Be Stroke Smart

    Dr. Dan Johnson, Deaconess Neurologist/Hospitalist and Medical Director of the Primary Stroke Center

    I want every person I meet to know three things about stroke:  What causes them, how to prevent them, and how to recognize the signs and symptoms of stroke.

    A stroke occurs when a blood vessel that carries blood from the heart to the brain is suddenly either blocked or breaks. Either of these events interrupts blood flow to an area of the brain, causing brain cells to die and brain damage to occur.

    Stroke is serious.  It’s the leading cause of long-term adult disability in the US, and it’s one of the leading causes of death.


    Stroke Risk Factors
    There are two kinds of stroke risk factors, those that can’t be controlled, and those that can. 
    The only risk factors that can’t be controlled include a family history of strokes, and being over the age of 55. 

    The way family history impacts an individual’s stroke risk is significant. We don’t know most of the genes involved in stroke risks yet, but we do know that stroke runs in families.

    Also, most strokes happen in people over age 55, because gradual changes in the body’s blood vessels happen over a lifetime. However, we often see strokes in younger people because of lifestyle-related risk factors.

    Major stroke risk factors that can be controlled:

     
    • High blood pressure (HBP) HBP damages blood vessels gradually over several years. Extremely high blood pressure can also cause a hemorrhage (rupture of the vessel).
    • High cholesterol  This causes the blood vessels to become clogged with a fatty-like layer. It narrows the vessels, resulting in less blood flow. It can also create a “rough surface” on which blood clots can form.
    • Diabetes  Chronic high blood sugar, which is the common effect of diabetes, damages the blood vessels. It also reduces the body’s ability to heal and repair itself the way it needs to.
    • Stress  What stress does to one person is different than another. However, if you are unable to properly care for yourself (with good diet and exercise), you aren’t sleeping well, suffer from anxiety related to stress, etc. it will take its toll on your health.
    • Smoking  Smoking kills more people than all illegal drugs/car wrecks/murders combined. Just because it’s legal doesn’t make it safe. Smoking damages your blood vessels in a profound way and robs your body of oxygen. Just don’t do it. I’ve seen in my practice that in patients under age 50 who have had a stroke, smoking was the most common identifiable risk factor.
    • Heavy alcohol use  This is a case of all things in moderation. While a small amount of alcohol (1-2 drinks per day or less) can help reduce risk for cardiovascular disease, excessive alcohol use can increase risk for hemorrhagic stroke.
    • Obesity  Obesity leads to many of the risk factors listed above, including diabetes and high blood pressure.
    • Physical inactivity  Physical inactivity often leads to obesity (and poor stress management) which leads to many of the earlier risk factors.
    • Irregular heartbeat  Specifically, the irregular heart beat called atrial fibrillation (a-fib) can cause blood clots to form in the heart, which can then break loose and travel to anywhere in the body, including the brain.
    • Other heart disease  If you have a heart that is damaged and pumps poorly (such as from a heart attack or heart failure issue), it can lead to reduced blood and oxygen flow to the brain, as well as development of clots.
    • Illegal drug use, especially cocaine or methamphetamines   There’s a reason these drugs are illegal. They cause significant damage to the lining of blood vessels. They can also cause spikes in blood pressure, and damage the heart itself.

    How to Reduce Your Risk
    • Know your blood pressure and cholesterol numbers, and manage them well.
    • If you have diabetes, keep it under control.
    • Manage your stress. If you think you have too much to do, you’ll get even less done if you have a stroke!
    • If you smoke, STOP!
    • Drink alcohol only in moderation.
    • Just move! Only 30 minutes of activity per day can improve your health in many ways, including reducing your risk for stroke.
    • Enjoy a lower sodium (salt) and lower fat diet.
    • If you have an irregular heartbeat (atrial fibrillation, or AF) work with your doctor to manage it.
    • If you have had other heart disease events, such as prior heart attack, stroke or “mini-stroke” (TIA), you are at high risk for stroke. Be your doctor’s partner in improving your health!
     
    Finally, I want to talk about the importance of recognizing the signs and symptom of a stroke. 
    The symptoms of a stroke can be remembered with a helpful acronym of F.A.S.T. 


    Posted: April 1, 2014 by Pam Hight
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