Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association | Arteriosclerosis, Thrombosis, and Vascular Biology

Genetic Map Of Cardiovascular Disease Unveiled

Researchers at Swedish institutions, including Karolinska Institutet, have identified gene variants that increase the risk of atherosclerosis. The goal is for these new findings to enable earlier detection of atherosclerosis and improved treatment of cardiovascular diseases such as heart attack and stroke. The study has been published in the journal Nature Communications.

Atherosclerosis is the disease process that leads to the formation of plaques in the blood vessels that supply the body's organs with blood. These plaques grow over time and can cause a sudden stop in the blood supply.

If this happens in the heart's coronary arteries, acute oxygen deficiency occurs in the heart muscle, causing a heart attack. If it occurs in plaques in the carotid arteries, the clot can travel with the blood to the brain and cause a stroke.

The current study, a collaboration between universities and university hospitals across Sweden, represents the largest genetic mapping of atherosclerosis, using advanced imaging diagnostics.

"Atherosclerosis is a silent killer. It becomes suddenly manifested when a myocardial infarction or a stroke occurs, but signs of atherosclerosis can be visualized and quantified in both carotid and coronary arteries. The genetic variants we have identified predispose to atherosclerosis and therefore may allow us to identify individuals amenable for early and aggressive prevention strategies", says Bruna Gigante , last author of the study, senior physician and associate professor at the Department of Medicine in Solna, Karolinska Institutet.

Twenty Genetic Variants Identified

The study is based on data from the population study SCAPIS, the largest in Sweden within heart, vascular, and lung research, involving 30,000 randomly selected Swedes aged 50-64 who have undergone extensive health examinations. What distinguishes SCAPIS are the highly detailed measurements of atherosclerosis made using advanced imaging diagnostics, including both computed tomography and ultrasound.

This enabled the researchers to examine several million genetic variants spread across the entire genome regarding their impact on the risk of atherosclerosis in the coronary arteries, which can cause heart attacks. Twenty genetic variants were found to have a statistically significant association.

The study also included similar analyses of atherosclerosis of the carotid arteries, which can lead to stroke. When the coronary and carotid results were compared, several differences emerged, suggesting different underlying disease mechanisms.

Atherosclerosis is common, and even relatively advanced atherosclerosis can be completely asymptomatic. For many of those affected by heart attack or stroke, it comes without warning. Cardiovascular disease is the most common cause of death in Sweden and most other countries.

"The study is an important piece of the puzzle in understanding why atherosclerosis develops, which could ultimately lead to new ways of preventing the disease process. We also hope to develop genetic tests to identify people at high risk of being affected", says Anders Gummesson, leader of the study, associate professor of molecular medicine at the University of Gothenburg, and senior physician in clinical genetics at Sahlgrenska University Hospital.

Result will be open to other researchers

The results will be available to other researchers worldwide so they can use them in their research.

"Above and beyond our current results, it is important to underline that the clinical, molecular, and imaging data collected in SCAPIS represent a golden mine for current and future epidemiological research in Sweden. Furthermore, through SCAPIS, close collaborations among universities have been consolidated, expertise maximized in different projects and a modern infrastructure for senior and young investigators has been created", says Bruna Gigante.

SCAPIS (Swedish CArdioPulmonary BioImage Study) is led and operated by six Swedish universities and six university hospitals: Sahlgrenska Academy, University of Gothenburg, Uppsala University, Karolinska Institutet, Umeå University, Lund University, Sahlgrenska University Hospital, Region Västra Götaland, Karolinska University Hospital, Skåne University Hospital, University of New South Wales, and Danderyd University Hospital.

The research is conducted in close collaboration with the Heart-Lung Foundation, which is the main financier. The project is coordinated at the University of Gothenburg.

Publication

"A genome-wide association study of imaging-defined atherosclerosis" , Anders Gummesson, Per Lundmark, Qiao Sen Chen, Elias Björnson, Koen F. Dekkers, Ulf Hammar, Martin Adiels, Yunzhang Wang, Therese Andersson, Göran Bergström, Carl-Johan Carlhäll, David Erlinge, Tomas Jernberg, Fredrik Landfors, Lars Lind, Maria Mannila, Olle Melander, Carlo Pirazzi, Johan Sundström, Carl Johan Östgren, Cecilia Gunnarsson, Marju Orho-Melander, Stefan Söderberg, Tove Fall & Bruna Gigante, Nature Communications, online March 31, 2025, doi: 10.1038/s41467-025-57457-7

/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.

Scientists Claim Major Breakthrough In Developing Vaccine For Stroke And Heart Attack

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Scientists in China have developed a potential vaccine to prevent the build-up of plaque in arteries that can lead to blood clots, stroke and heart attacks.

