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Healthy Heart Habits May Keep 'Mini Strokes' at Bay

Proper diet and exercise might keep you sharper as you age

MONDAY, Feb. 23, 2004 (HealthDayNews) -- Take care of your heart by exercising regularly and eating healthfully and you may also keep your brain young as you age.

That's the conclusion of a new study in which researchers found brain damage caused by "mini-strokes" that are thought to be related to the aging process occur more extensively in people with common heart health risk factors, such as high blood pressure or high cholesterol.

"We didn't do an intervention study," says study author Dr. Ian Cook, an associate professor of psychiatry at the UCLA Neuropsychiatric Institute in Los Angeles. It appears in the March issue of the American Journal of Geriatric Psychiatry.

"We watched what happened [to the 29 subjects, who were 60 and older and healthy]," he says. "We found people who at the start of the study had higher risk factors [for heart disease] had more adverse changes in the brain [over time]."

However, a Harvard University professor calls the study's conclusion premature, citing the small number of patients involved in the research.

Cook concedes the study is small. But he says it is the first one to use precise measurements of the volume of brain damage caused by "mini-strokes," to evaluate the amount of subclinical structural brain disease, or SSBD. SSBD is a term used to encompass a range of brain damage that commonly occurs to people starting in middle age, and is often dismissed as normal aging.

In previous research, Cook's team had found that large amounts of SSBD damage are common in patients with dementia.

For the new research, Cook and his colleagues performed structural magnetic resonance imaging (MRIs) on all 29 subjects at the start of the study, and then administered follow-up MRIs two to six years later. The researchers then used computer-assisted analysis to measure increases in the volume of four types of SSBD -- cortical atrophy; central atrophy; deep white-matter hyperintensities; and periventricular hyperintensities.

Most of the study participants showed increased SSBD volume in the follow-up scans. And Cook found the amount of change in the white matter tissue was directly related to heart risk factors, such as high blood pressure or high cholesterol.

While some researchers had suspected that heart risk could contribute to greater damage from "mini-strokes", the new study offers more objective evidence, Cook says. "The new part is that rather than just rely on a subjective feel for how bad things are getting, we have real numbers," he says.

But Dr. Tobias Kurth, an instructor of medicine at Harvard Medical School, takes issue with Cook's conclusions. "I would not conclude from this paper that if you have cardiovascular risk factors you are at risk for observing these changes," he says. "It's a study of 29 subjects, so that highlights the biggest problem. It's a limited number of people. However, it's a very carefully conducted study."

While the overall conclusion may prove to be valid, Kurth says, "it's not a valid conclusion from this paper." He calls for more research on the subject.

While Cook acknowledges the current study sample was small, he stands by his conclusion.

"Within the limits of this small sample, it does appear that taking good care of your heart health will also result in good health for your brain," Cook says. "With that [care], probably you will have less problems with memory and other things that are thought to be common with aging but need not be."

More information

For more information on a heart healthy lifestyle, visit the American Heart Association. The heart association also offers information on strokes and "mini strokes".

SOURCES: Ian Cook, M.D., associate professor, psychiatry, UCLA Neuropsychiatric Institute, Los Angeles; Tobias Kurth, M.D., Sc.D., instructor, medicine, Harvard Medical School, and associate epidemiologist, Brigham and Women's Hospital, Boston; March 2004 American Journal of Geriatric Psychiatry

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