Along with cancer and heart disease, stroke is one of the most common and most feared diseases we face, particularly as we reach older age. One of the most common nervous system diseases, ischemic strokes affect hundreds of thousands of people a year and is a major cause of death and disability in the United States and worldwide. While treatments for stroke have improved something in recent years, it is far from perfect. For many treatments to be effective, the victim must come to medical care within several hours after the onset of symptoms. Often this is simply not possible.
Therefore, the most effective way to avoid the potentially catastrophic results of a cerebral infarction (stroke) is to avoid the risk factors that increase a person's risk for the disease. Ischemic stroke is most commonly caused by blood vessel diseases that leads to clot formation which can block the flow of blood in a part of the brain. Therefore, the risk factors for stroke, those things that make stroke more likely in a given individual, are similar to those that increase the risk for other blood vessel disease such as coronary disease and peripheral vascular disease. So by decreasing your risk for stroke, you are simultaneously reducing your risk for these other diseases as well!
Some risk factors can not be changed or avoided. For example, increasing age, male gender, African American, HIspanic or Asian / Pacific Islander heredity, and a family history of stroke are all risk factors which can not be changed. However, many strong risk factors for stroke can be modified or controlled. Likewise, if you know you have some of these unavoidable risk factors, then it is all the more important to pay attention to reducing your other risks!
Below are a list of some of the most common controllable risk factors for stroke. Addressing each of these, if applicable, can help to decrease your risk for stroke and other blood vessel disease. However, keep in mind that because some risk factors are unavoidable nobody can be 100% free of risk. See your doctor regularly to help evaluate and reduce your risk.
High Blood Pressure (Hypertension)
High blood pressure can be damaging to your blood vessels over time. Prolonged, uncontrolled hypertension is one of the most important risk factors for stroke. Because high blood pressure usually does not cause any symptoms, many people do not realize they have it. The only way to be sure is to get regular check ups and have it checked. If you do have high blood pressure there are various ways to control it. Improved diet and exercise can help lower blood pressure. If this is not enough, there are medications which your doctor can prescribe which also help lower blood pressure.
Cholesterol is a naturally occurring, fat-like substance which is normal in the body at certain levels. At higher levels, cholesterol can contribute to damage to the blood vessels, called atherosclerosis, and contribute to narrowing and blockage of blood flow. You can help to control your cholesterol by eating a better diet which is lower in cholesterol and with exercise. Medication can also be prescribed to help control cholesterol. If you have not had your cholesterol checked recently, ask your doctor as it is a simple blood test.
Tobacco / Smoking
Everyone knows that smoking significantly increase the risk for lung cancer, emphysema and many forms of cancer. However, not as many people are aware that smoking is a huge risk factor for blood vessel disease. The damage smoking does to blood vessels speeds up the formation of atherosclerosis while also raising blood pressure. Therefore, avoiding smoking is one of the controllable risk factors that can help decrease your risk for stroke and other blood vessel disease. In particular, women who smoke, take oral contraceptives and have a history of migraine headaches have a much higher risk of stroke than the general population. Therefore, if you take oral contraceptives, quitting smoking is extremely important.
Obesity / Sedentary Lifestyle
Excess weight puts a strain on the heart and circulatory system. It also increase the risk for other factors like high cholesterol, high blood pressure and diabetes. Therefore, it has been consistently demonstrated that obesity and a generally sedentary lifestyle without physical activity are strong risk factors for blood vessel disease and stroke. Improving diet, losing weight and regular exercise can all help prevent these problems.
Diabetes is a disease which results from too little insulin or an improper response to insulin in the body. This leads to higher than normal levels of glucose (blood sugar) in the blood. Type II diabetes, or adult-onset diabetes, is very common in adults, with risk increasing as people get older and with increasing body weight. There are also familial risks for developing diabetes. Initially diabetes may cause no symptoms. However, prolonged, uncontrolled diabetes can lead to many complications leading to death and disability. One of the tissues that is damaged by high levels of glucose are the blood vessels. Therefore, patients with diabetes have an increased risk for the development of blood vessel disease and ultimately stroke or heart disease, particularly if they have any of the other risk factors listed here. In fact, about 2 out of 3 people with diabetes end up dying from stroke or heart disease! While diabetes is not completely reversible or preventable in all people, there are things you can do to improve the situation and lower your risk. First of all, good diet and physical exercise can help control weigh and blood glucose levels, preventing the onset of diabetes in the first place in some people. For people who already have diabetes, working closely with your doctor to help control blood glucose levels is critical. Good glucose control helps reduce the risk for all the complications of diabetes, including blood vessel disease and stroke. How do you control your glucose? You guessed it … good diet and exercise! Beyond this, medications are necessary in many diabetics to help control glucose as well. Talk to your doctor about your risk for diabetes and how you can help decrease your risk factors.
Atrial Fibrillation (AF)
Although less common than many of the other risk factors discussed here, atrial fibrillation can increase the risk for stroke considerably. Atrial fibrillation is an abnormal heart beat due to uncoordinated and irregular contractions of the atria, the two upper chambers in the heart. It is most common in elderly people and those who have heart disease or thyroid disorders. When the atria do not contract normally, blood tends to pool there which can lead to the formation of clots. These clots can then be transported by the bloodstream to other organs, including the brain, where they can cause a stroke if they block a blood vessel. In patients with atrial fibrillation, cardioversion and / or anti-arrythmia medications can sometimes reverse the condition. If not, blood thinners, which help prevent clot formation, can help decrease the risk for clots and stroke.
The Bottom line
If you have not noticed yet, the large majority of the risk factors for stroke described above can be avoided or improved with a good diet and plenty of physical exercise. It is no big secret! This healthy lifestyle can help lower cholesterol, lower blood pressure, avoid obesity, and lower blood glucose! Beside that, avoid smoking (!) And visit your doctor regularly. If you do develop problems with blood pressure, cholesterol, or diabetes which can not be controlled with diet and exercise alone, discuss medication options which may help reduce these risk factors. While stroke primarily affects older individuals, it is never too early to start reducing your risk. If you go years doing damage to your treaties, it may be too late to reverse the damage later on. By taking these steps to reduce your risk, you not only look and feel better, but your risk for many diseases decreases. Good luck!