The build-up of fatty plaque in arteries, a condition known as atherosclerosis, is one of the leading causes of death worldwide. The eventual hardening of arteries from inflammation can block the blood flow and lead to a stroke, aneurysm or heart attack.

Atherosclerosis is an inflammatory disease, mediated by the body's innate immunity consisting of natural barriers and enzymes as well as its adaptive systems consisting of antibodies.

A pipette is used to wash serum cells separated from the blood of vaccinated mice (Getty)

Such arterial blockages, once diagnosed via scans, are currently treated with surgical procedures like angioplasty and the use of stents to prevent the blood vessels from clogging up.

It has long been theorised that vaccination could be used to treat or prevent the disease.

A new study published in the journal Nature Communications described a vaccine that may mitigate atherosclerosis development in mice.

"Our nanovaccine design and preclinical data present a potential candidate for prophylactic treatment for atherosclerosis," scientists at Nanjing University of Science and Technology in China wrote.

Previous studies have helped create a digital library of various kinds of proteins that protect against inflammation and boost the body's immune response to atherosclerosis.

One such protein is called p210. It has been found to trigger an immune response against atherosclerosis progression, and it is what the new vaccine uses.

Lifestyle changes to prevent strokes

The vaccine latches the p210 antigen onto tiny iron oxide nanoparticles and attaches an adjuvant – a substance used to enhance the immune response of a vaccine – to a different set of nanoparticles.

The study reports that the "cocktail" design of the vaccine mitigated plaque progression and atherosclerosis development in mice fed a high cholesterol diet.

It worked by helping the body take up the antigen and adjuvant, which then activated the immune system's star-shaped dendritic cells.

A cascade of changes caused by the vaccine eventually triggered the production of antibodies against p210.

"Our findings demonstrate that the two-pronged nanovaccine delivery strategy is effective against atherosclerosis," researchers write.

They hope to conduct further studies to understand the duration for which the nanovaccine protects the mice against atherosclerosis.

The Hidden Factors That Trigger Devastating Strokes

When a stroke occurs, blood flow to part of the brain suddenly stops, causing brain cells to die within minutes. This medical emergency strikes someone in the United States approximately every 40 seconds, according to recent statistics. While many associate strokes primarily with older adults, they can happen at any age, making awareness of their causes essential for everyone.

Medical researchers have identified several key factors that significantly increase stroke risk. Understanding these underlying causes allows individuals to take preventive steps before a crisis occurs. Even more importantly, recognizing personal risk factors can motivate life-saving changes that protect brain health for years to come.

The pressure problem hiding in plain sight

Blood pressure remains the single most significant controllable risk factor for strokes. This measurement, often taken routinely during medical visits, provides crucial information about cardiovascular health that many people overlook or minimize.

When blood pressure consistently registers above normal levels, it creates a dangerous situation inside blood vessels. The excessive force damages artery walls throughout the body, including the critical vessels feeding the brain. Over time, this pressure can weaken vessel walls, creating bulges called aneurysms that may rupture and cause bleeding in the brain.

High blood pressure also accelerates the formation of plaque in arteries, narrowing these vital pathways. This narrowing increases the likelihood that a blood clot will become stuck, blocking blood flow to brain tissue and triggering an ischemic stroke, the most common type.

What makes hypertension particularly dangerous is its stealthy nature. The condition typically causes no noticeable symptoms until significant damage has already occurred. Many people live with dangerously elevated blood pressure for years without realizing the risk building in their circulatory system.

Medical experts emphasize that managing blood pressure through regular monitoring, medication when necessary, and lifestyle modifications provides the most effective protection against stroke. Even small reductions in blood pressure measurements can translate to significant decreases in stroke risk.

Daily choices with cumulative consequences

The habits that fill everyday life significantly influence stroke risk in ways many people fail to recognize. These lifestyle factors represent both a challenge and an opportunity, as they remain firmly within personal control.

Smoking damages blood vessels throughout the body while simultaneously reducing oxygen levels in the blood. This destructive combination accelerates plaque buildup in arteries and makes blood more likely to clot. Research shows that smokers face at least twice the stroke risk of nonsmokers, with the danger rising with each cigarette.

Physical inactivity contributes to numerous conditions that increase stroke risk, including obesity, high blood pressure, high cholesterol, and diabetes. Regular movement helps maintain healthy blood pressure, improves circulation, and prevents excessive weight gain.

Alcohol consumption presents a complex relationship with stroke risk. While moderate drinking may offer some cardiovascular benefits for certain individuals, excessive alcohol consumption raises blood pressure, contributes to irregular heart rhythms, and increases clotting factors in the blood—all pathways to increased stroke risk.

