A stroke happens every 40 seconds and is the leading cause of death in the United States. With these stunning statistics in mind, and the awareness that stroke is the primary cause of vascular dementia, we started our exploration of the topic last week. In our last post we defined stroke and discussed the causes and symptoms. Today we will explore the risk factors, complications and prevention.
RISK FACTORS
There are many constituents at play that can increase your risk of stroke, lifestyle risk factors include:
- Being overweight or obese
- Physical inactivity
- Heavy or binge drinking
- Use of illicit drugs such as cocaine and methamphetamines
Medical risk factors include:
- Blood pressure readings higher than 120/80
- Cigarette smoking or exposure to secondhand smoke
- High cholesterol
- Diabetes
- Obstructive sleep apnea
- Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm
- Personal or family history of stroke, heart attack or transient ischemic attack
Other factors associated with a higher risk of stroke include:
- Age — Individuals age 55 or older have a higher risk.
- Race — African-Americans have a higher risk than other races.
- Sex — Men have a higher risk than women. Women are usually older when they have strokes, and they’re more likely to die of strokes than men.
- Hormones — Use of birth control pills or hormone therapies that include estrogen, as well as increased estrogen levels from pregnancy and childbirth.
COMPLICATIONS
The level of complications from a stroke are dependent upon how long the brain lacks blood flow and which areas are affected. In a will contest or challenge to a trust, the trial court will ask the jury to decide if the person who executed the document had capacity to do so at the time that the document was signed. In a will contest, the jury is asked, for example, if the decedent had sufficient mental ability to understand that he / she is making a will, to understand the effect of the act of making the will, to understand the general nature and extent of his property, among other questions, to understand the identity of his / her heirs, to collect in his / her mind the elements of the business to be transacted and to be able to hold the elements long enough to perceive their obvious relation to each other and to form a reasonable judgment as to these elements.
The short of it boils down to understanding the will and the circumstances of the will’s execution. A will contest is the method for a beneficiary to challenge a will that was signed when a loved one did not have the capacity to act.
The medical complications can be temporary or permanent disabilities and may include:
- Paralysis or loss of muscle movement. The victim may become paralyzed on one side of the body, or lose control of certain muscles, such as those on one side of the face or one arm. Physical therapy may help the individual return to activities affected by paralysis, such as walking, eating and dressing.
- Difficulty talking or swallowing. A stroke might affect control of the muscles in the mouth and throat, making it difficult to talk clearly (dysarthria), swallow (dysphagia) or eat. The individual may have difficulty with language (aphasia), including speaking or understanding speech, reading or writing. Therapy with a speech-language pathologist might help.
- Memory loss or thinking difficulties. Many people who have had strokes experience some memory loss. Others may have difficulty thinking, making judgments, reasoning and understanding concepts.
- Emotional problems. People who have had strokes may have more difficulty controlling their emotions, or they may develop depression.
- Pain. Pain, numbness or other strange sensations may occur in the parts of the body affected by stroke.
- Sensitivity to temperature changes. Individuals may be sensitive to temperature changes, especially extreme cold, after a stroke. This complication is known as central stroke pain or central pain syndrome and generally develops several weeks after a stroke, and it may improve over time. Because the pain is caused by a problem in your brain, rather than a physical injury, there are few treatments.
- Changes in behavior and self-care ability. Individuals affected by strokes may become more withdrawn and less social or more impulsive. They may need help with grooming and daily chores.
LIFESTYLE PREVENTION
Awareness of stroke risk factors, following doctors’ recommendations and adopting a healthy lifestyle are the best steps to take to prevent a stroke. For those who have had a stroke a transient ischemic attack (TIA), the measures outlined below will aid in the prevention of another stroke. Stroke prevention strategies and those to prevent heart disease are often similar, as the the two conditions are medically linked. Of course, these are general, healthy lifestyle recommendations that bare consideration for all individuals.
- Controlling high blood pressure (hypertension). This is one of the most important factors to reduce stroke risk. If an individual has had a stroke, lowering their blood pressure can help prevent a subsequent TIA or stroke.Factors that decrease blood pressure include exercise, stress management, maintaining a healthy weight and limiting the amount of sodium and alcohol consumed. Doctors can also supplement lifestyle changes with medication.
- Lowering the amount of cholesterol and saturated fat in the diet. Eating less cholesterol and fat, may reduce the plaque in the arteries. If cholesterol can’t be controlled through dietary changes alone, doctors may prescribe a cholesterol-lowering medication.
- Quitting tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting tobacco use reduces the risk of stroke.
- Controlling diabetes. Diabetes can be managed with diet, exercise, weight control and medication.
- Maintaining a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing as little as 10 pounds can lower blood pressure and improve cholesterol levels.
- Eating a diet rich in fruit and vegetables. A diet containing five or more daily servings of fruit or vegetables may reduce the risk of stroke.
- Exercising regularly. Aerobic or “cardio” exercise reduces the risk of stroke by lowering blood pressure, increasing the level of HDL cholesterol (the good cholesterol) and improving the overall health of the blood vessels and heart.
- Drinking alcohol in moderation. Alcohol can be both a risk factor and a protective measure for stroke. Heavy alcohol consumption increases risk of high blood pressure, ischemic strokes and hemorrhagic strokes. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent ischemic stroke and decrease the blood’s clotting tendency.
- Treating obstructive sleep apnea (OSA). This condition is a sleep disorder in which the oxygen level intermittently drops during the night. Treatment for OSA includes oxygen at night or wearing a small device to help keep the air passages open.
- Avoiding illegal drugs. Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can narrow the arteries.
PREVENTATIVE MEDICATIONS
In the event of ischemic stroke or TIA, doctors may recommend medications to help reduce the risk of having stroke recurrence.
- Anti-platelet drugs. Platelets are cells in the blood that form clots. Anti-platelet drugs make these cells less sticky and less likely to clot. The most commonly used anti-platelet medication is aspirin.
- Anticoagulants. These drugs, which include heparin and warfarin, reduce blood clotting. Heparin is fast acting and may be used over a short period of time in the hospital. Slower acting warfarin may be used over a longer term.
In the book, “Save Your Mind: Seven Rules to Avoid Dementia,” Antoine Hakim discusses seven rules to follow that will exercise your brain and body. He addresses how developing a cognitive reserve can help protect brain injuries such as a stroke.