What to eat to beat heart disease

We've known for nearly two decades, for instance, that a single fast-food meal (Sausage & Egg McMuffins were used in the original study) is enough to stiffen your arteries within hours, halving their ability to relax normally.

But the good news is that you can reverse this damaging process just as swiftly.

There have been studies of patients with advanced heart disease who switched to plant-based diets in the hope this would stop the disease progressing further. But instead, something miraculous happened: the patients' heart disease actually started to reverse.

They weren't simply slowing the condition, they were actually getting better!

It seems that as soon as they stopped eating artery-clogging diets, their bodies were able to start dissolving some of the plaque that had built up.

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Saturated fat and strokes

Another important cause of death that doesn't get mentioned often in discussions about saturated fat, is stroke... otherwise known as a cerebrovascular accident.

A stroke happens when there is a disruption in blood flow to the brain, either due to a blockage or bleeding.

Strokes are actually the second most common cause of death in the world, accounting for 6.15 million deaths in the year 2008 alone (64).

In 2008, strokes killed 6.15 million, while heart disease killed 7.25 million... judging by these numbers, stroke is almost as significant as heart disease when it comes to mortality in the population.

Observational studies show that saturated fat is associated with a significantly lower risk of stroke, although some studies show no effect (65, 66, 67, 68).

BOTTOM LINE:Consumption of saturated fat is associated with a lower risk of stroke in many studies. Stroke is the second most common cause of death worldwide.

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Sleep deprivation causes strokes

Stroke or heart disease susceptibility is dependant on how much you sleep you get, a new study has suggested.

A Warwick Medical School study has discovered that prolonged sleep deprivation can have a seriously adverse effect on cardiac health.

The research team linked a lack of sleep to strokes, heart attacks and cardiovascular disorders which can often cause early death.

Professor Cappuccio and co-author Dr Michelle Miller examined evidence from more than 470,000 participants across eight countries, including Japan, the US, Sweden and the UK.

Professor Francesco Cappuccio said: “If you sleep less than six hours per night and have disturbed sleep you stand a 48% greater chance of developing or dying from heart disease and a 15% greater chance of developing or dying from a stroke.

“The trend for late nights and early mornings is actually a ticking time bomb for our health so you need to act now to reduce your risk of developing these life-threatening conditions.”

Dr Miller added chronic short sleep produces hormones and chemicals in the body, which increases the risk of developing heart disease and strokes, plus other conditions such as high blood pressure and cholesterol, diabetes and obesity.

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Strokes...obesity...lifestyle (again)

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Stroke victims are getting younger

PREVENT A STROKE - FREE COURSE

Magnesium

Magnesium reduces women's risk of heart attacks and bone fractures as they go through the menopause, yet 11 per cent are lacking in this vital nutrient. 

As well as hot flushes, women suffer fluctuating hormones levels in mid-life, putting them at risk of heart disease and bone fractures. 

Despite magnesium supporting heart and bone health, as many as 11 per cent of menopausal women miss out on the nutrient's health benefits, according to the UK Government's National Diet and Nutrition Survey.

This is thought to be due to women undergoing restrictive diets to counter mid-life weight gain or simply not eating enough magnesium-rich pulses, nuts and green vegetables. 

As well as risking long-term health complications, such women are also missing out on magnesium's sleep-inducing and mood-boosting effects.

In a piece for Get The Gloss, London-based registered nutritionist Rob Hobson explains how simply swapping rice for quinoa or throwing a handful of spinach in a smoothie could support women through the menopause.

Why is magnesium so important? 

Magnesium is one of the most abundant minerals in the body and is required for hundreds of enzymes to work properly. 

It plays a vital role in muscle relaxation and supports the production of brain chemicals that control mood, alongside healthy blood pressure, glucose control, energy metabolism, bone health and maintaining a healthy nervous system.

Magnesium can be particularly effective during the menopause, when oestrogen levels fluctuate. 

Long-term this increases the risk of heart disease and bone weakness. Magnesium has been shown to support both heart and bone health.

It can also help with menopausal insomnia and other symptoms such as low mood.

According to large-scale studies, those with the highest dietary intakes of magnesium appear to live longer than those with the lowest.

