Stroke—how to prevent it

STROKE is a sudden severe illness that attacks the brain. There are two basic types. Ischemic strokes, which account for about 80 percent of total strokes, happen when blood flow to a part of the brain is cut off, causing brain cells to die from lack of oxygen. This frequently occurs due to hardening and blockages in your carotid arteries, which feed blood from your neck to your head. Ischemic strokes can also be caused by atrial fibrillation, an irregular heartbeat that leads to blood clots that may travel through your body and lodge in the brain’s arteries.

Hemorrhagic strokes account for the remaining 20 percent. These strokes are caused by bleeding from either a blood vessel on the surface of the brain or an artery in the brain itself. These strokes can be more deadly than ischemic strokes, with a mortality rate of close to 50 percent. Men are more likely to have strokes than women. Family history of stroke can play a role, though just how much remains unclear. And the rise of stroke goes up as you age. Statistics show that the incidence of stroke more than doubles each decade for a man once he reaches age 55. Of course, you have no say over gender, genetics or age. But there are a lot of risks you can definitely control.

For example, high blood pressure. This is also known as hypertension which is the single most important risk factor for stroke. About half of all strokes are caused by high blood pressure. High blood pressure causes stroke by speeding up atherosclerosis and damaging smaller blood vessels. It can cause tiny blood vessels in your brain to blow out like an overinflated tire.

Smoking also puts you at increased risk for stroke by speeding up clogging in the carotid arteries. In fact, smoking and high blood pressure are stronger indicators than even blood cholesterol levels of atherosclerosis of your carotid arteries. Men with diabetes are also at greater risk of stroke. Risk factors for heart disease such as high cholesterol, obesity, inactivity can also increase atherosclerosis and raise the likelihood of stroke.

Saving yourself from stroke

Despite hundreds of studies, strokes remain shrouded in mystery. They seem to strike without warning. Sometimes, it’s hard to tell when you’re even in danger. But early prevention can be the key to improving your chances of avoiding stroke. “The process leading to a stroke begins in your forties, even earlier, so now is the time to intervene,” says David G. Sherman, MD, head of neurology at the University of Texas Health Science Center at San Antonio. Here are some tips to prevent and help lower your risk:

Check your blood pressure. Many people don’t even know they have high blood pressure because it produces few outward signs. That’s why the American Heart Association recommends having your blood pressure checked by your doctor at least once a year if it is 130/85 or higher. If your blood pressure is lower, get it checked every two years. Many cases of high blood pressure begin developing between ages 35 and 45. Research shows that controlling high blood pressure can cut your risk of stroke by as much as 40 percent. Any reading higher than 140/90 is considered high. Your doctor will be able to prescribe treatments for high blood pressure, from dietary changes to getting more exercise. Controlling hypertension is absolutely vital in stroke prevention.

Stop smoking. Studies show that kicking the habit of smoking can reduce your risk of stroke by 33 percent. Don’t just cut back on cigarettes. There’s no such thing as moderate smoking. You have to stop altogether, all the way, right now.

Check your neck. Ask your doctor to listen for a bruit, a whooshing sound in the carotid arteries in your neck. This is caused by partial blockage and turbulence in the crucial blood vessels that feed oxygen to the brain. This is especially important if you have atherosclerosis causing blocked blood vessels elsewhere in your body, says Dr. Patricia Grady, acting director of the National Institute of Neurological Disorders and Stroke. Have your doctor check your heart too. Treating atrial fibrillation can reduce stroke risk by up to 80 percent.

Get some exercise. Physical inactivity may be a risk factor for stroke, but a total exercise time of at least 30 minutes a day, three times a week, could help cut that risk. A British study of 125 people showed that the sooner you start exercising, the better. Guys who started regular exercise between ages 15 and 25 had 70 percent less risk of stroke than non-exercisers. And even if you’re a little late getting started, you can still benefit from exercise. The study showed that people who began exercising between ages 25 and 40 reduced their risk by 57 percent and that people who started exercising between ages 40 and 55 had a 37 percent better chance of avoiding a stroke. Exercise has so many benefits. If you’re not exercising, you could be robbing yourself of years later on.

If it’s orange or green, eat it. Continuing research shows just how powerful the nutrient beta-carotene can be in fighting stroke. Fruits and vegetables are high in beta-carotene, with sweet potatoes, carrots, pumpkin, red peppers, winter squash, apricots and spinach among the best sources.

Pack away some potassium. Studies at the University of Mississippi Medical Center in Jackson showed that potassium may help prevent the formation of blood clots, one of the primary factors in stroke and heart attack. Potatoes are some the best sources of potassium you can find. Other good sources include beans avocados, bananas, oranges, salmon, trout and tomato sauce.

Go low-fat. What’s good for your heart is good for your brain. Keeping your cholesterol in check can slow atherosclerosis and ward off ischemic stroke. So eat a low-fat diet. Along with exercise and quitting smoking, what you eat is key to preventing stroke. Your diet does not need to be extreme but needs to be well balanced and low in fat.

Toast your health in moderation. Excess drinking means increased stroke risk. Numerous studies show that having more than four drinks a day greatly increases your chances of having a hemorrhagic stroke. But some studies show a link between moderate alcohol intake and slightly reduced risk of ischemic stroke, at least among whites. There may be something about alcohol that helps in small levels. It may prevent both heart attack and stroke. I’m not telling my clients to drink for their health. If you’re not drinking now, I don’t recommend starting. The key to alcohol use is moderation.

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