While a great emphasis has been placed on teaching people how to recognize when a stroke has occurred and how to respond swiftly, increasing attention is wisely being devoted to one’s management of personal risk factors. As we become an aging nation living with multiple, chronic diseases and conditions, our susceptibility to suffering a stroke is growing. And while medical advancement is preventing fewer deaths from stroke, the neurological damage sustained from the trauma often impairs bladder and even bowel control and compromises mobility for safely reaching the toilet when the urge arises.
Studies show that up to 80% of strokes can be prevented by working with a healthcare professional to reduce personal risk. More than a decade ago, the National Stroke Association's Stroke Prevention Advisory Board established the first Stroke Prevention Guidelines.1 They were published in a 1999 issue of Journal of the American Medical Association (JAMA) and have been updated since to reflect current medical standards and knowledge from subsequent research.
Essentially, risk factors can be categorized as controllable or non-controllable risks. Controllable risks may include diseases that are treatable and thus manageable or they may represent lifestyle choices that can be altered by behavioral changes. The diseases that represent risk factors for stroke affect directly or indirectly the cardiovascular system of the body and include:
- Hypertension, or high blood pressure – a measurement of the force of blood pushing against the walls of arteries. If elevated, the heart has to pump harder to move blood through the body, causing the blood vessels to weaken. When blood flow is impaired, major organs may be deprived of the oxygen-rich blood they need to stay healthy and function and thus become damaged.
- Atrial fibrillation – occurs when the heart beats rapidly and in irregular patterns, causing blood to pool in the heart. When blood pools, clots can form and subsequently travel to the brain to precipitate a stroke.
- High Cholesterol – a fatty substance in the bloodstream. At elevated levels, it physically blocks arteries and can cause a stroke or heart attack. Although cholesterol is produced by the human body, its source when elevated is most often from fats in foods, particularly animal fats such as in meats and dairy products.
- Diabetes – failure of the body to produce enough insulin (Type 1 diabetes) to process sugar or to utilize the insulin available to it (Type 2 diabetes). Excess sugar in the blood stream ultimately causes tiny blood capillaries to break down, resulting in nerve damage and vascular disease first in peripheral parts of the body such as feet. Ultimately, it leads to kidney failure. People with diabetes are up to four times more likely to have a stroke than someone without diabetes.
- Atherosclerosis – the gradual buildup of fatty deposits and other cells that block the flow of blood to the brain and elsewhere, as passages are narrowed.
A University of Michigan study published in 20122 shows high risk stroke patients are twice as likely to get follow-up care from a primary care doctor if they receive a pep talk over the telephone. These patients not only were more engaged and compliant, they also modified their diet and even talked about seeing stroke specialists.
Staying in touch – and being motivated by others – is what keeps us all healthier. Let’s do more of it.
Nancy Muller, PhD
1 http://www.stroke.org/site/PageServer?pagename=prevent, accessed July 13, 2012.
2 XXXXX (2012). Enhancing the effectivenss of community stroke risk screening: a randomized controlled trial. Journal of Stroke and Cerebrovascular Diseases, 20 (4): 330 – 335.
Published On: July 18, 2012