Stress management often receives less attention than other lifestyle factors but plays a substantial role in stroke prevention. Chronic stress contributes to inflammation throughout the body, elevates blood pressure, and often leads to unhealthy coping behaviors like overeating, smoking, or drinking.

Medical professionals emphasize that even small positive changes in these areas can yield significant benefits. The body demonstrates remarkable resilience when given better conditions, with stroke risk beginning to decrease soon after healthier habits begin.

The sugar connection few recognize

Diabetes creates a particularly dangerous environment for blood vessels throughout the body, including those feeding the brain. The metabolic disorder, characterized by chronically elevated blood sugar levels, accelerates damage to the vascular system in multiple ways.

High blood glucose levels injury blood vessel linings, making them more vulnerable to damage and more likely to develop atherosclerosis—the hardening and narrowing of arteries that can lead to blockages. This process occurs more rapidly and extensively in people with diabetes, especially when blood sugar remains poorly controlled.

Diabetes also alters blood chemistry in ways that increase clotting tendency, raising the risk that a blood clot will form and potentially travel to the brain. Additionally, the condition frequently occurs alongside other stroke risk factors, including high blood pressure, elevated cholesterol, and obesity, creating a perfect storm of risk.

The connection between diabetes and stroke highlights the importance of comprehensive management for those with the condition. Maintaining target blood sugar levels, addressing co-occurring risk factors, and regular medical monitoring significantly reduce stroke probability.

For those without diabetes, preventing its development through healthy diet, regular physical activity, and weight management provides powerful protection against stroke. Early intervention when prediabetes appears can prevent progression to full diabetes and the vascular complications that accompany it.

The meal-by-meal decisions that protect or harm

Diet influences stroke risk through multiple pathways, with each meal either contributing to protection or increasing vulnerability. The cumulative effect of these daily food choices plays a crucial role in determining overall stroke risk.

Excessive sodium intake presents a particular concern, as it raises blood pressure in most individuals, especially those already predisposed to hypertension. Processed foods, restaurant meals, and many convenience items contain surprisingly high sodium levels that contribute to this risk.

Saturated and trans fats, found in many fried and processed foods, contribute to unhealthy cholesterol profiles and arterial plaque formation. These fats promote inflammation throughout the circulatory system and accelerate atherosclerosis—the narrowing of arteries that can eventually lead to blockages and stroke.

In contrast, diets rich in fruits, vegetables, whole grains, and lean proteins provide protective compounds that support vascular health. Antioxidants found in colorful produce help prevent arterial damage, while fiber assists in maintaining healthy cholesterol levels and stable blood sugar.

Nutrition experts emphasize that dietary patterns matter more than individual foods. The Mediterranean and DASH (Dietary Approaches to Stop Hypertension) eating patterns have demonstrated significant protective effects against stroke through their emphasis on plant foods, healthy fats, and limited processed items.

Making gradual improvements rather than dramatic dietary overhauls tends to create more sustainable changes. Even modest adjustments toward healthier eating habits can contribute to meaningful reductions in stroke risk over time.

The family connection you cannot change but must understand

Genetic factors create a complex background influence on stroke risk that varies significantly between individuals. While genetics cannot be modified, understanding this aspect of personal risk enables more informed prevention strategies.

Family history serves as an important indicator of genetic predisposition. Having a close relative who experienced a stroke, especially before age 65, signals potentially inherited risk factors that deserve attention. These genetic influences may affect blood pressure regulation, blood clotting tendencies, or blood vessel formation.

Certain ethnic backgrounds also carry elevated stroke risk, with African Americans, Hispanic Americans, and Native Americans experiencing higher rates than other groups. These disparities reflect a combination of genetic factors and social determinants of health that affect stroke risk.

Some specific genetic conditions dramatically increase stroke likelihood. Disorders affecting blood clotting, blood vessel formation, or heart structure create particularly high risk that requires specialized medical management.

Health experts emphasize that genetic predisposition does not guarantee stroke occurrence. Even with strong family history, proactive management of other risk factors significantly reduces overall danger. For those with known genetic risk, more aggressive prevention measures and regular medical monitoring provide essential protection.

Understanding stroke causes empowers individuals to take control of their neurological health. By addressing modifiable risk factors through lifestyle changes and appropriate medical care, most people can significantly reduce their likelihood of experiencing this potentially devastating event.

Working with healthcare providers to develop personalized prevention strategies based on individual risk profiles offers the most effective protection. This collaborative approach ensures that preventive efforts target the most relevant factors for each person while providing appropriate monitoring for early detection of problems.

The encouraging reality is that most strokes can be prevented. With awareness, motivation, and appropriate action, individuals can significantly strengthen their protection against this serious health threat.

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