3 new studies point to promising ways to reduce stroke risk

 The Mediterranean diet has NO SPECIFICS WHATSOVER! So go ask you competent? doctor and hospital for SPECIFICS! Not being able to provide them means your board of directors is so incompetent they can't recognize incompetence in their hospital!  The Shigrix vaccine and asundexian have been out there for years; only an incompetent? doctor wouldn't already have provided them!

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• Shingrix vaccine (10 posts to October 2017)

3 new studies point to promising ways to reduce stroke risk

• A recent study has found that following the Mediterranean diet may help reduce the risk of stroke in women, including ischemic and hemorrhagic stroke.
• The shingles vaccine may help reduce the risk of stroke and other heart problems in people with atherosclerotic cardiovascular disease (ASCVD), according to recent findings.
• Research from April 2026 suggests that the drug asundexian may help reduce the chance of secondary ischemic stroke in people who have had an ischemic stroke or high risk transient ischemic attack (TIA).

An ischemic stroke happens when the blood supply to the brain is restricted or cut off. A hemorrhagic stroke occurs when there is bleeding in or around the brain. A transient ischemic attack (TIA) is similar to an ischemic stroke, but occurs due to a more short-term blockage of blood flow to the brain.

Stroke is the fourth most common cause of death in the United States, according to the American Stroke AssociationTrusted Source. They also suggest that up to 80% of strokes are preventable.

Some recent studies have explored various factors that may help lower the risk of stroke.

For example, the Mediterranean diet may help reduce the likelihood of stroke in women, according to research published in Neurology Open Access. The Mediterranean diet focuses on plant-based foods such as fruits, vegetables, and whole grains.

A study presented at the American College of Cardiology’s Annual Scientific Session (ACC.26) in March 2026 suggests that the shingles vaccine may help reduce the risk of stroke. The study results have not yet been published in a peer-reviewed scientific journal.

Additionally, the oral medication asundexian may reduce the risk of secondary stroke in people who have experienced an ischemic stroke or high risk TIA. This means it could help protect against an additional stroke.

Here’s what Medical News Today‘s coverage of these studies found.

Mediterranean diet may reduce stroke risk

A 2026 study published in Neurology Open Access looked at the possible benefits of the Mediterranean diet for reducing the risk of stroke in women.

The research asked the 105,614 participants about their eating habits, and assigned them a Mediterranean diet score. A higher score meant that their diet was more closely aligned with that of the Mediterranean diet.

The research found that those who followed the Mediterranean diet or a similar diet had a reduced risk of ischemic and hemorrhagic stroke.

Hypertension, or high blood pressure, is the greatest risk factor for stroke. However, diet can also play a significant role in blood pressure, with certain diets potentially helping lower blood pressure, thereby reducing the risk of stroke.

While more research is necessary, this study suggests that focusing on a plant-based diet, with plenty of fresh fruits, vegetables, and healthy fats, may help reduce the risk of stroke in some cases.

“Emphasis on extra-virgin olive oil, omega-3–rich fish, fruits, vegetables, legumes, nuts, and seeds supports endothelial function, improves cholesterol quality, and helps regulate blood pressure, blood sugar, and inflammation,” said Michelle Routhenstein, MS, RD, CDCES, CDN, a registered dietitian, who spoke to Medical News Today in an interview and was not involved in the study.

Shingles vaccines could reduce stroke risk

A recent study, the findings of which were presented at the American College of Cardiology’s Annual Scientific Session (ACC.26) in March 2026, looked at the effects of the shingles vaccine on heart health.

The study included 275,304 people who had received the shingles vaccine and 275,304 people who had not. It determined that people who had received the vaccine were less likely to experience major adverse cardiac events.

However, as the study was observational, it cannot directly prove cause and effect for the shingles vaccine providing these benefits. The findings are also yet to be published in a peer-reviewed scientific journal.

“We already recommend that all adults 50 and older receive the shingles vaccine. This study further supports this recommendation, especially in patients with established cardiovascular disease,” said Cheng-Han Chen, MD, a board-certified interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA, in an interview with MNT. Chen was not involved in the study.