Yet, surprisingly, 11 per cent of adult women do not get enough magnesium from their diet, according to The National Diet and Nutrition Survey. 

The daily recommended intake for magnesium is 375mg, with quinoa, mackerel and cashews containing the highest amount per serving at 118mg, 108mg and 80mg respectively. 

Why are levels so low?

Lack of magnesium in the diet could be down to restrictive diets to help counterbalance the weight-gaining effects of menopause. 

Women may also eat insufficient quantities of magnesium-rich pulses, nuts, seeds and green vegetables.

In addition, too much caffeine, alcohol and sugar can deplete the body of magnesium, while the stress hormones adrenaline and cortisol put extra demand on the body, upping a person's need for the mineral. 

How does magnesium help during the menopause? 

Reduces blood pressure 

The risk of heart disease increases for women during mid-life. 

High blood pressure can be a silent killer and symptoms are not recognisable until things become critical. 

Magnesium has many positive effects on the circulation, including relaxing blood vessels to lower high blood pressure. 

Studies have shown that people with the highest magnesium levels are 48 per cent less likely to develop high blood pressure after taking other known risk factors into account.

Lowers the risk of heart attack and stroke 

The risk of heart disease for women increases after the menopause and falls in line with that of men. 

Low magnesium levels are associated with artery health issues and may cause spasms, calcification and unwanted blood clots, which are more pronounced with stress. 

A study of more than 300,000 people, found that an increase in circulating blood levels of magnesium is associated with a 30 per cent lower risk of heart attack or stroke.

This same study also found that an increase in magnesium from food by 200mg per day reduced the risk of heart disease by 22 per cent.

Keeps bones strong  

During the menopause women can lose up to 10 per cent bone density. 

Magnesium is needed to regulate the flow of calcium in and out of bones, which is important for the prevention of osteoporosis in postmenopausal women. 

Women with osteoporosis have significantly lower levels of magnesium than those without the condition, and those with the lowest intakes are at greater risk of hip fractures.

Combats insomnia and low mood 

As many women have experienced, the menopause can impact sleep patterns. 

Studies have shown people who have difficulty sleeping generally often have lower levels of magnesium and increasing their intake via supplements can not only help them to nod off but also improve their sleep quality. 

Magnesium is known as 'nature's tranquilliser', and has been shown to help with other menopausal symptoms such as bloating, anxiety, irritability and other mood changes.

Relieves constipation 

Dr Sarah Brewer, GP and Healthspan Medical Director, said: 'The female bowels are sensitive to hormonal fluctuations, and may trigger constipation or other digestive issues in some women. 

'Other factors include changes in bowel bacterial balance (try taking a probiotic to address this) and lower intakes of nutrients such as magnesium, plus vitamin D deficiency, all of which can be contributors to constipation. 

'There may be reduced exercise levels and changes in medication, too, which can also aggravate constipation.'

Epsom salts were often prescribed as a laxative in Victorian times due to the laxative effect of magnesium sulphate. 

These days, doctors sometimes prescribe magnesium in high doses to clear the bowel before surgery. 

The laxative effect of magnesium may be beneficial for people suffering with constipation and IBS as this mineral has a muscle-relaxing effect that may help to soothe bowel spasms.

Supplements taken at night may aid sleep by relaxing muscles.

How to boost magnesium intake 

• Nuts and seeds are rich in magnesium. Keep them in tubs on your kitchen work surface to sprinkle on salads, yoghurt, porridge and stir-frys. They can also be added to smoothie made in a powerful blender.
• Eat oily fish once or twice a week by adding it to fish pies, curries and pasta. Use smoked fish with eggs or make a kedgeree.
• Make cashew milk by adding a handful of the nuts to 300ml of water. Include 1tbsp of cocoa powder for an extra magnesium hit. Served warm before bed may also aid sleep.
• Use cashew nuts, pumpkin seeds, dates and cocoa powder to make protein balls. Each ball can contain 15 per cent of the recommended magnesium intake. 
• Throw a handful of spinach or oats into smoothies to make up five and 10 per cent of the recommended daily allowance, respectively.
• Swap rice for quinoa to contribute an extra 10 per cent to the recommended intake.
• Take a supplement containing magnesium citrate for optimal absorption. 

