Among the many risk factors for stroke, some, such as age and family history, are well beyond our control. Others, such as atrial fibrillation and hypertension, can pose a great challenge to keep under control. But some risk factors, such as weight, smoking, exercise and sleep apnea are manageable with some effort and the understanding that improvements you make in these areas can directly lower your odds of having a stroke. Two recent studies also identify two possible risk factors that may be within your power to manage and further protect yourself against stroke.
Getting too little or too much sleep can mean trouble for your heart. A study presented at the American College of Cardiology conference in March found that sleeping less than six hours a night significantly raises the risk of stroke, heart attack and congestive heart failure. Individuals who sleep more than eight hours a night have a higher prevalence of angina, coronary artery disease and other heart problems. This latest study underscores evidence from earlier research that has linked insufficient sleep with changes in blood pressure, resting heart rate, glucose intolerance and the hyper-activation of the sympathetic nervous system-all of which are associated with cardiovascular disease.
A study in the Oct. 25, 2011 issue of Circulation: Journal of the American Heart Association, found that the risk of heart attack in people with insomnia ranged from 27 percent to 45 percent greater than for people who rarely experienced trouble sleeping. Insomnia was characterized in the study in three different ways: Having trouble falling asleep almost every night (45 percent higher heart attack risk); having problems staying asleep almost every night (30 percent higher risk); and not waking up feeling refreshed in the morning more than once a week (27 percent higher risk).
I recently saw a news item about how people who dont spend a lot of time in the deeper stages of sleep are at a greater risk of developing high blood pressure. I have slightly elevated blood pressure, but I do wake up a few times a night. Will poor sleep make it harder to manage my blood pressure?
You may know how a poor nights sleep affects your mental focus the next day, but repeated nights of little sleep can pose a huge risk to your heart, too. A study presented at the EuroPRevent 2011 conference in April was the first to look not just at how short sleep duration affects cardiovascular health, but how poor quality sleep also contributes to greater heart risk. Sleeping less than seven hours, on average, has been shown to be unhealthy for your heart. But when insufficient sleep time is combined with a night of frequent sleep interruptions or a shortage of time in the deeper, restorative stages of sleep, researchers found that the risk for cardiovascular disease can be 65 percent higher than for people who sleep at least seven hours and feel rested when they wake up the next day.
Door sleep is common among older adults: Theyre more likely to suffer from age-related conditions that disrupt sleep, and also tend to spend more time in light sleep. That doesnt mean you should put up with the problem or dismiss it as one of the perils of aging, however, says Leo Pozuelo, MD, staff psychiatrist and associate director of the Bakken Heart Brain Institute at Cleveland Clinic. "Even if many aspects of sleep-including why exactly we need it-remain a mystery, research suggests that not sleeping enough or sleeping badly runs counter to the bodys internal clock, disrupting every physiologic function in the body," he notes.
Daytime sleepiness is the least of your worries if you suffer from sleep apnea, a condition that affects your breathing at night. Its estimated to affect between 11 million and 20 million Americans and research suggests that it raises the risk of death from any cause, but is particularly associated with increased cardiovascular risk. According to the National Center on Sleep Disorders Research, roughly 38,000 cardiovascular deaths annually are in some way related to sleep apnea, with the links including high blood pressure and stroke. Recent research found that people with the most common type of sleep apnea-obstructive sleep apnea, or OSA-have more non-calcified plaque in their arteries, and a much higher risk of developing aggressive atherosclerosis than individuals without OSA.
Youve had open-heart surgery-perhaps coronary artery bypass grafting (CABG), valve surgery, or a combination of the two-and now youre adjusting to life as a cardiac patient. But getting used to focusing on diet and exercise, new medications and physical healing are only some of what you may experience in the weeks and months ahead. While some patients sail through recovery, others are at increased risk of postoperative complications. Knowing your risk can help you have realistic expectations for your post-surgical recovery.
I have type 2 diabetes and have been on aspirin therapy for several years. But my doctor told me recently that there is some question about whether the aspirin will help protect patients with diabetes. Should I keep taking aspirin (I have never had a heart attack, but I do take medications to manage my blood pressure and cholesterol)?
In one of the strongest recent studies supporting the link between sleep-disordered breathing and an increased risk of death, the Sleep Heart Health Study found that people with severe sleep apnea had a 40 percent increased risk of death compared to those without the condition. The research, which included 6,440 men and women over the age of 40, studied from October 1995 to February 1998, was published in the Aug. 18 online edition of the Public Library of Science (PLoS) Medicine. An estimated nine percent of women and 24 percent of men in the general population have sleep-disordered breathing, which has been linked to coronary disease, hypertension, and stroke. Researchers suggest that despite the large numbers of people with sleep-disordered breathing, it remains significantly underdiagnosed.Obstructive sleep apnea (OSA)-a condition in which the soft tissues of the throat collapse during sleep, blocking the airway and causing loud snoring-can lead to cardiovascular problems including heart attack, heart failure, and stroke.
The term atrial fibrillation (AFib) refers to an irregular rhythm (arrhythmia) that begins in the atria of the heart. People with AFib have an increased risk of stroke and heart attack because an arrhythmia can increase the risk of developing blood clots. The classic risk factors for AFib include comorbid conditions such as valve disease, diabetes, and hypertension, but in recent years, risk factors such as alcohol abuse, obesity, and sleep apnea have been linked to dangerous arrhythmias. "Alcohol abuse can cause cardiomyopathy (deterioration of the heart muscle), which increases the risk of AFib," says Bruce Wilkoff, MD, a staff cardiologist in the Department of Cardiovascular Medicine, Section of Cardiac Pacemakers and Electrophysiology, at Cleveland Clinic. "Just one alcohol binge can induce an episode of atrial fibrillation."
Swelling in the legs and ankles is fairly common among older adults, but it also may be a sign of a more serious condition. "Swelling, in general, is abnormal," says Dr. Wilson Tang, a heart failure specialist in the Department of Cardiovascular Medicine at Cleveland Clinic. In fact, swelling, also referred to as "edema," could be a symptom of heart failure.