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Understanding and avoiding stroke risks

Someone suffers a stroke in America every 45 seconds, and each year this catastrophic attack on the brain kills 150,000 people. It’s the third leading cause of death in our country, yet in a recent survey, four out of every 10 adults couldn’t name a single stroke symptom.

These statistics would no doubt improve if people knew more about preventing stroke—and recognizing its signs. (See ”Handling the Pressure.”) In fact, studies show there’s a critical ”therapeutic window”—a span of about three hours—during which permanent damage may often be largely or fully avoided with proper diagnosis and treatment.

What is a stroke?

Essentially, a stroke is a severe injury to the brain that’s caused when a blood vessel that feeds the brain is either closed off by a clot (an ischemic stroke) or bursts (a hemorrhagic stroke). If deprived of its oxygen-rich blood supply even for just a few minutes, the brain becomes injured, and a portion of it may die.

Depending on its severity, a stroke may result in disability, such as motor and vision impairment, loss of feeling, difficulty with speech and language, problems with memory or loss of ability to reason. A stroke may also result in paralysis, coma or death.

Protection plan

No one can protect himself or herself completely from stroke. That’s because some of its risk factors are beyond our control, such as:

  • increasing age (most strokes occur after age 55)
  • personal or family history of stroke
  • gender (stroke is equally common among men and women after 55 but more women than men die of stroke)
  • race (African-Americans’ risk of first stroke is almost double that of Caucasians)

Nevertheless, you can dramatically reduce your risk of stroke by taking the following steps and seeing your doctor immediately if any symptoms appear:

1. Have regular checkups

The three strongest risk factors for stroke—high blood pressure, heart disease and diabetes—often don’t cause symptoms in their early stages. So it’s important that all adults, especially those with a family history of heart disease and stroke, have regular screenings to detect these conditions while they’re still highly treatable.

  • Lower your blood pressure. First and foremost, take steps to lower your blood pressure, if necessary. Hypertension is the number one risk factor for stroke, contributing to half or more of all attacks. And one in every three Americans has high blood pressure—readings consistently higher than 140/90 mm Hg ("140 over 90")—yet one-third of these people have no symptoms and don’t realize they’re courting trouble. Even prehypertensive readings of 120/80 to 139/89 mm Hg increase your risk of stroke.
  • Control heart disease symptoms. Having cardiovascular disease or another heart condition can increase your stroke risk. Atrial fibrillation, which results in rapid, uncoordinated heartbeat, is a major risk factor for stroke. So is carotid artery disease, which causes the carotid arteries—the brain’s main blood lines—to become congested with plaques that form clots. And patients with atherosclerosis (clogging of the arteries) who follow their doctors’ advice about lifestyle changes and take prescribed medications as directed will likely reduce their risk of stroke as well as heart attack.
  • Manage diabetes. Likewise, having diabetes is an independent risk factor for stroke and often results from related stroke risks, like high cholesterol and being overweight. Managing the disease is vital, since people with diabetes tend to develop blood clots and atherosclerosis more easily. What’s more, keeping high blood sugar under control can help reduce the severity of complications if a stroke occurs.

2. Make lifestyle changes

Adopt a stroke-protective lifestyle that can dramatically lower your risks. Important steps to take:

  • Lose weight. Being overweight or obese contributes to conditions that cause atherosclerosis, coronary disease and diabetes.
  • Change your diet. A brain-protective eating plan typically includes less fat and cholesterol and more fish, poultry, fiber-rich whole grains, fruits and vegetables and low-fat dairy items. Think about changing cooking habits, too—bake and broil instead of frying. Ask your doctor about adding B vitamins to your nutrition plan—they help control homocysteine, an amino acid that can enhance blood clotting.
  • Lower salt intake. Too much salt can contribute to high blood pressure. Keep your daily intake to one teaspoon or less—about 2,400 milligrams.
  • Exercise regularly. Aerobic workouts—jogging, swimming, power walking and bicycling—strengthen your heart muscle. They also help raise good cholesterol levels, control weight and reduce blood pressure and stress. Get your doctor’s OK, then gradually work up to 30 to 45 minutes of exercise most days of the week.
  • Limit alcohol. If you drink alcohol, keep daily consumption to two beers, glasses of wine or mixed drinks if you’re a man, and one a day if you’re a woman. Drinking more can raise blood pressure, levels of bad cholesterol and triglycerides in the bloodstream and increase your weight.
  • Quit smoking. Stopping now is the single best change you can make for your health. And research shows it’s never too late: Just five years after quitting, an ex-smoker reaches the same level of risk for stroke as someone who never smoked.

The bottom line

Although some risk factors for stroke aren’t controllable, many are. And bear in mind that the tips mentioned here not only will help you reduce your risk of stroke, but they’ll also help you avoid other health problems, such as heart disease and the complications of diabetes. That’s enough health protection to make your efforts well worth your while.

Handling the pressure

Hypertension increases the pressure of blood against artery walls, making them more likely to thicken, become narrowed with plaque or rupture.

Sometimes, lifestyle changes are sufficient to bring high blood pressure down to healthier levels. If not, medications can effectively lower it. These include:

  • beta blockers to reduce heart rate and the outflow of blood
  • angiotensin-targeted drugs, referred to as ACE inhibitors and receptor blockers, to blunt angiotensin, a chemical that causes arteries to constrict
  • calcium antagonists that reduce heart rate and help blood vessels relax
  • sympathetic nerve inhibitors that keep nerves throughout the body from constricting blood vessels
  • vasodilators that relax muscles in the artery walls and widen blood vessels

Symptoms to look out for

If you or someone nearby has any of these stroke symptoms, dial 911 right away:

  • sudden numbness, weakness or paralysis in one arm or leg or the entire side of the body
  • sudden slurred speech
  • blindness or dimmed vision in one eye
  • sudden "thunderclap" headache—the worst you’ve ever had
  • sudden trouble hearing or understanding what’s being said
  • difficulty swallowing
  • sudden difficulty with balance or steadiness
  • convulsions or sudden unconsciousness