Asundexian may reduce risk of secondary stroke

Secondary stroke, or recurrent stroke, refers to a stroke that happens in somebody who has already had a stroke. Around 1 in 4 strokes in the United States each year are secondary ischemic strokes.

A study published in the New England Journal of Medicine in April 2026 suggests that asundexian, an oral anticoagulant, may help reduce the risk of a second stroke in people who have experienced a noncardiometabolic ischemic stroke or high-risk TIA. “Noncardiometabolic” means that the blood clot or blockage formed outside of the heart.

Asundexian works by inhibiting activated clotting factor XIa. This is a protein that plays a role in blood clots. Inhibiting the activity or factor XIa may help reduce blood clot formation, potentially lowering the risk of stroke.

“For about 50 years, the mainstay of secondary stroke prevention has been aspirin monotherapy. This represents the first significant improvement for most ischemic strokes apart from short-term use of dual antiplatelet therapy,” explained Ashkan ShoamaneshTrusted Source, MD, co‑principal investigator of the study and Population Health Research Institute (PHRI) senior scientist, in an interview with MNT.

If you’d like to read more about MNT’s coverage of these studies and explore them in detail, please visit our news hub.

Asundexian Gets FDA Priority Review for Secondary Stroke Prevention

 

What are the EXACT STEPS your competent? doctor and hospital are taking to implement this? Oh, NOTHING, LIKE USUAL?

Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING? Your choice; let them be incompetent or demand action!

Your competent? doctor should have known of this trial as it started; IF COMPETENT AT ALL! We've already established your doctor is incompetent, so find a competent one to tell you what this research means for you!

• Asundexian (9 posts to April 2025)

Is it better than all these others that your doctor discussed with you?

• secondary stroke prevention (13 posts to February 2018) No discussion of these: ARE YOU SURE YOU'RE SEEING A COMPETENT? DOCTOR?

Asundexian Gets FDA Priority Review for Secondary Stroke Prevention

Factor XIa Inhibition Tied to Benefit Beyond Stroke Prevention

 What are the EXACT STEPS your competent? doctor and hospital are taking to implement this? Oh, NOTHING, LIKE USUAL?

Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING? Your choice; let them be incompetent or demand action!

Your competent? doctor should have known of this trial as it started; IF COMPETENT AT ALL! We've already established your doctor is incompetent, so find a competent one to tell you what this research means for you!

• Asundexian (7 posts to April 2025)

Is it better than all these others that your doctor discussed with you?

• secondary stroke prevention (13 posts to February 2018) No discussion of these: ARE YOU SURE YOU'RE SEEING A COMPETENT? DOCTOR?

Factor XIa Inhibition Tied to Benefit Beyond Stroke Prevention

Further results from the OCEANIC-STROKE trial have shown that the investigational Factor XIa inhibitor, asundexian (Bayer), not only reduces the risk of recurrent ischemic stroke but also lessens the clinical severity of those strokes when they do occur.

The trial was conducted in patients with non-cardioembolic stroke or high-risk transient ischemic attack (TIA). The main results, reported earlier this year, showed a significant reduction in ischemic stroke recurrence with asundexian versus placebo, without any increased risk of bleeding, a major achievement which has not been seen before with previous antithrombotic agents. 

Now, new analyses from the trial have been reported showing further benefits of asundexian.

“We know from the primary results of this trial that asundexian is associated with reduction in recurrent strokes. Now we have shown that recurrent strokes that do occur are less severe, and less likely to be disabling compared to the patients on placebo and that the benefits of asundexian treatment appears constant throughout the follow up period, suggesting that treatment should be continued long term,” lead investigator of the trial, Mike Sharma, MD, Population Health Research Institute, Hamilton, Canada, told Medscape Medical News. 

Article Key Points

Asundexian, a Factor XIa inhibitor, reduces recurrent ischemic stroke risk and severity without increasing bleeding risk, offering potential long-term benefits for stroke prevention. Its approval could significantly impact stroke management strategies.

Asundexian is not yet available and is currently under regulatory review in multiple countries, with hopes that it could reach the market later this year. If approved, it would likely be used in patients similar to those enrolled in the OCEANIC-STROKE trial — individuals with noncardioembolic ischemic stroke or high-risk TIA and a National Institutes of Health Stroke Scale (NIHSS) score of 15 or lower. Sharma estimates that could include about 70%-75% of stroke patients. 

