THURSDAY, July 17 (HealthDay News) -- Sleeping either too much or too little appears to heighten the risk of stroke, a new study finds.

And while the researchers said their findings can be applied only to the postmenopausal women in the study, other experts said the same relationship between sleep and stroke risk seems to be universal.

The study of more than 93,000 women found that those who regularly slept more than nine hours a night had a 60 percent to 70 percent higher risk of stroke than women sleeping seven hours.

The risk of stroke was 14 percent higher for women who regularly slept six hours or less, compared to those sleeping seven hours a night.

The study, to be published online July 18 in the journal Stroke, was led by Dr. Jiu-Chiuan Chen, an assistant professor of epidemiology at the University of North Carolina School of Public Health.

A number of studies have documented adverse effects of sleep deprivation, Chen said, and this report adds to that evidence.

"There have also been many studies showing a link between abnormally long sleep and an increased risk of cardiovascular disease and high blood pressure," he said.

Similar findings have been seen in studies of other groups of people, said Dr. Adnan I. Qureshi, professor of neurology, neurosurgery and radiology at the University of Minnesota Medical School, who has done some of those studies.

"If you sleep too much or sleep too little, it seems your risk of stroke goes up," said Qureshi. "This is not explained by traditional risk factors such as cholesterol levels or high blood pressure."

It isn't clear why sleep affects stroke risk, but there are several possible explanations, he said. One is that people who report long hours of sleep may have "ineffective sleep," because their periods of sleep are broken up by unnoticed wakenings, sometimes due to the breathing disorder called sleep apnea.

"Or you may be looking at a psychosocial profile," Qureshi said. "People who have depression tend to sleep longer."

As for too-brief sleep, "in experimental models, it has been shown that if you do not get enough sleep, the risk that you will die increases," he said. "Both sleep and the quality of sleep are important for survival."

There might be some factors specific to postmenopausal women, said Sylvia Wassertheil-Smoller, head of the division of epidemiology at Albert Einstein College of Medicine in New York City.

"Women who sleep less than six hours, all kinds of things happen to the hormonal system," she said. "Lots of studies clearly show that it is detrimental, that lots of stress hormones get released."

And sleeping longer than normal might be related to depression, Wassertheil-Smoller said, in agreement with Qureshi.

"People who are depressed tend to sleep longer," she said. "Depression is related to an increased risk of cardiovascular disease and stroke."

Simply setting the clock to sleep an allotted amount of hours is not a solution to the problem, Wassertheil-Smoller said. "If a woman is not sleeping long enough, she can try stress reduction and other methods to get more sleep," she said. "If a woman is habitually sleeping more than nine hours, she can discuss it with her doctor. She should also act to lower the known risk factors for stroke, especially high blood pressure."

More information

To learn more about the importance of sleep, visit the National Sleep Foundation  .

MONDAY, July 14 (HealthDay News) -- Men who thought they had a lower risk of dying from heart disease turned out to be right over the next 15 years, no matter what their conventional risk factors showed.

The death rate for men who had the optimistic point of view was only one-third that of those who listed themselves as being at average risk, said the report in the July/August issue of the Annals of Family Medicine.

But the happy result of an upbeat outlook was not seen among the women in the study. The cardiovascular death rate was the same for women who listed themselves as having below-average risk as for those who said they were at average risk.

The lesson of the study isn't that men can cheerfully ignore what their doctors tell them about risk factors such as cholesterol, smoking and obesity, said Dr. Robert Gramling, who led the study while at Brown University. He now is assistant professor of family medicine at the University of Rochester, in New York.

It does say that physicians could do a better job of describing risk factors and what to do about them, Gramling said.

"In medical systems, we often have a pessimistic bias," he said. "We use normative language, telling people their risk might be high. Using the Framingham Heart Score places a fair amount of people into the categories of high or very high risk. After the age of 40, 80 percent might be viewed as at high risk."

That is how a physician would see it, but it is a question "of how we communicate uncertainty to patients about different aspects of medical care," he said.

A high-risk classification often strikes fear, "and I would suggest that fear-based prevention, meaning making changes based on fear, is not as helpful as holding an optimistic view," Gramling said. "We should focus on helping make changes easy to do, rather than on making people more fearful."

The failure to see a similar effect in women can be explained by the era in which the study was started -- the early 1990s, when the focus was entirely on the risk of cardiovascular disease for men, he said.

Today, it is widely known that cardiovascular disease is the leading cause of death for American women as well as men, Gramling said. "So, in men, you got more of a fear response," he said. "In women, being at higher risk was not as threatening. That might not be true any more."

Gramling is working along the same lines at Rochester. "The next step is to test under what conditions holding an optimistic view is most helpful and under what conditions it is not helpful," he said.

Meanwhile, there is no harm in feeling cheerful about cardiovascular health, as long as you follow the advice about the value of a good diet, exercise, blood pressure control and the like, Gramling said.

