Stroke. Reduce Your Risk, and Know the Signs

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

    Stroke. It’s the leading cause of long-term adult disability, and the fourth leading cause of death in the United States. Because of these serious statistics, I want everyone to know more about stroke risk factors, stroke signs and symptoms, and the importance of immediate treatment if stroke is suspected.

    What is stroke?
    A stroke or "brain attack" occurs when a blood vessel that carries blood from the heart to the brain is either blocked (such as by a blood clot), or when one of those blood vessels breaks. Either of these events interrupts blood flow to an area of the brain. When either happens, brain cells begin to die and brain damage occurs.


    How can I recognize the symptoms of stroke?
    The symptoms of a stroke can be remembered with the helpful acronym F.A.S.T.


     















    Act F.A.S.T.


         FACE
    • Does one side of the face droop? Ask the person to smile. Is it even?

         ARMS
    • Is one arm weak or numb?
    • Ask the person to raise both arms. Does one arm drift downward?

         SPEECH
    • Is speech slurred?
    • Ask the person to repeat a simple sentence. Is it correct?

         TIME
    • TIME is critical. If the person shows any of these symptoms, call 911 and get them to the hospital immediately.
    • Note the time of symptoms, and get to a PRIMARY STROKE CENTER.


    Remember, stroke is an emergency. When it comes to stroke, time is brain, and the faster someone is treated, the greater chance of a better outcome.
     
    Deaconess is a Primary Stroke Center. This means we meet national criteria for providing stroke care that is not available at all hospitals. We are the only primary stroke center in Evansville. What that means to you and your family is that from the moment a stroke patient enters our emergency department, they are under the care of specially-trained/certified stroke professionals. For more information about this designation, visit the Deaconess Stroke page.
     

    Are strokes preventable?
     
    Actually, up to 80% of all strokes are preventable through risk factor management. 
     
    We’ll first focus on the ones that cannot be controlled: family history and age (over 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. Most strokes happen in people over age 55. The reason for this is that 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. 
     

    What are these lifestyle-related risk factors?
     
    These common risk factors for stroke CAN be controlled with  personal choices and lifestyle decisions.
    • High blood pressure. HBP damages blood vessels gradually over several years. Extremely high blood pressure can also cause a hemorrhage (making the blood vessel rupture).
    • 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 (in 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 only 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, lead to poor nutrition, and can also cause early death from liver failure.
    • 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) allows 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, such as cocaine or methamphetamines.  There’s a reason these drugs are illegal, as they cause significant damage to the lining of blood vessels. They can also damage the heart itself, cause spikes in blood pressure, etc.
    • Sleep disorders, such as sleep apnea.  Sleep apnea is related to increased blood pressure and reduced oxygen to the brain.  If someone has sleep apnea, a CPAP machine or other piece of equipment that helps to keep the airway open can help reduce this risk.


    What is the best way to reduce stroke risk?
     
    Pay attention to your risk factors, and do what you can to manage them.  Be your doctor’s partner in improving your health!

    • Know your blood pressure and cholesterol numbers, and work to keep them low.
    • 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.
     
     
    Final thoughts

    Remember, up to 80% of strokes are preventable.  Take steps now to reduce your risk. 
     
    Also, stroke can happen at any time to anyone.  You could be at the grocery store, work or church and someone around you could be having a stroke.  You could be at home, and a loved one could have a sudden stroke.  Learn the signs and symptoms to spot a stroke FAST.  You may just save a life.
    Posted: June 20, 2014 by Jessica Gerlach
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