TIME Heart Disease

Americans Are Having Fewer and Fewer Strokes

Blood pressure check-up
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In the last two decades the stroke rate among Americans has dropped, and those that do have strokes have a lower risk of dying from then than they did in the past.

In a new study, researchers followed 14,357 Americans who were stroke-free in 1987 until 2011. They found a 24% overall drop in first-time strokes in each of the last two decades and an overall 20% decline per decade in deaths after stroke. The authors note that progress in stroke rates was primarily seen in the over-65 age group and stressed the continued need to lower the number of strokes in younger people.

The study, published in the Journal of the American Medical Association (JAMA), reports that the declines can be credited to better control over risk factors like blood pressure, getting people to quit smoking, and the fact that so many Americans are on cholesterol-controlling statins.

There’s still concern, however, over the high number of Americans suffering from obesity and type 2 diabetes, since both can increase the risk for stroke. About a third of American adults are obese, and if trends continue, one in three Americans will have a form of diabetes by 2050, according to CDC data. Considering already about 80,000 people in the U.S. have a stroke each year, the number still needs to drop, and addressing all risk factors is one way to get Americans’ overall health in check and continue to lower the stroke rate.

TIME Stroke

This Microwave Helmet Can Sense Strokes

Scientists have invented a helmet that can detect the occurrence and type of a stroke by bouncing microwaves off the brain

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Scientists in Sweden have invented a helmet that can identify whether a person has experienced a stroke, the BBC reports.

The headwear can further determine what kind of a stroke has occurred, allowing doctors to quickly diagnose and treat patients.

The helmet works by bouncing microwaves off a person’s brain and identifying whether there’s a bleed or a clot within it. Initial tests, involving 45 patients, proved successful. The helmet’s inventors now plan to roll the device out to ambulance teams and eventually put the technology in pillows as well.

At present, doctors treating stroke victims need to determine whether a clot or a leaking blood vessel caused the stroke. A CT scan is able to show this, but CT scanners aren’t available in every hospital and a scan can take time to set up. Delays in stroke treatment can be serious — brain tissue can begin to die if more than four hours passes between a stroke and treatment. The microwave helmet could reduce such delays, though researchers say more testing is required.

Some doctors have suggested that the helmet won’t completely replace other forms of diagnosis.

Dr. Shamim Quadir from the UK’s Stroke Association said that “while this research is at an early stage, microwave-based systems may become a portable, affordable, technology that could help rapidly identify the type of stroke a patient has had, and get them treated faster.”

[BBC]

 

TIME medicine

FDA Clears the Way for New Blood-Clot Medication

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A microscopic view of blood clotting inside an artery. Getty Images

Zontivity, a new drug from Merck, can be used to reduce the risk of stroke or cardiovascular death and treat patients who have suffered a heart attack

The FDA gave the go-ahead to a new drug on Thursday that can be used to inhibit blood clots.

The new medication, which reduces the risk of heart attacks and strokes, is produced by American pharmaceutical manufacturer Merck & Co. and will be sold under the name Zontivity.

“In patients who have had a heart attack or who have peripheral arterial disease, this drug will lower the risk of heart attack, stroke and cardiovascular death,” said Ellis Unger, director of the FDA’s Office of Drug Evaluation I.

However, like other blood-clot inhibitors, Zontivity increases the risk of bleeding by hindering platelets in the blood from clustering together. For these reasons, the FDA advises patients who have suffered from a stroke or traumatic head injury to avoid the medication.

The approval of the drug was reportedly delayed over safety concerns due to fatal bleeding in patients who were given the medication during clinical trials, according to Reuters.

TIME

States That are Cheating Death

Where you live can help determine how long you'll live.

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The only sure things in life are death and taxes, and now your home state might control both of them. A report in the Center for Disease Control’s Morbidity and Mortality Weekly Report this week analyzed premature deaths from the five leading causes – heart disease, cancer, lower respiratory illnesses, stroke and unintentional injuries – by state and found that 40% of them were preventable.

