Like a heart attack, a stroke is a medical emergency. Any delay in treatment can mean irreversible damage, resulting in disabilities.
A stroke can occur at any age but becomes increasingly likely with advancing age. A family history of stroke also increases the risk. African Americans are particularly vulnerable; strokes are not only more common but more likely to be fatal and more likely to occur at an earlier age in a person of African American descent.
Managing Your Risks
If you have an above average risk, you should be vigilant about early signs. But the major risk factors for stroke are lifestyle matters that everyone should try to control.
HYPERTENSION, which affects more than half of Americans adults, is the number one risk factor. Blood vessels in the brain, damaged from the stress of chronically high blood pressure, eventually become susceptible either to blockage or hemorrhage.
If you don’t know your blood pressure, you should. If you’ve been diagnosed with high blood pressure, and you’re ignoring your treatment because you feel no symptoms, you are basically a stroke waiting to happen.
Although most persons with hypertension require medication, they also benefit from lifestyle measures–exercise, weight control and a diet rich in fruits and vegetables and low in saturated fats.
Most persons with hypertension are salt sensitive, and nearly everyone benefits from keeping sodium intake under 2000 milligrams, or 2 grams a day.
SMOKING: Nicotine increases blood pressure; other substances in tobacco damage blood vessels and reduce the amount of oxygen the blood can carry to the brain. Smoking also makes the blood thicker and more likely to clot.
Quitting at any age reduces your risk of stroke as well as heart disease, cancer and chronic breathing disorders.
CHOLESTEROL: High levels of LDL cholesterol in the blood endanger the brain as well as the heart, and for the same reasons. When the carotid arteries carrying blood through the neck to the brain become diseased with a buildup of fatty deposits, the risk of a stroke increases.
In addition to diet, exercise, medications and other measures to lower cholesterol, most persons with a risk of stroke or heart disease are advised to take a small dose of daily aspirin or other medications to help prevent the formation of clots.
When tests show the carotid arteries to be significantly blocked off, even if the patient is not experiencing symptoms, a surgical procedure known as a carotid endarterectomy may be performed to remove plaque and reduce the risk of a stroke. An alternative procedure is balloon angioplasty and insertion of a mesh stent.
ATRIAL FIBRILLATION is a rhythm disturbance that increases the risk of blood clots. Persons with atrial fibrillation should get treatment and take aspirin or other medications to help prevent clots.
DIABETES increases a person’s risk of both stroke and heart disease. If you have diabetes, it’s important to control your blood sugar and take steps to prevent and treat complications, particularly those involving blood vessels. When a stroke does occur, it is usually less severe if blood sugar is under control.
Many individuals have diabetes without knowing it or have pre-diabetes. Studies have shown that moderate exercise and weight loss help prevent or delay diabetes and its complications.
TIAs: Transient ischemic attacks or TIAs are mini strokes. The patient experiences one or more stroke symptoms such as loss of sight in one eye or numbness or weakness on one side of the body, but the symptoms pass within a few minutes.
It’s tempting–but unwise–to deny these symptoms and pretend nothing happened. At least a third of persons suffering a TIA will have a full-blown stroke at some time in the future, with one half of strokes occurring within the next two days.
It’s important to consider any stroke symptom to be a medical emergency and not wait to see whether the symptom lasts.
These symptoms include
- sudden numbness or weakness, especially on one side of the body;
- sudden confusion and trouble speaking or understanding;
- blindness or trouble seeing in one eye or both;
- trouble walking;
- dizziness, loss of balance or coordination; and
- a sudden severe, unexplained headache.
Some doctors recommend a 60-second test: asking the person to smile, raise both arms and repeat a simple sentence. Failure to perform any of these tests is reason to call 911 immediately.
Although a stroke is often a bolt from the blue that seems to unfairly single out victims, there are measures that can be taken to reduce your risk. Early attention to these measures can save you years of regret.
Michelle Herbert Thomas, PharmD, CDE
Clinical director