“This treatment should be applicable to the majority of strokes, and most stroke patients will benefit. As we haven’t seen a bleeding hazard with this drug, that removes one of the barriers seen with other antithrombotic treatments,” he said. 

“We believe this drug will change the paradigm for stroke prevention — it will decrease the number of strokes occurring and reduce the severity of those strokes that do occur. It will be a big step forward in our goal of preventing death and disability due to stroke,” Sharma added. 

The results were presented at European Stroke Organization Conference (ESOC) 2026.

Fewer, Less Severe Strokes 

The trial enrolled 12,327 patients within 72 hours of a noncardioembolic ischemic stroke or high-risk TIA who were randomly assigned to receive either asundexian 50 mg once daily or placebo in addition to standard antiplatelet therapy.

The primary analysis showed that asundexian reduced the risk of ischemic stroke, with an absolute risk reduction of 1.9% at 1 year (hazard ratio [HR], 0.74; P < .001), without increasing the risk of major bleeding.

The latest findings showed that recurrent strokes were generally less severe among patients treated with asundexian. Among those who experienced a recurrent stroke, patients receiving asundexian were less likely to have a severe event — defined as an NIHSS score of 8 or higher — than those receiving placebo (22.9% vs 30.3%).

“We found that the strokes that do occur are milder in the asundexian group, so distribution of severity on the NIHSS is shifted towards lower scores,” Sharma said. 

Strokes that occurred in the asundexian group were also less likely to be disabling or fatal. Disabling or fatal stroke — defined as a modified Rankin Scale score of 3 or higher at 90 days — occurred in 2.1% of patients receiving asundexian compared with 3.0% of those receiving placebo (HR, 0.69; 95% CI, 0.55-0.87).

In addition, fewer patients in the asundexian group required endovascular thrombectomy (6.0% vs 7.3%), suggesting a possible reduction in large artery occlusion stroke.

“So, we have shown that patients on asundexian are less likely to have a recurrent stroke, and if they do, the stroke is not as severe, and recovery seems to be better,” Sharma noted.

Net Clinical Benefit 

In a second presentation, further data were reported showing continued separation of the event curves over time, and a net clinical benefit with asundexian.

“We calculated the hazard ratio for specific time intervals, and we see a consistent benefit at all intervals. This shows that there is no loss of efficacy with continued treatment, suggesting that it would be beneficial to continue treatment indefinitely,” said Sharma. 

“We feel that the asundexian should be thought of in the same way we think of aspirin and other medications we use to prevent stroke: they should be continued for as long as there is a risk of stroke, and to our knowledge, that doesn’t go away,” he added.

Asundexian also demonstrated significant net clinical benefit across all three prespecified composite endpoints: ischemic stroke or International Society on Thrombosis and Haemostasis (ISTH) major bleeding (7.0% vs 8.6% with placebo; P = .002); cardiovascular death, any stroke (ischemic or hemorrhagic), myocardial infarction, or ISTH major bleeding (8.5% vs 10.0%; P = .008); and all-cause mortality, disabling stroke, fatal bleeding, or symptomatic intracranial hemorrhage (3.1% vs 3.8%; P = .04).

Despite the encouraging efficacy and safety findings, questions remain about how the drug would fit into real-world clinical practice if approved.

Isabel Fragata, MD, of Centro Hospitalar Universitário de Lisboa Central in Lisbon, Portugal, who was not involved in the research, described the results as “important” but questioned how costly asundexian would be if approved, noting that the antithrombotic agents currently used for stroke prevention — such as aspirin and clopidogrel — are inexpensive and widely available 

Sharma agreed that cost will likely be a key issue if the drug reaches the market but said he hopes asundexian will ultimately be used broadly in eligible patients. He noted that the lack of an increased hemorrhage risk removes one major barrier to use and suggested that reductions in disabling and fatal stroke could help justify reimbursement for the therapy. 

This study was sponsored by Bayer. Sharma declares consulting for Bayer, Regeneron and Anthos; research funding for the current study from Bayer paid to his institution; research funding from BMS and Janssen; and serving on an endpoint review committee for AtriCure.