The fact that we can do better in avoiding early death isn’t news, given that we’re fond of some unhealthy habits, including smoking, eating lots of fat, sugar and salt and not exercising enough, but what’s surprising is that where you live plays such a large role in determining how likely you are to die early from a preventable cause. Living in states in the southeast, for example, can increase your chances of dying prematurely from each of the five leading causes than living in certain western states. Different regional lifestyles certainly play a part, but the availability of health-related programs such as screening for cancer and blood pressure, and safe places to exercise, can also help to bring preventable death rates down. Living healthy is half the battle in avoiding an early death, and living in the right state can be the other.

TIME

Researchers Are Going to Dose 18,000 Volunteers With Little Chocolate Pills

Chocolate bars heap
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Rest of the world dies of envy

Researchers will feed intense concentrations of chocolate to thousands of volunteers to see if it improves their heart health.

No, this isn’t a chocoholic’s fever dream, this is a three year study just launched by the National Heart, Lung and Blood Institute and chocolate-maker Mars Inc.

According to AP, the study expands on previous research of cocoa flavanols, the essential nutrients in dark chocolate, which have been shown to lower the risk of strokes and heart attacks.

Lest anyone think about self-medicating in the name of science, researchers caution that the pills also strip out sugar and fat. They also contain concentrations of chocolate nutrients that no one could get from regular candy bars without bursting.
[AP]

TIME Pregnancy

Increased Risk of Blood Clots Lasts 12 Weeks After Pregnancy, Not Just Six

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New research shows that women are at risk of stroke or heart attack after giving birth for longer than doctors originally thought

Women have a heightened risk of blood clots for 12 weeks following birth, twice as long as doctors originally believed, according to new research. Blood clots can cause problems such as stroke or heart attack.

The head of the study, Dr. Hooman Kamel, presented the new research, published online in the New England Journal of Medicine, on Thursday at the American Heart Association stroke conference. Women are more prone to blood clots after giving birth because blood components increase during labor to prevent too much bleeding. As a result, blood from the legs has more trouble traveling to the heart. If clots in the legs travel to the lungs, they can be fatal. Strokes are rare after pregnancy, but result in death about 10% of the time.

Doctors sometimes prescribe blood thinners to women at high risk of blood clots for six weeks after pregnancy, but the new study suggests that isn’t long enough. The study followed 1.7 million California women who gave birth to their first child. Over the next year and a half, 1,015 of them developed clots — 248 of whom had strokes and 47 of whom had heart attacks. The risk of blood clot was 11 times greater in the first six weeks and more than two times greater for the six weeks following that.

TIME Heart Disease

As Temperatures Dip, Risk of Stroke Rises

Young woman about to cross the street in snow
Jose Luis Pelaez—Getty Images

Colder weather linked to more deaths, but more research needed to understand connection

Changes in temperature may impact stroke risk, hospitalization, and even death from stroke, new research says.

Major changes in temperature and humidity could be linked to more hospitalizations from stroke, researchers say. In their study, which was presented at the American Stroke Association’s International Stroke Conference in San Diego, the researchers also found that colder temperatures were linked to more hospital stroke deaths. With every 1°F increase in temperature, there was a 0.86% decrease in likelihood of being admitted to a hospital for a stroke, and a 1.1% decrease in dying from a stroke.

To come up with these findings, the researchers look at more than 134,500 people sent to hospitals between 2009 and 2010 for a stroke. They then compared the stroke cases and outcomes to temperature data for that time period.

The mechanics behind the trend are not fully understood, but in an interview with the Associated Press, researchers said that our blood vessels constrict in cold weather and this can raise blood pressure and add stress to the body, which makes blood more likely to clot. High humidity can also cause dehydration, which leads to an increased risk for clotting and stress.

More research is needed to confirm the findings, but the researchers say that the people at risk for stroke may want to protect themselves from exposure to massive changes in temperature and humidity.

TIME Women's Health

First Stroke Guidelines for Women Created

Strokes are the third leading cause of death for women in the U.S.
Strokes are the third leading cause of death for women in the U.S. Jaime Monfort—Getty Images

Hormonal changes caused by pregnancy or birth control are factors in the third leading cause of death for females, the American Heart Association reports

The American Heart Association outlined Thursday its first ever guidelines for primary care provider sand OBGYNs developed specifically to prevent women’s strokes, the third leading cause of death for U.S. women, and the fifth leading cause for men.

Stroke risk factors for both men and women include high blood pressure, high cholesterol, and smoking, but certain hormonal changes can reportedly increase a woman’s risk.