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Rhythm Pad

A new device that detects an abnormal heart rhythm by scanning a patient’s hands could be used to prevent strokes by speeding up diagnosis in GP surgeries.

Called RhythmPad, it’s about the size of a laptop and has two hand shapes cut into the surface. The patient places both hands on the device and tiny sensors then record electrical pulses generated by the heart as they pass through the muscles and nerves beneath the base of the thumb.

From the results, their GP can tell if they may have a condition called atrial fibrillation (AF), which causes about 16,000 strokes a year in the UK.

About 25 RhythmPads are already being used in GP waiting rooms across England, and a separate trial involving more than 700 patients is under way at Ashford and St Peter’s Hospitals NHS Foundation Trust in Surrey.

At least a million people in the UK are known to have AF, when electrical activity in the heart goes haywire and causes it to beat irregularly. Symptoms include chest pain, dizziness and fatigue, but a significant number have no idea they are ill until they have a stroke.

The cause is unknown, though high blood pressure, chest infections, an overactive thyroid and too much caffeine or alcohol have been cited as possible triggers.

Research suggests people with AF are five times more likely to have a stroke than those who are well.

This is because as the heart no longer beats regularly, blood that should get pumped around the body instead begins to pool and thicken in the left ventricle — the heart’s main pumping chamber. If a clot then breaks away and travels up the narrow blood vessels that feed the brain, it can block the supply of oxygen-rich blood, causing a stroke.

Common treatments include the blood-thinner warfarin to stop clots forming, and cardioversion, where the heart is shocked into normal rhythm.

The RhythmPad harnesses the same technology used in electrocardiograms (ECGs) to check patients with suspected heart attacks. In these, up to ten electrodes are attached to different parts of the body to measure electrical signals.

The RhythmPad, which costs just over £1,000, gives a slightly less detailed result, but is sufficient to detect abnormal rhythms.

Patients with signs of AF would then be referred for more thorough tests and get treatment earlier.

Research shows more than 28,000 patients have used the devices in GP waiting rooms over the past year.

Cardiocity, the UK-based firm that manufactures the device, says so far almost 200 new cases of AF have been identified. The results are due to be published in a scientific journal next year.

Professor Nicholas Peters, an expert in abnormal heart rhythms at Imperial College London, says the device will be helpful in detecting AF, but warned that some cases would be missed as abnormal rhythms can come and go.

‘This will be helpful and quite appealing to patients, who are increasingly aware of the benefits of automated health screening,’ he says. ‘But atrial fibrillation can occur intermittently and may not be present at the time of use.’

Ice cubes can erase pain of jabs in A&E

Ice cubes are an effective way to reduce the pain from local anaesthetic injections given to patients in A&E before their wounds are stitched, reports the Emergency Medicine Journal.

Injections of lidocaine, a widely used local anaesthetic, can often be painful. In a trial of 50 patients aged 18 to 65 at Ajou University Hospital in South Korea, some patients had an ice cube inside a sterile vinyl glove held against their skin for two minutes before the jab.

They reported much less pain than those who had the injection without the ice cube.

 

■ Half an hour of moderate to vigorous physical activity a day can ease inflammation in the body, according to recent published research. The study, based on 396 adults, showed that being active for 30 minutes every day over a period of a week saw white blood cell counts drop, a sign of reduced inflammation.

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A daily helping of bio-live yogurt or sauerkraut could lower high blood pressure and cut the risk of a stroke or heart attack - even if you have a salty diet

Eating yogurt high in ‘good bacteria’ could help lower high blood pressure, according to new research.

In a scientific first, researchers have discovered diets high in salt are killing off beneficial bacteria in our guts.

Without these ‘friendly’ microbes, our bodies start producing cells that increase inflammation – making our blood vessels narrower, which puts people at risk of suffering a stroke or heart attack. 

But the germs in the gut that are killed off by high-salt diets could be replaced by a dose of ‘good bacteria’ in a pro-biotic yogurt drink, scientists said.

Experiments on humans and mice fed the unhealthy diet found the treatment reduced inflammation-triggering cells that cause high blood pressure.

