Stroke is the 5th leading cause of death in the United States. There are about 600,000 people that will have a first time stroke each year, and an additional 200,000 will have their 2nd instance of a stroke. Even if having a stroke does not kill you, you may still have significant disability after, including weakness or paralysis of your arms, your legs, or difficulty/inability to speak.
Most strokes are “blood clot type” strokes, where the blood flow in the brain is interrupted by blood clots or severe narrowing of the blood vessels in the brain. Less common is the “bleeding” type of stroke, where a burst blood vessel leads to significant bleeding and brain injury.
There are many things you can do to reduce your risk of a stroke. Recent guidelines have been released by the American Heart Association and American Stroke Association detailing the steps you can take to reduce your chance of this devastating illness. Their major recommendations are as follows:
DIET
Following a Mediterranean diet has been shown in many studies to be very beneficial in reducing your chance of heart disease, stroke, and the development of diabetes. The specifics vary based on the part of the world you live in, but generally focus on incorporating fruits and vegetables, olive oil, nuts and legumes, whole grains and leaner meats (fish) into your diet, while avoiding red meats, processed foods, and foods made from enriched white flour.
EXERCISE
Aim to engage in 150 minutes of moderate intensity exercise a week, or 75 minutes of high intensity exercise. Moderate intensity=brisk walking, strenuous yoga, stationary cycling, etc. High intensity=high intensity weight lifting, circuit training, running sprints, etc.
TOBACCO USE/SMOKING
If you don’t smoke, don’t start! If you do, talk to your doctor about quitting. There are several ways to help stop smoking, with the most effective being the use of nicotine replacement products (gums, patches) and the prescription medication varenicline (Chantix).
DIABETES
If you are diabetic, there is strong evidence that the GLP-1 medications (Ozempic, Mounjaro), made popular for helping people lose weight, are very effective in reducing the risk of cardiovascular disease and stroke. If you are diabetic and at high risk for cardiovascular disease, talk to your doctor to see if these medications are right for you.
BLOOD PRESSURE
Work to keep your blood pressure normal, with levels below 120/80. Following some of the recommendations above for diet and exercise will help, but if not, getting your blood pressure down with the use of medication is a must. Unfortunately, most people requiring medication (approximately 70%) will need 2 or more medications to achieve goal blood pressure levels.
For pregnant women, high blood pressure control is very important for both mom and baby, and should be treated if levels are more than 160/110.
SLEEP
Adequate sleep plays a huge role in helping “reset our bodies”. Without enough sleep, blood pressure may become uncontrolled, and levels of cortisol (our stress hormone) may spike, leading t to inflammation in the body. The right amount of sleep will vary from one person to the next, but trying to achieve 7-8 hours a night is generally recommended.
If you have excessive daytime tiredness, or are told you snore, talk to your doctor about being checked for obstructive sleep apnea, which can greatly disrupt your sleep and lead to other heart and lung issues, which then pose risks for stroke.
CHOLESTEROL
Have your cholesterol checked regularly by your doctor, especially if you are over 40. Management with diet, exercise, and/or prescription medications can help lower levels and reduce your chance of blood vessels becoming narrow or clogged.
OTHER SPECIAL CONSIDERATIONS
Patients who have other illnesses, such as lupus and antiphospholipid syndrome, are prone to blood clots. Use of blood thinning agents, such as aspirin, Eliquis, and coumadin may be needed to reduce stroke risk if you have these conditions. Talk to your doctor about what is right for you.
In addition, women with endometriosis, early menopause (under age 45) and those who take estrogen may be at higher risk for stroke. Make sure you discuss these topics with your physician so that you can determine what is right for you.
Reduce your risk of stroke! Schedule a preventative care appointment today with DR Thomas Bailey at Mahoning Valley Direct Primary Care.
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