We are all responsible for our own lives, and Americans are taking charge of their health more than ever before. The importance of keeping high blood pressure (hypertension) under control can never be sufficiently stressed, as one of the most devastating complications of high blood pressure is stroke. (Hypertension is present in about seventy percent of all victims of stroke). This debilitating disorder is among the top ten diseases that cause death in the United States (latest data from 2016).
What is a stroke? Called brain attack, cerebrovascular disease (cerebral refers to the brain and vascular to the blood vessels), cerebrovascular accident or CVA, a stroke is a sudden impairment of brain function resulting from a substantial reduction in blood flow to some part of the brain. It occurs when an artery that supplies blood to the brain leaks or bursts (hemorrhagic) or is blocked by a blood clot (ischemic). Within minutes, the nerve cells in that area of the brain are damaged, and they may die within a few hours. As a result, the part of the body controlled by the damaged section of the brain cannot function properly.
Before having a stroke, a person may have one or more transient ischemic attacks (TIAs). They are called mini strokes because their symptoms can be like those of a stroke, and are a warning signal that a stroke may occur. However, unlike stroke symptoms, TIA symptoms usually disappear within 10 to 20 minutes, although they may last up to 24 hours.
Many strokes can be prevented. The National Stroke Association (NSA), an independent national nonprofit organization that devotes all its efforts and resources to stroke, has released guidelines in stroke prevention, both for physicians and the public. The guidelines were prepared by the nation’s leading stroke experts, and are the first set of recommendations to help prevent stroke.
The ten preventive guidelines are:
- Know your blood pressure, and if it is elevated, work with your doctor to keep it under control.
- Find out if you have atrial fibrillation (also called AF or A-Fib) and if so, comply with your doctor’s instructions to manage it. This condition is an irregularity of the heartbeat originating in the part of the heart called the atrium.
- If you smoke, stop.
- If you drink alcohol, do so in moderation.
- Know your cholesterol number, and if it is high, work with your doctor to control it.
- If you have diabetes, follow your doctor’s recommendations carefully to keep it under control.
- Include exercise in the activities of your daily routine.
- Enjoy a lower sodium (as in salt), lower fat diet.
- Ask your doctor if you have circulation problems that increase your risk for stroke. If so, work with her/him to control them.
- If you have any stroke symptoms, seek immediate medical attention.
Increasing the number of servings of fruits and vegetables, ensuring adequate calcium intake, and taking B complex vitamins, especially B-6, B-12 and Folic Acid may also help to lower your risk of stroke.
The most common stroke symptoms are:
- Sudden numbness or weakness of the face, arm, or leg, especially on one
side of the body.
- Sudden confusion, trouble speaking or understanding.
- Sudden trouble seeing in one or both eyes.
- Sudden trouble walking, dizziness, loss of balance or coordination.
- Sudden severe headache with no known cause.
Your physician has a variety of options available to help prevent stroke if you are at risk. Several drugs are used as powerful weapons in this fight. Mainly, three types of medications are used:
Anti-hypertensives: reduce blood pressure; can decrease stroke risk as much as 50%.
Anti-clotting drugs: thwart blood clots by preventing platelets from sticking together. Aspirin is most commonly used, but newer prescription agents such as Plavix, are prescribed for people who have had either a previous stroke or a TIA, or when aspirin alone isn’t sufficiently effective.
Anti-coagulants: prevent blood clots by inhibiting clotting factors. Coumadin (warfarin) is the most effective drug in this class; studies show a 68 percent reduction in stroke risk with this drug.
All of these drugs are powerful and need close medical supervision.
Surgical treatment (carotid endarterectomy) is sometimes necessary and may lower the risk of a carefully selected group of patients. This procedure is used to surgically remove blockages in the carotid arteries, the large arteries on either side of the neck that supply blood to the head.
Stroke is a medical emergency. Don’t wait to seek help; every minute counts. If medical treatment begins soon after symptoms are noticed, fewer brain cells may be permanently damaged. See your physician on a regular basis to prevent big problems.
A small dose of aspirin is being used to prevent a first heart attack or stroke.
If you are 50 to 69 years old, ask your physician if you would benefit from a daily dose of 81 milligrams (mg) of aspirin. There is currently not enough evidence for those who are under 50 or older than 70 years. Although the use of aspirin only applies to prevent a first heart attack or stroke, the use of preventive aspirin in some people is a proven way to prevent a second heart attack or stroke.