Yet, experts warn further studies are required before probiotics can reliably be linked to reduced blood pressure. 

Professor David Relman from Stanford University in California, said: ‘Should hypertension be added to the list of conditions promoted by the gut microbiota? Future studies will no doubt tell.'

Yogurt therapies could tackle high blood pressure

Probiotics are commonly found in yogurts as well as fermented products such as sauerkraut.

The American and German team warned it was not a licence for people to consume as much salt as they like as long as they ate yogurt.

But the breakthrough could lead to yogurt-based therapies to tackle high blood pressure, or hypertension, that affects one-in-four Britons. A diet high in salt is a major risk factor.

Adults in the UK eat about 8.1g of salt a day - well above the recommendation of no more than 6g.

Salt drives bacteria in the gut that cause hypertension 

Professor Eric Alm, a biological engineer at Massachusetts Institute of Technology, said: ‘I think certainly there’s some promise in developing probiotics that could be targeted to possibly fixing some of the effects of a high-salt diet.

‘But people shouldn’t think they can eat fast food and then pop a probiotic and it will be cancelled out.’

Professor Alm and colleagues showed a high-salt diet shrank the population of a certain type of beneficial gut bacteria called Lactobacillus murinus.

As a result pro-inflammatory cells of the immune system known as Th-17 - which have been linked with high blood pressure - grew in number.

In the study of healthy humans adding 6 grams of table salt to their daily diet for a fortnight reduced the lactobacillus bacteria in their gut.

Their blood pressure went up - along with their counts of Th-17 cells.

But when the participants - all male and aged 18 to 50 - were given a commercially available probiotic for a week before going on the high-salt diet their gut lactobacillus levels and blood pressure remained normal.

This followed similar results in mice. For two weeks table salt made up 4 percent of their diet - eight times more than normal.

This led to a drop in lactobacillus, more of the troublesome Th-17 cells - and a rise in blood pressure.

But when they were given a probiotic containing Lactobacillus murinus the inflammatory cells went down and hypertension was reduced.

It is still unclear exactly how Th-17 cells contribute to the development of high blood pressure and other ill effects of a high-salt diet.

'Profound potential for global health benefits'

Professor Alm said: ‘We’re learning the immune system exerts a lot of control on the body, above and beyond what we generally think of as immunity. The mechanisms by which it exerts that control are still being unravelled.’

It is hoped the findings published in Nature will shed more light on the association between a high-salt diet and disease.

Prof Alm said: ‘If you can find that smoking gun and uncover the complete molecular details of what’s going on you may make it more likely that people adhere to a healthy diet.’

Scientists have long known a high-salt diet can lead to cardiovascular disease. As it accumulates in the bloodstream the body retains more fluid to dilute it.

It means the heart and blood vessels have to work harder to pump the extra volume of water.

This can stiffen the blood vessels - potentially leading to high blood pressure, heart attack and stroke.

Recent evidence has also implicated the body’s immune system in some of the effects of a high-salt diet.

Professor David Relman, of Stanford University in California, reviewed the findings or the journal and said they have ‘profound potential.’

He said: ‘Should hypertension be added to the list of conditions promoted by the gut microbiota? Future studies will no doubt tell.

‘If this connection is real, one might predict - because of other variable factors - that the effects will be modest and restricted to a subset of individuals.

‘Nonetheless, even modest effects are more than worthy of further study, because of the profound potential for global health benefits.’

A shocking 16 million people in the UK suffer from high blood pressure - the biggest risk factor for stroke and heart attacks - with over half unaware they have the condition.

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Virtual reality help for stroke patients

Virtual reality therapy for stroke patients is just as effective as standard physical therapy, a new study found.

Researchers discovered that virtual reality therapy improved arm, hand and finger movement after a patient had lost muscle control due to a stroke. 

A stoke occurs when blood flow to an area of the brain is cut off, causing cells to die which can lead to impaired movement in parts of the face and body. 

This development could make rehabilitation therapy accessible to patients at home and in their own time. 

Nearly 800,000 Americans suffer from a stroke each year and it is the fifth leading cause of death in the US. 

But stokes can be treated and prevented, and death due to strokes has decreased in the last 15 years.

