News Briefs: Stroke Risk Factors; Shingles Vaccine Recommendations; DASH Diet

Risk Factors for Stroke on the Rise

Researchers have found a significant increase in the percentage of people with stroke who have high blood pressure, diabetes, smoking, and other risk factors for stroke. According to study author Fadar Oliver Otite, MD, University of Miami Miller School of Medicine, an estimated 80 percent of all first strokes are due to risk factors that can be changed, such as high blood pressure, and many efforts have been made to prevent, screen for and treat these risk factors. “Yet we saw a widespread increase in the number of stroke patients with one or more risk factors,” says Dr. Otite. “These alarming findings support the call for further action to develop more effective methods to prevent and control these risk factors to reduce stroke risk.” For the study, researchers examined a public database of U.S. hospitalizations, and identified 922,451 adult hospitalizations for ischemic stroke between 2004 and 2014. An ischemic stroke is caused by a blockage in a blood vessel, such as a blood clot. Of those stroke cases, 93 percent of people had one or more risk factors, which increased from 88 percent in 2004 to 95 percent in 2014. The prevalence of high cholesterol more than doubled during the study period, from 29 percent to 59 percent; diabetes increased from 31 percent to 38 percent and high blood pressure increased from 73 percent to 84 percent. And the prevalence of drug abuse doubled, from 1.4 percent to 2.8 percent. Dr. Otite says that while we have made great strides in reducing the proportion of people who die from stroke, we still have progress to make on preventing stroke and better controlling these risk factors. The study appeared in the Oct. 11, 2017, online issue of Neurology, the medical journal of the American Academy of Neurology.

New Shingles Vaccine Recommendations

The FDA has approved a new shingles vaccine, Shingrix, that the CDC says is better than a zoster vaccine (such as Zostavax), the vaccine that has been in use for 10 years. Shingrix is recommended for people age 50 and older and in some cases for those who previously received a zoster vaccine. Shingles is caused by the reactivation of the varicella zoster virus (VZV), the same virus that causes chickenpox. Nearly all older adults have the VZV dormant in their nervous system.As people age, the ability of the immune system to resist reactivation of VZV decreases. Shingles typically presents as a painful, itchy rash that develops on one side of the body and can last for two to four weeks. The pain associated with shingles is often described as burning, shooting or stabbing. Even once the rash is gone, a person can experience postherpetic neuralgia (PHN). This pain lasts at least three months and may persist for several years. PHN is the most common complication of shingles, occurring in 10 to 18 percent of all shingles cases. There are an estimated 1 million cases of shingles in the United States each year. One in three Americans will develop shingles in their lifetime. The risk increases to one in two for adults aged 85 years and older. Shingrix has been found to be about 90 percent effective across all age groups. That is higher than Zostavax, which is about 60 percent effective in people in their 60s and only 40 percent effective in people over age 70. However, temporary side effects (fever, muscle pain) are reportedly higher with Shingrix.

DASH Diet Ranked as Best Diet Overall

For the eighth consecutive year, U.S. News and World Report ranked the National Institutes of Health-developed DASH Diet “best overall” diet among the nearly 40 it reviewed. The announcement came just as new research suggests that combining DASH, or Dietary Approaches to Stop Hypertension, with a low-sodium diet has the potential to lower blood pressure as well as or better than many anti-hypertension medications.

With its focus on vegetables, fruits, whole grains, low-fat dairy, and lean proteins, DASH tied this year for “best overall” diet and was ranked No. 1 in the “healthy eating” and “heart disease prevention” categories. Previous research has shown that people who follow the DASH diet may be able to quickly reduce their blood pressure by a few points in as little as just two weeks. Over time, their systolic blood pressure (the top number in a blood pressure reading) could drop by eight to 14 points, which significantly reduces the risk of cardiovascular disease.

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