Healthy Edge
Stroke Prevention
Did you know that 80 percent of all strokes are avoidable? Stroke prevention takes a little work on your part and in some cases, some shared work with your medical provider. Read on to get a better understanding of your personal stroke risk and what you can do to improve your chances of staving off strokes.
According to the CDC, 700,000 individuals each year experience strokes. Stroke is the leading cause of long-term disability in adults. It's the third leading cause of death. One out of every 16 Americans die from stroke each year. Currently, 25 percent of men and 20 percent of women have a stroke by age 85.
What exactly is a stroke?
In general, strokes occur when the blood flow to the brain is impaired by the blockage or rupture of an artery.
Arterial blockage can be caused by hardening/narrowing of the artery (aka atherosclerosis), blood clots or atherosclerotic plaques (cholesterol and calcium deposits in the arteries that dislodge and can form a plug elsewhere).
Arterial rupture can by caused by aneurysms. Rupture-related strokes are often a more severe but less common type of stroke.
During a stroke, brain cells don't receive needed oxygen, causing brain tissue damage and death. That's why stroke experts say, "time is brain."
Massive loss of brain cells occurs in minutes to hours as a stroke progresses. Each minute that passes results in an average loss of 1.9 million neurons and 14 billion synapses, reports UCLA Stroke Unit Director Dr. Jeffrey Saver. The brain of an under-treated patient having a stroke ages 3.6 years for every hour that passes after stroke onset.
Remember: getting into the emergency room within one hour of stroke onset is critical.
What are the stroke warning signs?
You may have seen materials from the F.A.S.T. stroke prevention campaign. F.A.S.T. stands for face numbness, arm numbness, slurred speech and time. There is no time to waste if the first three symptoms are presenting!
Other symptoms that may indicate a stroke include mental confusion, headache, face and limb pain, nausea and hiccups, as well as symptoms typically believed to be unrelated to stroke (e.g., chest pain, shortness of breath, palpitations). These "non-traditional" symptoms occur in women more frequently than men, said Lynda Lisabeth, Ph.D., Assistant Professor of Epidemiology at the University of Michigan Health System.
F.A.S.T. can also help you identify transient ischemic attacks (TIAs) --strokes that seem as if they're over within several minutes. The warning signs for strokes and TIAs are the same.
At least 15 percent of the time, a TIA precedes a full-blown blockage-related stroke, and most likely, the full-blown stroke will occur within 48 hours of a TIA. So, TIAs are perhaps the most important stroke warning sign.
To reduce the risk of a post-TIA stroke by 80 percent, see if your medical provider can help you get emergent implementation of secondary prevention strategies.
When should I suspect a TIA?
Sadly, almost half of you experiencing a TIA don't report this dangerous warning sign to your provider.
Further, it's often the case that you're asymptomatic once you get to your provider's office because TIAs usually resolve in minutes. However, even if TIA symptoms are no longer present, it doesn't mean that you're free and clear.
If you had any stroke-like symptoms (including transient vision loss or dizziness) and then said to yourself, "I don't know what happened. Whatever it was, it's all better now," then, please get checked for a TIA.
What are the risk factors for strokes/TIAs?
Medical stroke risk factors include hypertension, atherosclerosis of large vessels, atrial fibrillation (AF), asymptomatic carotid artery stenosis and other cardiovascular diseases -- conditions that are common in Seniors. The American Heart Association (AHA) also recognizes that postmenopausal hormone replacement therapy puts women at risk for stroke. For those under age 65, the large 2007 Framingham Study published in "Stroke" showed that depressive symptoms are significant stroke risk factors. Your provider can help you with the above controllable risk factors.
Other important controllable risk factors include smoking, inactivity, obesity and diabetes. If you've been diagnosed with hyperhomocysteinemia or hyperlipidemia, follow the diet changes that were recommended!
Poor diet and nutrition (general)
According to a 1999 JAMA article, stroke risk is reduced 6 percent for each serving of fruit or vegetables per day. Increasing potassium and reducing sodium intake also mitigates the risk of stroke. The CDC-supported Dietary Approaches to Stop Hypertension (DASH) diet -- which is rich in fruit, vegetables and low-fat dairy products -- has been shown to lower blood pressure and likely reduce the risk of stroke.
Physical Inactivity
A habitual sedentary lifestyle increases your chance of stroke. Although duration and activity levels influence the risk of stroke, light to moderate exercise is beneficial. Walk or exercise at a moderate intensity for 30 minutes or more daily.
Obesity and Body Fat Distribution
The risk of stroke is increased for individuals with a body mass index of 25 kg/m2 or more and abdominal obesity (i.e., waist circumference of 40 inches or more in men and 35 inches or more in women). According to the AHA, weight loss lowers blood pressure and cholesterol and positively affects other risk factors for stroke. So, lose a little weight if you need to; you'll prevent stroke and look and feel better!
Here's a rule of thumb: 500 calories less per day = 1 pound lost per week and 1000 calories less per day = 2 pounds lost per week.
Smoking
According to the U.S. Department of Health and Human Services, smoking more than doubles the risk for blockage-related stroke and rupture-related stroke; repeated exposure to second-hand smoke almost doubles the risk of stroke.
The good news: following cessation, the stroke risk decreases over time.
Address the above controllable risk factors to stave off stroke. If you want a personal stroke risk scorecard to present to your medical provider, go to www.stroke.org/site/DocServer/Scorecard.Q._08.pdf?docID=601 and take the test. It's worth it!
Kendra Siler-Marsiglio, Ph.D. is the Director of the Rural Health Partnership at WellFlorida Council.
