Preventive healthcare is important and key in managing your overall health. It means gaining understanding and taking action to deal with the prevention of illness. And it means making a commitment that can be applied at all stages of your life and along a disease spectrum to prevent further decline over time.
I have found that many people do not understand that the decisions they make about their health today can impact their health tomorrow. One example is stroke, a leading cause of death, disability and personal healthcare expenditures for men and women in the United States. And yet, up to 80% of strokes could be prevented through healthy lifestyle changes and working with personal health care providers to control health conditions that raise your risk for stroke.
Do you know what actions to take to help prevent a stroke? Learning about strokes will not only help you personally, but can also help you take timely action to save a loved one’s, colleague’s, relative’s or friend’s life.
About a stroke
The formal medical term is cerebrovascular accident (CVA), and describes insufficient or disrupted blood flow to a part of the brain. When this occurs, brain cells die in the area that the blood vessel supplied, hence it is also colloquially referred to as a “brain attack.” Our brain cells, known as neurons, are responsible for thinking, memory, movement, feeling or sensation, talking and practically every aspect of our body and life. Because neurons are so active, they require a large and constant supply of oxygen and nutrients that are provided by our blood vessels. Every 60 seconds of interrupted blood flow can result in 2 million brain cells dying. This can rapidly create significant disability in how we live our lives — and if blood flow is not restored quickly, can lead to death. Thus, it is a medical emergency.
Types of stroke
There are three main types of stroke:
• Ischemic (ih-skee-mik): The artery gets blocked, often by a clot, and this prevents adequate blood flow. It is responsible for 87% of all strokes.
• Hemorrhagic (hem-ur-ajic): An artery leaks or ruptures. In addition to disrupted blood flow, the resultant leaked blood puts pressure on the surrounding neurons, causing further damage. This type of stroke can occur from dangerously high blood pressure that overwhelms the blood vessel walls, chronic high blood pressure that causes wear and tear over time, and/or weakened blood vessels known as aneurysms.
• Transient ischemic attack (TIA) or “mini stroke”: A temporary blockage caused by a clot. Unlike a stroke, the symptoms resolve, and there is no permanent injury to the brain. A TIA is an important warning sign for a future stroke and must be taken seriously. More than 30% of people who have a TIA end up having a major stroke within a year if they do not receive treatment. Recognizing and treating TIAs can reduce the risk of a major stroke. If you have a TIA, your health-care team can find the cause and take steps to prevent a major stroke.
Recognize the symptoms
The symptoms of a stroke depend on where in the brain they occur and the intensity of the event. Common signs include any sudden weakness, numbness or loss of movement in a leg, arm or the face — especially if it affects only one side of the body. Other indicators are mental confusion, headaches with vomiting, loss of balance or trouble walking or difficulty with vision or speaking.
Take immediate action. If you or someone you know may be having a stroke, seconds count. These understandings can help you identify symptoms of stroke quickly. Often when it comes to a stroke, it is a bystander who notices the stroke and calls 911.
It is important for everyone to know and understand these warning signs. A simple way to remember the symptoms is “BE FAST”:
• Balance: Does the person have a sudden loss of balance? Did they fall suddenly?
• Eyes: Has the person lost vision in one or both eyes?
• Face: Does the person’s face look uneven? Ask the person to smile.
• Arms: Is one arm hanging down? Ask the person to raise both arms. Does one arm drift downward?
• Speech: Is the person’s speech slurred? Does the person have trouble speaking or seem confused or sound strange? Ask the person to repeat a simple phrase.
• Time: If you observe any of these signs, call 911 immediately (even if they resolve)
There is a saying: “With stroke, time lost is brain lost.” Every minute — in fact, every second counts. BE FAST, as treatment is imperative to minimize damage and save a life. Timeliness is crucial.
Stroke does not discriminate, and while risk increases with age, young adults, children and even unborn babies can suffer strokes. It can happen to anyone at any age if there is an inadequate blood supply to meet the demands of the neurons.
However, there are certain known risk factors — lifestyle, medical illnesses and genetics — that increase risk.
While you cannot change your genes, you can make adjustments to lifestyle choices that contribute to stroke, such as poor diet, physical inactivity, excess weight and smoking. You can manage and optimize illnesses, including high blood pressure, diabetes, high cholesterol, atrial fibrillation, heart disease and certain blood disorders that cause clotting, such as sickle cell disease, to decrease your risk for a stroke. Again, 80% of all strokes are preventable, and you have tremendous power when it comes to decreasing your risk, but action is required.
You can help prevent stroke by making healthy lifestyle choices and working with your healthcare provider to control health conditions that raise your risk for stroke. Here are some key understandings to:
• Physical activity is a win-win-win situation in that it helps maintain a healthy weight, lowers cholesterol levels and blood pressure and improves blood sugar control in diabetics. Aim for at least 30 minutes a day, 5 days a week.
• Eating heart-healthy foods is also good for the brain — they are “brain healthy.”
• Choosing healthy meal and snack options can help you prevent stroke. Make sure to get at least 5-9 servings of fresh fruit and veggies a day; opt for lean meats and fatty fish; and incorporate nuts and legumes into your diets. Eating foods low in saturated fat and trans-fat and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet can also lower your blood pressure. Both high cholesterol and high blood pressure increase your chances of having a stroke.
• Be committed to maintain a healthy weight — being overweight or obese increases your risk for stroke.
• When it comes to smoking, quit, or don’t ever start. Cigarette smoking greatly increases your chances of having a stroke.
• Limit alcohol — and if you choose to drink, do so in moderation.
• Manage medical illnesses. Work with your doctor to optimize your blood pressure, cholesterol and blood sugars. Elevated blood pressures, over time, can damage your brain vessels. If extremely elevated, they can even cause the vessels to rupture. When cholesterol levels are elevated, it promotes the buildup of fatty plaques inside blood vessel walls that decrease blood flow. These plaques can also shear and cause complete blockage. Chronically-elevated blood sugars can damage large and small blood vessels. Your carotid arteries in your neck are considered large vessels and our brain is dependent on small vessels to deliver oxygen and nutrients to each and every neuron.
• See your physician if you have any concerns or symptoms and schedule a routine physical for a heart (and brain) healthy check-up
While stroke is largely treatable, time matters. The faster someone is treated, the more likely they are to recover without permanent disability. Upon arrival at the hospital, a history and physical exam, as well as a brain scan, will be performed immediately. Depending on the type of stroke and time elapsed since symptoms started, treatment will be tailored to the patient. It may include specialized medications to break up a clot, endovascular (noninvasive) treatment or surgery.
Understanding health truths, eating right, maintaining your healthy weight, getting exercise and avoiding destructive substances like tobacco, alcohol and excessive amounts of sugar and salt are crucial, as is getting enough sleep each night. Healthy habits are an “automatic” defense against stroke and most illnesses, thus helping to provide you a long, healthy and happy life.
Dr. Nina Radcliff, of Galloway Township, is a physician anesthesiologist, television medical contributor and textbook author. Email questions for Dr. Nina to firstname.lastname@example.org with “Dr. Nina” in the subject line. This article is for general information only and should not be used for the diagnosis or treatment of medical conditions and cannot substitute for the advice from your medical professional.