their risk of stroke and heart failure [1]. There are several things that can be done to lower that risk, but the problem is that a lot of folks have no clue that their heart’s rhythm is out of whack!
So, what can we do to detect AFib and get people into treatment before it’s too late? New results from an NIH-funded study lend additional support to the idea that one answer may lie in wearable health technology: a wireless electrocardiogram (EKG) patch that can be used to monitor a person’s heart rate at home.
Can Barbers Help Black Men Lower Their Blood Pressure?
Posted on by Dr. Francis Collins
Caption: Barber Eric Muhammad (left) in his barbershop taking the blood pressure of patron.
Credit: Smidt Heart Institute, Cedars-Sinai Medical Center
You expect to have your blood pressure checked and treated when you visit the doctor’s office or urgent care clinic. But what about the barbershop? New research shows that besides delivering the customary shave and a haircut, barbers might be able to play a significant role in helping control high blood pressure.
High blood pressure, or hypertension, is a particularly serious health problem among non-Hispanic black men. So, in a study involving 52 black-owned barbershops in the Los Angeles area, barbers encouraged their regular, black male patrons, ages 35 to 79, to get their blood pressure checked at their shops [1]. Nearly 320 men turned out to have uncontrolled hypertension and enrolled in the study. In a randomized manner, barbers then encouraged these men to do one of two things: attend one-on-one barbershop meetings with pharmacists who could prescribe blood pressure medicines, or set up appointments with their own doctors and consider making lifestyle changes.
The result? More than 63 percent of the men who received medications prescribed by specially-trained pharmacists lowered their blood pressure to healthy levels within 6 months, compared to less than 12 percent of those who went to see their doctors. The findings serve as a reminder that helping people get healthier doesn’t always require technological advances. Sometimes it may just involve developing more effective ways of getting proven therapy to at-risk communities.
Snapshots of Life: The Birth of New Neurons
Posted on by Dr. Francis Collins
Credit: Kira Mosher, University of California, Berkeley
After a challenging day at work or school, sometimes it may seem like you are down to your last brain cell. But have no fear—in actuality, the brains of humans and other mammals have the potential to produce new neurons throughout life. This remarkable ability is due to a specific type of cell—adult neural stem cells—so beautifully highlighted in this award-winning micrograph.
Here you see the nuclei (purple) and arm-like extensions (green) of neural stem cells, along with nuclei of other cells (blue), in brain tissue from a mature mouse. The sample was taken from the subgranular zone of the hippocampus, a region of the brain associated with learning and memory. This zone is also one of the few areas in the adult brain where stem cells are known to reside.
Does Gastric Bypass Reduce Cardiovascular Complications of Diabetes?
Posted on by Dr. Francis Collins
Thinkstock/IPGGutenbergUKLtd
For obese people with diabetes, doctors have increasingly been offering gastric bypass surgery as a way to lose weight and control blood glucose levels. Short-term results are often impressive, but questions have remained about the long-term benefits of such operations. Now, a large, international study has some answers.
Soon after gastric bypass surgery, about 50 percent of folks not only lost weight but they also showed well-controlled blood glucose, cholesterol, and blood pressure. The good news is that five years later about half of those who originally showed those broad benefits of surgery maintained that healthy profile. The not-so-good news is that the other half, while they generally continued to sustain weight loss and better glucose control, began to show signs of increasing risk for cardiovascular complications.
New Imaging Approach Reveals Lymph System in Brain
Posted on by Dr. Francis Collins
Considering all the recent advances in mapping the complex circuitry of the human brain, you’d think we’d know all there is to know about the brain’s basic anatomy. That’s what makes the finding that I’m about to share with you so remarkable. Contrary to what I learned in medical school, the body’s lymphatic system extends to the brain—a discovery that could revolutionize our understanding of many brain disorders, from Alzheimer’s disease to multiple sclerosis (MS).
Researchers from the National Institute of Neurological Disorders and Stroke (NINDS), the National Cancer Institute (NCI), and the University of Virginia, Charlottesville made this discovery by using a special MRI technique to scan the brains of healthy human volunteers [1]. As you see in this 3D video created from scans of a 47-year-old woman, the brain—just like the neck, chest, limbs, and other parts of the body—possesses a network of lymphatic vessels (green) that serves as a highway to circulate key immune cells and return metabolic waste products to the bloodstream.