A stroke occurs when the blood supply to part of the brain is cut off or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die which can cause memory loss and impaired muscle control. 

Researchers from Denmark conducted the study over a four-week period with four to five-hour long sessions.

The study focused on the upper-area of the body and involved 120 patients with an average age of 62 who had all suffered a stroke about a month before the study began. 

Each of the participants had mild to severe muscle weakness or impairment in their wrists, hands or upper arms.

The patients were split into two groups -half had standard physical and occupational therapy, while the other half had virtual reality therapy designed for rehabilitation. 

The virtual reality therapy was adapted to the patients' ability and involved playing games that incorporated arm, hand and finger movements.

The findings published in an online issue of Neurology discovered that both groups showed substantial improvement in movement and functioning, but there was no difference between the two groups.  

Study author Iris Brunner, PhD, of Aarhus University, said:  'These results suggest that either type of training could be used, depending on what the patient prefers.'

Brunner added: 'Future studies could also look at whether people could use virtual reality therapy remotely from their homes, which could lessen the burden and cost of traveling to a medical center for standard therapy.' 

A stroke can be caused by a blocked artery or a bursting blood vessel which can be prevented by lowering blood pressure, exercising, and drinking in moderation.

Obesity, as well as complications linked to it, including high blood pressure and diabetes, raise the risk of having a stroke. 

By exercising, losing weight and reducing salt intake, a person can reduce their blood pressure and ultimately decrease their risk of a stroke.

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Thrombectomy

Thousands of stroke patients will be saved from lifelong disability after NHSEngland decided to invest millions of pounds in a new treatment hailed as a “gamechanger”.

About 8,000 people a year who have a stroke will benefit from a massive expansion in the number of hospitals offering mechanical thrombectomy.

Currently only a few hundred patients a year receive the treatment and just a handful of hospitals in England offer it, despite its proved effectiveness. Strokeexperts say the procedure can produce remarkable results, with patients who would otherwise have ended up in a wheelchair instead able to walk out of hospital within 48 hours of having it.

“Thrombectomy is a real gamechanger which can save lives and reduce the chances of someone being severely disabled after a stroke,” said Juliet Bouverie, the chief executive of the Stroke Association.

“This decision by NHS England could give thousands of critically ill stroke patients an increased chance of making a better recovery. It could also mean more stroke survivors living independently in their own homes, returning to work and taking control of their lives again as a result,” she added.

A thrombectomy is used to remove a blood clot in someone’s brain which has not dissolved despite the patient receiving clot-busting thrombolytic drugs. It involves a doctor putting a thin tube into a patient’s artery, usually through their groin, and then feeding it up through their body to where the clot is in their brain. Once there, a wire mesh tube called a stent – usually used in heart or vascular surgery – on the top of the tube is wrapped around the clot and it is then pulled out by a doctor called an interventional neuroradiologist.

Doing that restores normal blood flow to the brain and greatly reduces damage to brain tissue, which is what causes patients to suffer long-term, often serious damage to their physical and mental functions. Patients are either sedated or under general anaesthetic during the procedure, which must be carried out within six hours of the stroke occurring.

“This major national upgrade to stroke services puts the NHS at the leading edge of stroke care internationally,” said Simon Stevens, NHS England’s chief executive. “It’s another practical example of the NHS quietly expanding innovative modern care that will really benefit patients, but which tends to be invisible in the public debate about the NHS.”

Stevens is keen that the NHS follows the lead of Germany and France, which undertake 7,500 and 3,500 thrombectomies a year respectively. While the procedure can help 10% of the 90,000 people a year in the UK who are admitted to hospital following a stroke, fewer than 600 patients a year in England have one.

Although the procedure costs about £12,000 to perform, the big savings in medical and social care for patients who would otherwise have been left seriously disabled have convinced NHS England that it represents value for money.

St George’s in London is the only hospital in the UK to offer thrombectomy around the clock every day of the week. NHS England hope the massive expansion will lead to 24 NHS trusts which are centres of excellence in neuroscience operating on the same 24/7 basis as the NHS becomes more of a seven-day service.

