Stroke Archive

Research we're watching

Think you're doing your heart a favor by drinking diet instead of regular soda? That may be wishful thinking, according to a research letter published Nov. 3, 2020, in the Journal of the American College of Cardiology.

Researchers studied nearly 105,000 people who filled out three 24-hour dietary recall surveys every six months. During a 10-year follow-up, researchers tracked the participants' cardiovascular health.

Ask the doctor

Q. I read that the death rate from COVID-19 is going down, but that people who recover from the infection still can remain sick for a long time. Is that true?

A. It is true, but we don't yet know how big the problem is: COVID-19 has been with us for only a year, and there hasn't been enough time to know the long-term effects.

The potential causes may be hard to pin down. Here are some of the most common ones — and what to do about them.

Sometimes it's easy to know why a particular part of your body is itchy. Maybe you have a bug bite, allergies, or a visible skin condition such as eczema. It's harder to know the cause when there's nothing obvious behind all-over, generalized itching. "It's the most common skin complaint in people over age 65," says Dr. Kenneth Arndt, a dermatologist and former medical editor of the Harvard Special Health Report Skin Care and Repair.

Potential causes

Generalized itching has many potential triggers. One is aging. "The skin barrier doesn't work as well as it used to, and things that may not have irritated you before may now be absorbed in the skin and cause itching," Dr. Arndt explains. "The skin also develops a somewhat impaired immune response, a reduction in fat and blood flow, and altered sensory perception, making it more prone to itching."

Experts say that while there are many unknowns about long-term COVID effects, it's hoped that more information will be available soon.

A growing number of Americans have now experienced a bout of COVID-19, and doctors are only just beginning to learn more about the aftereffects of the infection.

"Reports are coming out describing long-term lung effects — which is not surprising, as scarring may occur and cause permanent impairment — and also of neurological, cardio­vascular, and kidney effects," says Dr. David Christiani, a professor of medicine at Harvard Medical School and a pulmonary physician at Massachusetts General Hospital.

If you have chickenpox as a child, the virus stays in your body, and can emerge later in life as a painful, burning rash called shingles. It’s not fully understood what triggers a resurgence of the virus, but factors that weaken the immune system increase the risk of developing shingles, and it is more common in people over age 60.

Millions of people suffer from the burning, tingling, and numbness of a form of neuropathy called idiopathic sensory polyneuropathy. A recent study directly comparing four medications produced disappointing results, but is a step in the right direction.

News briefs

If your doctor or pharmacist offers a service to monitor blood pressure measurements you send from home (called telemonitoring), consider taking advantage of it. Past research has shown that telemonitoring — often paid for by Medicare — may help you reduce your blood pressure. And a study published online Aug. 31, 2020, by Hypertension suggests telemonitoring is also associated with a long-term reduction in heart attacks, strokes, and medical costs. The recent study is a follow-up to a randomized controlled trial from 2013 that divided 450 people into two groups: those who received routine primary care, and those who received a year of telemonitoring services with a pharmacist who helped manage their treatment. People in the telemonitoring group had lower blood pressure for up to two years afterward, compared with people who received routine care. In the recently published follow-up, which followed the same participants for five years, researchers found there were about half as many heart attacks, strokes, and hospitalizations in the telemonitoring group as there were in the group that received routine care. Because there were fewer cardiovascular problems, people in the telemonitoring group also saved an estimated $1,900 each in medical costs.

On call

Q. I would occasionally get some swelling in my legs. But now I notice it by late afternoon every day. I otherwise feel fine. Should I be worried?

A. It sounds like you have edema, swelling in your legs due to fluid in the soft tissues beneath your skin. This usually occurs when pressure from the fluid inside your veins is high, which forces water out of the blood vessels and into the surrounding tissues.

Research we're watching

A drug made from a highly purified form of EPA (an omega-3 fatty acid found in fish) appears to help reduce plaque in the heart's arteries, according to a study published online Aug. 29, 2020, by the European Heart Journal. The findings may explain why the drug, icosapent ethyl (Vascepa), lowers the risk of heart attack and stroke by 26% in people at high risk for those serious problems.

The study included 80 people with fatty plaque in the arteries of the heart (coronary artery disease). Most of them had diabetes and were taking a statin. Their trigly­cerides were elevated, ranging from 135 to 499 milligrams per deciliter. Half were randomly assigned to take 4 grams of icosapent ethyl daily; the other half received a placebo.

In the journals

Scientists continue to explore the right balance of carbohydrates and fat in people's diets. But for overweight or obese older adults, a recent study found that a low-carbohydrate, high-fat diet might offer special health benefits. The results were published online Aug. 12, 2020, by Nutrition and Metabolism.

Researchers asked 40 obese adults, ages 60 to 75, to follow an eight-week diet in which 10% of calories came from carbs, 25% from protein, and 65% from fat. Carb sources included leafy greens, non-starchy vegetables, some fruit, and high-fiber grains. Protein intake consisted of eggs, fish, pork, and poultry. Fat-containing foods included olive oil, coconut oil, nut oils, nut butter, cheese, coconut milk, and avocados.