Creative Minds: Exploring the Role of Immunity in Hypertension
Posted on by Dr. Francis Collins
Meena Madhur / Credit: John Russell
If Meena Madhur is correct, people with hypertension will one day pay as much attention to their immune cell profiles as their blood pressure readings. A physician-researcher at Vanderbilt University School of Medicine, Nashville, Madhur is one of a growing number of scientists who thinks the immune system contributes to—or perhaps even triggers—hypertension, which increases the risk of stroke, heart disease, kidney disease, and other serious health problems.
About one of every three adult Americans currently have hypertension, yet a surprising number don’t know they have it and less than half have their high blood pressure under control—leading many health experts to refer to the condition as a “silent killer”[1,2]. For many folks, blood pressure control can be achieved through lifestyle changes, such as losing weight, exercising, limiting salt intake, and taking blood pressure medicines prescribed by their health-care provider. Unfortunately, such measures don’t work for everyone, and some people continue to suffer damage to their kidneys and blood vessels from poorly controlled hypertension.
Madhur wants to know whether the immune system might be playing a role, and whether this might hold some clues for developing new, more targeted ways of treating high blood pressure. To get such answers, this practicing cardiologist will use her 2016 NIH Director’s New Innovator Award to conduct sophisticated, single-cell analyses of the immune systems of people with and without hypertension. Her goal is to produce the most comprehensive catalog to date of which human immune cells might be involved in hypertension.
Clot Removal: Impressive Results for Stent Retrievers in Acute Stroke
Posted on by Dr. Francis Collins
Caption: Schematic of how the clot retriever used in the reported trials is opened inside a blood vessel to surround a clot that is blocking blood flow. Once caught by the stent, the entire apparatus with the clot is removed from the body out a small puncture in the femoral artery at the groin.
Credit: Covidien
Despite the recent progress we’ve made in preventing stroke by such steps as controlling weight, lowering blood pressure, and stopping smoking, nearly 700,000 Americans suffer clot-induced, or ischemic, strokes every year [1]. So, I’m very pleased to report that, thanks to years of rigorous research and technological development, we’ve turned a major corner in the emergency treatment of this leading cause of death and disability.
The most severe strokes—those that can cause lifelong loss of independent function—are often due to blood clots that suddenly enter and block one of the main arteries supplying blood flow to the brain. No less than four large, randomized clinical trials recently reported results showing, for the first time, that using catheters to remove large clots from cerebral arteries can restore blood flow and halt further damage to the brains of patients with acute strokes. In fact, the stent-based retrievers and other mechanical approaches used to remove stroke-causing clots proved so effective, that three of the four trials were stopped early, allowing the results to be made swiftly available to medical professionals and the public.
Rare Disease Sleuths Uncover New Clues to Stroke
Posted on by Dr. Francis Collins
Caption: A variation in the gene that codes for a key blood vessel enzyme makes children prone to fevers, rash, and strokes.
Credit: Jonathan Bailey, National Human Genome Research Institute, NIH
A medical mystery that began when a 3-year-old girl came to the NIH Clinical Center here in Bethesda, MD, a decade ago has just been solved. The findings not only promise to help children suffering from a devastating rare disease, but to advance our overall understanding of stroke and other blood vessel disorders.
When researchers first met the little girl, they were baffled. She had a most unusual—and unexplained—constellation of symptoms: recurring fevers, rashes, and strokes, which, sadly, had left her severely disabled. Researchers thought the cause probably wasn’t genetic, because none of the girl’s family members were affected, plus they hadn’t seen other children with similar problems. While they searched for clues, they treated the girl with immunosuppressive drugs to reduce blood vessel inflammation and thereby lower the chance of future strokes.
MicroRNA Research Takes Aim at Cholesterol
Posted on by Dr. Francis Collins
Caption: Illustration of artery partially blocked by a cholesterol plaque.
If you’re concerned about your cardiovascular health, you’re probably familiar with “good” and “bad” cholesterol: high-density lipoprotein (HDL) and its evil counterpart, low-density lipoprotein (LDL). Too much LDL floating around in your blood causes problems by sticking to the artery walls, narrowing the passage and raising risk of a stroke or heart attack. Statins work to lower LDL. HDL, on the other hand, cruises through your arteries scavenging excess cholesterol and returning it to the liver, where it’s broken down.
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