“If you are a woman…your risk is also influenced by hormones, reproductive health, pregnancy, childbirth and other sex-related factors,” said Cheryl Bushnell, M.D., M.H.S., author of the new scientific statement published in the American Heart Association journal Stroke.

According to the guidelines, women with a history of high blood pressure before pregnancy are at risk for preeclampsia, a blood pressure disorder that occurs during pregnancy. Preeclampsia doubles the risk for stroke and increases the risk for high blood pressure four-fold, according to the guidelines.

The combination of high blood pressure and birth control use can also raise a woman’s risk for stroke. Migraines with aura, diabetes, depression, and emotional stress, which occur more frequently among women, are also contributing factors.

MONEY Health Care

How to Navigate a Medical Crisis

photo: jason hindley

After a diagnosis of a serious illness, you need to tend to your finances as well as your recovery.

When you or a family member is faced with a potentially life-threatening illness, a speedy recovery is your No. 1 concern.

Getting the best treatment, though, isn’t the only critical task ahead. You’ll have to master the nuances of your health insurance coverage, arrange for time away from the office, and find slack in your budget for the inevitable out-of-pocket costs. A serious condition such as cancer or heart disease can cost you thousands, even with health insurance.

To keep your finances healthy while you mend, take these three crucial steps right away.

Fight for more coverage

Research shows that patients have better outcomes with experienced surgeons who repeatedly perform a procedure, says Miles Varn, chief medical officer at PinnacleCare, a service that helps workers navigate complex illnesses.

But what if the most seasoned specialists are not in your insurance network? Going outside it could be costly.

Not only must you typically meet a separate out-of-network deductible, but your yearly out-of-pocket maximum can be high; both are usually about double the in-network thresholds, says Sunit Patel, a senior benefits consultant at Fidelity.

Plus, co-insurance is higher, and your insurer will reimburse you based on what it considers a reasonable charge, not what the doctor bills; in-network, the rate is pre-negotiated.

To keep costs in check if you go out of network, negotiate. First find out what the in-network rate is for your treatment — ask your insurer or look up what’s typical in your area at healthcarebluebook.com. Then see if your doctor is willing to take the in-network rate. Many are.

You can also appeal to your insurer to cover an out-of-network provider as an insider. For the best chance at success, show that no specialists in your area focus solely on your condition, or none have researched or performed the procedure as frequently as your top choice has, says Pat Palmer, founder of Medical Billing Advocates of America.

Speak up about your care

One in seven diagnoses is incorrect, according to a report in The American Journal of Medicine. Your insurer is likely to pay for a second opinion. So take advantage of that, even if you think the world of your doctor.

When you sit down with a physician, don’t be afraid to talk money. In a recent study, researchers at Duke Cancer Institute found that when patients raised financial concerns, more than half felt the conversation lowered their costs.

“Some patients are afraid if they bring up cost they’ll get a lesser-quality treatment, but it doesn’t mean care will be inferior,” says lead author Yousuf Zafar. See if care can be tailored to what your insurance covers, or ask what alternatives cost less. For example, says Zafar, “a colon cancer patient taking an oral chemotherapy pill may be able to switch to an IV form of the same drug for much less.”

Get your office involved

A serious illness can make doing your job tough: The median time away from work — for patients or spouses — is two months, a survey by Sun Life Financial found.

You may want to stay tightlipped until you have a clear idea of your treatment, says Jessie Gruman, author of AfterShock, a guide to coping with a devastating diagnosis, but speak up before your performance suffers. You, or a caregiver in your immediate family, are entitled to 12 weeks of unpaid leave under the Family and Medical Leave Act, provided the firm has 50 or more workers.

Most large firms go beyond that and offer three to six months of paid leave. You may start at 100% of your salary, then ratchet down to 75% or so, depending on how long you’ve been at the job or how much time you need, says Rich Fuerstenberg, a Mercer benefits consultant.

Your company may offer other help. At a small but growing number of firms, an outside doctor can review your case for free. More than 80% of big firms have employee assistance programs, which can connect you with local resources such as in-home help. If you’re anxious or depressed, EAPs will typically arrange for three to eight free counseling visits and unlimited phone support. In tough times, that’s an invaluable perk.

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