New research on keeping you safer from stroke

Women have a somewhat higher risk of stroke than men, but men can also be at significant risk.

Many people think that strokes are just events that happen to the elderly who have hypertension and cardiovascular disease. Not true. Depending on a number of factors, strokes can occur at any age. Some infants suffer strokes during delivery. Children, teens and young adults are not immune to strokes, either. Individual risk factors, concomitant diseases and genetics play a role.

The number of new first-time strokes can be decreased. The factors that account for almost 90% of strokes can be modified by patients. The recommendations to decrease stroke risk include:

Dietary

Eat a Mediterranean or DASH-type (Dietary Approaches to Stop Hypertension) diet

The two diets are fairly similar. The AHA suggests:

  • Emphasizing vegetables, fruits, and fat-free or low-fat dairy products.
  • Including whole grains, fish, poultry, beans, seeds, nuts, and vegetable oils.
  • Limiting sodium, sweets, sugary beverages, and red meats.
Nuts, via Shutterstock

Nuts, via Shutterstock

Both diets should be supplemented with nuts like almonds, hazelnuts and walnuts, but almost any nut is beneficial. Just don’t eat too many, they are calorie-dense and can increase your weight unless you cut back on calories elsewhere in your diet.

The following study was done on a large number of American women. It is unknown if the results hold true for men, as well. Researchers reviewed information on measly 100,000 women in the age range of 50-79. They followed the women for up to 11 years. They looked at how much potassium the women ingested (from foods, not supplements) and whether they had strokes or died during the study period.

The investigation revealed:

  • Women who ate the most potassium were 12 percent less likely to suffer stroke in general and 16 percent less likely to suffer an ischemic stroke than women who ate the least.
  • Women who ate the most potassium were 10 percent less likely to die than those who ate the least.
  • Among women who did not have hypertension (whose blood pressure was normal and they were not on any medications for high blood pressure), those who ate the most potassium had a 27 percent lower ischemic stroke risk and 21 percent reduced risk for all stroke types, compared to women who ate the least potassium in their daily diets.
  • Among women with hypertension (whose blood pressure was high or they were taking drugs for high blood pressure), those who ate the most potassium had a lower risk of death, but potassium intake did not lower their stroke risk.
  • They also noted that most older American women do not eat the recommended amounts of potassium from foods.

Non-dietary interventions

If you have high blood pressure (hypertension):

  • Monitor your blood pressure (BP) at home with a cuff-device.
  • Help get your BP into a healthy range by: decreasing salt intake, getting regular exercise.
  • Have your BP checked at least 1-2 X per year by your doctor during regular visits.
  • If you’re on a medication to lower your BP and it isn’t working or it’s causing you side effects, let your doctor know so he can change the dose, change the medication, add another medication, etc. DON’T just stop taking it without telling him. [This also holds true if you find your medication to be too expensive – talk to your doctor. He may be able to prescribe something less expensive.]
  • Stop smoking and avoid second hand smoke. Women who smoke and are on birth control pills have a higher risk of stroke than similar women who are non-smokers.

If you have hypertension, even a small weight gain can make your BP higher than it was previously, so keep an eye on your weight, as well.

Some stroke signs and symptoms to watch for

Some common stroke warning signs. Think FAST (as in F, A, S, T):

F- Face Drooping: Does one side of the face droop or does it feel numb? Look for facial asymmetry. When, on command, the patient smiles, wrinkles forehead, etc. see if one side doesn’t move or droops.

A – Arm Weakness: Is one arm weak or numb. Ask the patient to raise both arms. Does one arm drift downward when he tries to hold them steady at shoulder height. (There may also be similar symptoms in a leg.)

S – Speech Difficulty: Can the patient speak? Is the speech slurred? Is the patient hard to understand? Ask the patient to repeat a simple sentence like, “The sky is blue.” Does he understand and is the sentence repeated correctly?

T – Time to call 911: If the person shows any of the above symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately.

Additional stroke signs: Sudden severe headache with no known cause; sudden trouble walking or dizziness, loss of balance, poor coordination; sudden trouble seeing in one or both eyes or other unusual visual symptoms; sudden onset of confusion or difficulty in understanding speech, having difficulty reading and understanding.

In general, the faster the patient gets to the hospital, the better the prognosis. For example, if the patient has a clot in a blood vessel in the brain, he may need a “clot buster” drug (a special anticoagulant). If so, there’s only a limited time that drug will be effective after the onset of stroke symptoms. Delaying the trip to the hospital, might cause him to lose a chance of getting this drug if it is needed.

For more information on stroke, stroke research and prevention and additional information you can go to: http://www.heart.org


Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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