Dr Jeremy Madigan, a consultant diagnostic and interventional neuroradiologist at St George’s, said: “Our patients are benefiting from the thrombectomy service we provide, with an 80-90% chance of opening up blocked vessels via this technique, compared to 30% with traditional clot-busting drugs.

“Providing a thrombectomy service at all times of day, as we do at St George’s, radically improves the range and mix of interventions available to us as clinicians.”

However, Bouverie said that creating 24 centres to perform the procedure would compel the NHS to centralise acute stroke services in fewer places, which would likely prove controversial.

It would also require a big increase in the number of interventional neuroradiologists the NHS employs – currently about 90 – especially if the service is to operate around the clock.

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Stroke patch saving lives

A skin patch costing as little as 39p could revolutionise stroke treatment, significantly increasing the chances of survival, researchers have found.

The patch contains glyceryl trinitrate (GTN), which lowers blood pressure and opens up blood vessels, helping reduce the damage caused in the immediate minutes and hours following a stroke.

A stroke is usually caused by an artery clot or burst blood vessel in the brain and causes permanent disability in about a quarter of patients.

A small trial of 41 randomised patients in and around Nottingham found that administering the patch to a patient’s shoulder or back while they were travelling to hospital halved the stroke death rate from 38% to 16%.

As a result, the British Heart Foundation (BHF) has funded the University of Nottingham researchers to work with seven ambulance services to trial the patch on patients and chart their recovery over 12 months.

Paramedics can administer the patch in the ambulance before arrival in A&E, saving vital time.

Prof Sir Nilesh Samani, the BHF’s medical director, said: “Current treatment for stroke is fairly limited and patients are dying or suffering life-changing disabilities as a result.

“This trial uses a simple patch that can be applied rapidly by paramedics as soon as they reach the patient.

“If successful, this could revolutionise treatment for stroke patients across the UK and potentially globally and could be a huge step forward in the advancement of stroke treatment which currently lags behind heart attack treatment.”

There are more than 100,000 strokes in the UK each year, according to the Stroke Association, and the BHF says 40,000 people die as a result annually, making it the country’s fourth biggest killer. One in eight strokes are fatal in the first 30 days.

The cost to the NHS and social care system is estimated at £2bn a year in England and research has suggested the cost to society as a whole in the UK is £9bn.

Funding for stroke research, which was £56m in 2012, is approximately a tenth of the £544m spent on cancer research. Cancer’s cost to the health and social care system is estimated at £5bn a year.

GTN is used for chest pain associated with angina, but the use of the drug for treating hyperacute stroke is new and the researchers believe they are the only people in the world testing it.

Prof Philip Bath, a BHF researcher from the University of Nottingham, said: “We believe that by improving blood flow in the brain in stroke patients we can dramatically improve their survival chances and recovery.

“This patch enables us to do this within minutes and early trials have been very promising.”

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Spiders and strokes

Doctors have stumbled on an unlikely source for a drug to ward off brain damage caused by strokes: the venom of one of the deadliest spiders in the world.

A bite from an Australian funnel web spider can kill a human in 15 minutes, but a harmless ingredient found in the venom of one species can protect brain cells from being destroyed by a stroke, even when given hours after the event, scientists say.

If the compound fares well in human trials, it could become the first drug that doctors have to protect against the devastating loss of neurons that strokes can cause.

Researchers discovered the protective molecule by chance as they sequenced the DNA of toxins in the venom of the Darling Downs funnel web spider (Hadronyche infensa) that lives in Queensland and New South Wales.

Venom from three spiders was gathered for the study after scientists trapped and “milked exhaustively” three spiders on Orchid beach, about 400km north of Brisbane.

The molecule, called Hi1a, stood out because it looked like two copies of another brain cell-protecting chemical stitched together. It was so intriguing that scientists decided to synthesise the compound and test its powers. “It proved to be even more potent,” said Glenn King at the University of Queensland’s centre for pain research.

Strokes occur when blood flow to the brain is interrupted and the brain is starved of oxygen. About 85% of strokes are caused by blockages in blood vessels in the brain, with the rest due to bleeds when vessels rupture. Approximately six million people a year die from stroke, making it the second largest cause of death worldwide after heart attacks.