Another report in the same issue of the journal described a helpful outcome of combined treatment for high blood pressure and depression. A study of 64 adults found that those who had drug therapy for both conditions simultaneously achieved lower blood pressure level and were more likely to take their antidepressant drugs on schedule, according to physicians at the University of Pennsylvania.

More information

A scale for determining your individual cardiovascular risk is provided by the National Cholesterol Education Program  .

THURSDAY, July 10 (HealthDay News) -- Whether drinking alcohol helps or hurts your chances of avoiding heart disease and stroke may depend on your gender as well as how much you imbibe, a new study finds.

The report, which appears online July 11 in the journal Stroke, looked at the drinking habits and lifestyles of more than 80,000 Japanese men and women over a 14-year period. None had previously experienced cancer, stroke or heart disease prior to the study.

Among the findings:

• Men who drank heavily (at least 46 grams of alcohol -- roughly four or more standard alcoholic beverages a day) had a 19 percent lower risk of dying from coronary heart disease than non-drinking men. However, these heavy drinkers also had a 48 percent increased risk of death from all types of stroke.
• Women who drank heavily quadrupled their risk of heart disease death compared with women who didn't drink. Women who drank heavily had a 92 percent higher risk of death from stroke.
• Among women, light drinking (less than 23 grams of alcohol or about two drinks a day) was associated with a 17 percent lower risk of death by heart disease death, but moderate drinking (between 23 grams and 46 grams per day) was linked to an increased risk of 45 percent. Prior studies had suggested that light-to-moderate alcohol consumption might be associated with a lower risk of cardiovascular disease in women.

"An amount of alcohol that may be beneficial for men is not good for women at all," study co-author Dr. Hiroyasu Iso, a professor of public health at Osaka University in Japan, said in an American Heart Association news release.

Iso noted that one limitation of the study is that the Japanese culture has social restrictions against women drinking as they get older, so the women who drank in the study may have had other factors that affected their heart disease and stroke risk.

More information

The American Stroke Association has more about alcohol and cardiovascular health  .

THURSDAY, July 10 (HealthDay News) -- For years, scientists have known that flavonoids, antioxidants found in foods as diverse as fruit, vegetables, herbs, grains and chocolate, are heart-healthy.

Now, researchers who looked at the effects of flavonoid-rich foods on cardiovascular disease risk factors such as high blood pressure have linked certain foods with specific benefits.

Health benefits associated with flavonoids have been reported for decades, but it's still difficult for experts to make specific recommendations about which flavonoids to eat for specific health effects because of a lack of data. Antioxidants slow or prevent the oxidative process caused by substances called free radicals, which can cause cell dysfunction and the onset of heart disease and other health problems.

In the new study, Dr. Lee Hooper, a lecturer at the University of East Anglia in Norwich, U.K., and colleagues sifted through the 133 studies to look at the links between different flavonoid subclasses and flavonoid-rich foods on different risk factors for cardiovascular disease, such as unhealthy cholesterol, high blood pressure and blood flow.

Among the findings:

• Eating chocolate or cocoa increased a measure called flow-mediated dilation, which is a good indication of blood flow in the veins. It also reduced blood pressure, both systolic (the upper number, reflecting the maximum pressure exerted when the heart contracts) by about 6 points, and diastolic (the bottom number, reflecting the maximum pressure when the heart is at rest), by about 3.3 points. But it didn't seem to have an effect on so-called "bad" LDL cholesterol.
• Soy protein reduced diastolic blood pressure by almost 2 points of mercury and improved bad cholesterol but didn't improve so-called good HDL cholesterol. But those effects were found just for isolated soy protein, not for other soy products.
• A habit of green tea drinking reduced bad cholesterol levels, but drinking black tea boosted both systolic and diastolic pressure -- by 5.6 points for systolic and 2.5 for diastolic.

As more research on flavonoids becomes available, it is likely that no single one will emerge as a "miracle food, but that many will contribute to our cardiovascular health," said Hooper, whose review was published in the July issue of The American Journal of Clinical Nutrition.

The new review helps define the role of foods rich in antioxidants, said Dr. Johanna Geleijnse, a nutritional epidemiologist at Wageningen University, the Netherlands, who co-authored an editorial to accompany the report.

"Evidence is accumulating that these substances are more important to cardiovascular health than vitamin C and vitamin E," and this most recent analysis strongly suggests good effects on blood pressure and blood vessel function, she said.

But much remains to be found out, she added.

Meanwhile, what to do? Eat a good mixture of the flavonoid-rich foods you like best, said Hooper. "For me, this would include lots of fruit, small amounts of a good dark chocolate (at least 70 percent cocoa), plus the basics like onions and green tea and an occasional glass of red wine."

More information

To learn more about flavonoids, visit the American Dietetic Association  .