10 Commandments to Reduce Your Risk of Stroke

Man holding his head in pain.Strokes usually aren’t medical mysteries that strike at random. High blood pressure and other preventable risk factors account for 90 percent of strokes, a huge international study confirms. Even so, you don’t have to live like a monk, eat like a dietitian or train like an elite athlete to avoid a devastating brain attack. Making modest changes in your life and incorporating healthy habits can help you stave off stroke. Below are your top 10 evidence-based areas for self-care improvement:

1. Blood Pressure: Lower It

If you have high blood pressure, you can reduce your stroke risk with a small investment of time and money and a little help from your health care provider. In developed countries like the U.S., tools to stay on top of blood pressure are readily available, says Martin O’Donnell, lead author of the 32-country study published in The Lancet, a medical journal. People have easy access to regular blood pressure measurements, whether it’s a quick reading at the supermarket or buying an inexpensive machine to use at home.

So much is already known about lifestyle approaches to lowering blood pressure, says O’Donnell, an associate clinical professor at NUI Galway, in Ireland, and at McMaster University in Ontario, Canada. When lifestyle tweaks aren’t enough, he adds, people have access to generic, low-cost medications.


2. Physical Inactivity: Move It

Carving out leisure time for regular exercise – such as playing sports, going to the gym or taking walks – was more common in higher-income countries and tied to lower stroke risk in the new study. That isn’t a big surprise.

“A lot of these risk factors have been established for decades now,” says Dr. Hugo Aparicio, a neurologist with Boston Medical Center and an assistant professor at Boston University School of Medicine. Aparicio is part of the research team for the famedFramingham Heart Study, now following a second generation of Massachusetts participants. What the new global study does, he says, is confirm that the top suspected stroke risk factors in Western society also play the biggest role in risk in different regions of the world.

3. Unhealthy Diet: Balance It

Dietary guidelines have it right, O’Donnell says. Emphasizing a balanced diet packed with fruits and vegetables and including fish – while avoiding processed foods and limiting red meat and fried and salted foods – works to prevent stroke. The Mediterranean eating pattern is one example, he says.

One surprise from the global results: Eating vegetables was not stroke-preventing in South Asia, a finding that needs more confirmation, O’Donnell says. One possible reason is vegetables are consumed differently in various parts of the world. So that raw spinach in your salad may be healthier – if less tasty – than prepared spinach in the Indian dish saag paneer.

4. Obesity: Lose It

Exercise and healthy eating help reduce obesity, which further lowers your risk of stroke. Stroke risk factors don’t exist in isolation – they’re highly interconnected, Aparicio points out. The same lifestyle changes that stave off stroke may also contribute to reduced risk of having a heart attack or developing diabetes, cancer or dementia.


5. Smoking: Quit It

Not only is smoking tied to many types of cancer, such as lung cancer and stomach cancer, it’s also a top risk factor for stroke. Call a quit line, get your health provider on board and do your best to kick the habit.

6. Heart Risk: Treat It

Heart disease and stroke risk go hand in hand. A heart-rhythm problem called atrial fibrillation is a major risk factor for stroke if left untreated. Many people can control their a-fib with treatment involving regular checkups and anticlotting medication, along with incorporating lifestyle changes.

7. Diabetes: Manage It

When it comes to cutting stroke risk, “other parts of it are a little harder for the individual to do, like monitoring or treating your blood pressure or diabetes,” Aparicio says. “But that’s where the role of the health care provider can come in to help you measure these things and treat them if you need it.” The risk of stroke is 1.5 times higher for people withdiabetes, according to the American Diabetes Association. Keeping blood sugar levels on target helps lower that risk.

8. Alcohol: Moderate It

Whether people should consume alcohol at all or limit it is one of the trickier stroke risk factors to pin down. O’Donnell says while excess and binge drinking clearly contribute, the role of low or moderate drinking is less certain. Types of alcohol people drink and reasons for drinking vary widely. Binge drinking, which may contribute to stroke risk by raising blood pressure, is associated with the most common type of stroke – ischemic stroke, he adds.


9. Stress: Ease It

Easier said than done, but if you can subtract stress from your life, your brain and body will thank you. Among his patients, Aparicio says, “Once people learn about stroke and the causes of stroke, they often talk about how the wish they had had better control of their risk factors. A healthier lifestyle, or had less stress in their lives,” he says. “But on the other hand, they realize this is a red flag for them, and they have this opportunity now to own their own health.”

10. Cholesterol: Control It

When you have a blood test to measure cholesterol, it’s broken down into several categories. Stroke risk is only weakly tied to total cholesterol counts, O’Donnell says. However, HDL and LDL cholesterol levels are important, he says, especially HDL – the good cholesterol. Eating foods high in HDL – such as olive oil, legumes, beans and high-fiber fruits – and having your cholesterol checked are good ways to help tamp down stroke risk by keeping blood vessels clear of plaque.

Doable, Not Drastic

You don’t have to do everything at once. First, it’s a matter of tackling top stroke contributors like high blood pressure and smoking, Aparicio says. Then, as patients see success, he talks with them about lifestyle adjustments like changing their diet and incorporating more physical activity into the their routines.

The unrealistic concept of “You’ve got to be a perfect body weight; you’ve got to exercise all the time; you’ve got to lead this almost monkish life,” can be put to rest, O’Donnell says: “What our study suggests is most of these risk factors are on a continuum. So if you can’t achieve perfection, modest, imperfect changes in these risk factors will reduce your risk of stroke.”