When a stroke happens, the oxygen level in the brain drops. This forces the brain to burn its primary fuel, glucose, very differently. Instead of oxidising glucose for energy, the brain switches to a process called anaerobic glycolysis. The reaction releases energy to keep the brain working, but it also produces acid, which can cause brain cells to die.

In a series of studies on rats, King showed that a single small dose of the spider venom molecule protected neurons from induced strokes. The compound works by blocking what are called ion channels in cells, specifically those that respond to the onset of acidic conditions in the brain.

Reporting in the journal, Proceedings of the National Academy of Sciences, King describes how administering Hi1a two hours after stroke reduced the extent of brain damage in rats by 80%. But the compound was still effective eight hours after stroke, reducing the amount of brain damage by about 65% when compared with untreated animals.

Rats that had the compound recovered far better than those that went without. “The untreated rats performed very badly after stroke. Their neurological and motor performance were terrible,” said King. But treatment with Hi1a “almost restored these functions to normal,” he added.

The researchers hope to start human trials of the compound in the next two years, but have more experiments to perform first. These will test whether the molecule works in all cases of stroke and is safe to use when blood vessels rupture in the brain, rather than become blocked. In the latest study, the compound was infused directly into the brain, but the scientists have found since that nasal deliver works too.

If trials show that the compound works, it could potentially transform the treatment of stroke patients. There are no drugs on the market that can protect the brain from stroke injuries. The best hospitals can offer are infusions of clot-busting drugs if a clot is to blame, or a surgical procedure called endovascular thrombectomy, which physically pulls the clot from the brain.

Before doctors can administer clot-busting drugs, they must confirm with a brain scan that the stroke was caused by a blockage. This is because the treatment thins the blood and could make matters worse if the stroke was caused by a haemorrhage. If Hi1a is found to be safe for people who have had with brain bleeds, it could be given to patients as soon as they reach a doctor. “The drug could be given in the ambulance to most stroke patients before hospital arrival, maximising the number of neurons that can be saved,” said King. “This should diminish the mortality from stroke and provide much better outcomes for those that survive as more brain function will be retained.”

Kate Holmes at the Stroke Association, said it was unknown whether Hi1a could be an effective treatment in humans. “We welcome any treatment that has the potential to reduce the damage caused by stroke, particularly if this can benefit people who are unable to arrive at hospital quickly,” she added. “Current treatments must be given in half this time period and it is too early for us to know if this research can offer an alternative for stroke patients.

“We urge for stroke to be treated as an emergency. The sooner a person can get to hospital after a stroke, the sooner the right treatment can be received which can improve survival and help recovery,” she said.

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Strokes and drinks

Consuming a can a day of low- or no-sugar soft drink is associated with a much higher risk of having a stroke or developing dementia, researchers claim.

Their findings have prompted renewed questions about whether drinks flavoured with artificial sweeteners can increase the risk of serious illness, as heavily sugared drinks have already been shown to do.

“Drinking at least one artificially sweetened beverage daily was associated with almost three times the risk of developing stroke or dementia compared to those who drank artificially sweetened beverages less than once a week,” according to the American researchers who carried out a study published in Stroke, the journal of the American Heart Association.

“After adjustments for age, sex, education (for analysis of dementia), calorific intake, diet quality, physical activity and smoking, higher recent and higher cumulative intake of artificially sweetened soft drinks were associated with an increased risk of ischaemic stroke, all-cause dementia and Alzheimer’s disease dementia,” the co-authors write.

Those consuming at least a can of so-called diet drinks every day were 2.96 times more likely to suffer an ischaemic stroke and 2.89 times more likely to develop Alzheimer’s disease than those who drank them less than once a week, they found.

Ischaemic strokes occur when blood cannot get to the brain because of a blockage, often one caused by a blood clot forming in either an artery leading to the brain or inside a vein in the brain itself. They comprise the large majority of the 152,0000 strokes a year which occur.

Surprisingly, though, the research also contradicted previous studies by finding that sugared drinks did not raise the risk of either serious outcome. It is based on data for more than 4,300 participants in the Framingham Heart Study, a long-term medical research project in the United States.

“To our knowledge, our study is the first to report an association between daily intake of artificially sweetened soft drink and increased risk of both all-cause dementia and dementia because of Alzheimer’s disease,” the co-authors added.