Young mom becomes nurse after stroke, reminds all to watch for signs, symptoms

Stroke AwarenessAt 21 years old, Kimberly Eckard, 25, had a stroke. She was doing laundry when she started to feel weak, and her fingers slowly went numb. When she went to lie down, she blacked out.

“It started in my finger tips, they felt kind of numb, just detached from my body,” Eckard said.

When she woke up, she called her mom because her head hurt. She thought she was overly stressed, but when she started to speak on the phone, her words weren’t complete.

“(Strokes) can happen to anybody; you can have no risk factors and it can still happen,” Whitney Arrington, Frye Regional Medical Center’s stroke care coordinator, said.

Once an individual has a stroke, they are 60 percent more likely to have another one in the next three years, she said.

Two types of strokes can occur: ischemic is most common and hemorrhagic is most fatal, Arrington said.

Ischemic strokes occur when oxygen isn’t getting to the brain due to a blood clot. A hemorrhagic stroke is when an artery in the brain is leaking or ruptures causing damage to brain cells.

“In one part of the brain it can affect your speech, in another your arm,” Arrington said. “It can affect your mood and emotion; it really depends where that clot is in your brain.”

Strokes are the fifth leading cause of death and the first leading cause of disability.

“We live in what’s called the stroke belt of America,” Arrington said.

Knowing the signs and symptoms of stroke is important to anyone’s health along with knowing the risk factors. Age, race, sex, cholesterol, high blood pressure, and diabetes are factors in a stroke.

When an individual has a stroke, calling 911 should be the first response, Arrington said.

Frye educates the community to know the signs and symptoms of stroke and to call 911 and get EMS involved as soon as possible, Arrington said.

“It’s always better to go to the ER and let them say you don’t have a stroke than to sit at home with a stroke,” Dr. Robert Yapundich, neurologist and medical director of the stoke program, said.

It is crucial to get care immediately because after 90 minutes since the stroke occurred, activase, also known as tissue plasminogen activator (TPA), is not applicable, she said.

“The name of the game is time and speed,” Yapundich said.

TPA is a clot busting medication that can reverse stroke symptoms, Arrington said.

“The biggest leap forward was TPA,” Yapundich said.

Before TPA, strokes were treated the same as heart attacks, he said. Doctors quickly learned that the brain is different from the heart.

Frye uses a stroke assessment monitor and intervention robot to communicate with Wake Forest Baptist Medical Center. A neurologist who specializes in stroke care can quickly and efficiently consult with an ER physician to decide whether or not a patient receives TPA.

Eckard wasn’t a candidate for TPA because she wasn’t within 90 minutes of the stroke when treated. She went to her primary doctor first before being told to immediately go to the hospital because she didn’t know she was having a stroke.

If TPA isn’t available for use such as in Eckard’s case, getting a patient back to the most functional level is the goal, whether that is through rehab, medication or other measures.

“There really is no one set path each person takes, it depends on that person and what their risk factors are,” Arrington said.

Some patients will have full function the following day, while others may never regain function again, Arrington said.

In Eckard’s case, after doing a computed tomography (CT) scan and a few magnetic resonance imagings (MRI), arteriovenous malformations (AVM) were found in her head, Eckard said.

“The goal is to always put (patients) on a regimen that will prevent future strokes,” Arrington said.

AVMs, a birth defect that tangles blood vessels in the brain, most likely caused Eckard’s stroke, Arrington said.

“Out of my entire check list, the only thing I had was one family history of a stroke,” Eckard said.

She said she was healthy, exercised regularly and didn’t smoke, but yet she had a stroke.

“For the most part I came back close to baseline pretty quickly which was very fortunate,” Eckard said.

She spent three days in the hospital, but didn’t have to undergo any rehab. Her speech cleared up first before she even reached the stroke unit floor.

“Majority of patients aren’t that lucky,” Arrington said.

Ninety-nine percent of patients leave the hospital with some kind of deficit, a long-lasting effect of stroke, where they need rehab or to be placed in a facility for rehab, Arrington said.

“For the first part, it was hard for me because yes, I was 21, I was a young mom,” Eckard said. “It just felt like a mess, like you were a fish bowl and people were looking at you.”

Her daughter doesn’t remember the incident because she was 2 years old, but when she is older, Eckard plans on discussing what happened.

“I want (my daughter) to be aware, because if not, the same thing could happen,” Eckard said. “Now it’s in our family history, it’s a big deal.”

Years later, Eckard still sees a neurologist every 6 months. She occasionally has migraines and numbing in the tip of her fingers.

Eckard originally went to school to be a physical therapist, but after her life-changing event, she went into nursing. She is a certified nurse assistant (CNA) at Frye and recently passed her boards to be a registered nurse (RN).

As an RN, she will work in the stroke unit right beside patients to make sure they know about testing, results, rehab, medication, and all the steps in between.

“I’ll be on the floor that I was treated on,” Eckard said.

She also works with the nurse that treated her when she had her stroke.

A few weeks ago, Eckard had a patient come in with a stroke who was a young mom and in a similar situation Eckard experienced.

“We really get to connect, and I really like having that connection with some of the patients,” Eckard said.

An important part of nursing is being a patient advocate and making sure everyone is on the same page, Arrington said.

“It takes a special person to do that,” Arrington said.

Source : hickoryrecord.com