However, they admitted that they could not prove a causal link between intake of diet drinks and development of either medical condition because their study was merely observational and based on details people provided in questionnaires logging their food and drink habits.

Matthew Pase, a senior fellow in the department of neurology at Boston University’s school of medicine who was one of the co-authors, said that despite no evidence of a causal link, the apparent connection between sweetened drinks and the two conditions “does identify an intriguing trend that will need to be explored in other studies”.

This is not the first time that sweetened drinks have been implicated in the development of serious ill-health. The paper quotes the Northern Manhattan study as having found that “daily consumption of artificially sweetened soft drink was associated with a higher risk of combined vascular events but not stroke”. It also cites the conclusion of the Nurses Health study and Health Professionals follow-up study that “greater consumption of sugar and artificially sweetened soft drinks was each independently associated with a higher risk of incident stroke over 28 years of follow-up for women and 22 years of follow-up for men”.

Sales of diet versions of soft drinks have boomed in recent years as sales of fully sugared ones have declined sharply.

Defra’s Family Food Survey, published last month, found that sales of regular soft drinks fell by 34.6% between 2010 and 2014, while low-calorie drinks purchases increased by 35.8%. Now just 38% of all soft drinks consumed are fully sugared, it said.

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Residual symptoms after transient ischaemic attack

The symptoms of a TIA are similar to that of stroke, but they may only last a short while, certainly no more than 24 hours. If symptoms last longer than 24 hours but are mild usually this would be defined as a ‘minor stroke’. There was some confusion amongst some people we interviewed about whether they had actually had a stroke or TIA. The terms ‘TIA’, ‘minor stroke’ and ‘mini stroke’ were used by people to describe what they had experienced, based on the diagnosis they had been given by their GP or consultant.

Many of the people we interviewed recovered from their TIA or minor stroke and did not experience any continuing symptoms afterwards.

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11 ways to prevent a stroke

Factors you can't change Age Gender Race/ethnicity

Factors you can change High blood pressure Lack of exercise Smoking Diabetes High cholesterol Atrial fibrillation Sickle cell disease Use of oral contraceptives Obesity Presence of other cardiovascular disease Alcohol abuse Drug abuse

Harder to change or emerging evidence Obstructive sleep apnea Migraine Certain infections Gum disease Blood markers like factor V Leiden, lipoprotein(a), others

11 strikes against stroke

You can fight stroke on many fronts. A single thrust is good; a many-pronged attack is even better. Here are 11 things you can do to stay stroke-free:

• Know and control your blood pressure.
• Don't smoke; stop if you do.
• Lose weight if needed.
• Become more active.
• Identify and manage atrial fibrillation.
• Be aggressive about treating a transient ischemic attack (TIA, or mini-stroke).
• Treat circulatory problems like peripheral artery disease, sickle cell disease, or severe anemia.
• Know and control your blood sugar and cholesterol.
• If you drink alcohol, do so in moderation.
• Adopt a healthy diet low in sodium and rich in potassium.
• Know the warning signs of stroke (see "Stroke warning signs") and respond immediately.

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The Many Roles of Statins in Ischemic Stroke

Stroke is the third leading cause of human death. 

Endothelial dysfunction, thrombogenesis, inflammatory and oxidative stress damage, and angiogenesis play an important role in cerebral ischemic pathogenesis and represent a target for prevention and treatment. 

Statins have been found to improve endothelial function, modulate thrombogenesis, attenuate inflammatory and oxidative stress damage, and facilitate angiogenesis far beyond lowering cholesterol levels. 

Statins have also been proved to significantly decrease cardiovascular risk and to improve clinical outcome. Could statins be the new candidate agent for the prevention and therapy in ischemic stroke? In recent years, a vast expansion in the understanding of the pathophysiology of ischemic stroke and the pleiotropic effects of statins has occurred and clinical trials involving statins for the prevention and treatment of ischemic stroke have begun. 

These facts force us to revisit ischemic stroke and consider new strategies for prevention and treatment. Here, we survey the important developments in the non-lipid dependent pleiotropic effects and clinical effects of statins in ischemic stroke

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