Serious as a Heart Attack: Minimize Your Rish for Stroke & High Blood Pressure
February 2020 Issue
Many people think a stroke happens in the heart, but it happens in the brain, and it can be devastating. Stroke is a disease you must be educated about. When it happens, it is always sudden and never expected. Knowing the signs and symptoms, and acting FAST, can mean the difference between a stroke victim being permanently disabled, or being able to resume a normal, healthy life. It can also be the difference between life and death. Read on to educate yourself on the risk factors, signs and symptoms of stroke.
Minimizing Your Risk for Stroke: Why You Must Act FAST
By Phillip P. Amodeo, M.D., Board-Certified Neurologist
Q. What are ways to prevent stroke?
About 90 percent of stroke risk may be explained by nine major risk factors: Hypertension (high blood pressure), diabetes, hyperlipidemia (high cholesterol), cardiac causes, current smoking, diet, obesity, physical inactivity and alcohol consumption.
Regarding high blood pressure: Maintaining normal blood pressures have been proven to be one of, if not the most, important factors for reducing the risk of primary strokes, as well as preventing further strokes in patients who have already suffered from a stroke.
Diabetes: Maintaining control of blood sugars in patients who are diabetics also reduces risk for strokes.
Hyperlipidemia: Cholesterol control, particularly lowering LDL which is the “bad cholesterol”, has been proven in clinical trials to have an association with stroke risk reduction. Along these lines consuming a diet rich in fruits and vegetables is recommended. Medications may be necessary to decrease cholesterol that cannot be controlled with diet alone.
Cardiac Causes: Abnormal heart rhythms, specifically an irregular heart rhythm called atrial fibrillation, can cause blood clots to form in the heart, which can travel to the brain and cause strokes. Patients with atrial fibrillation should be assessed if they are a candidate for blood thinning medications that are more effective for preventing strokes than taking over the counter medications like aspirin. In addition, some medications and therapies can be given to make these heart rhythms normal again.
Quit Smoking: Abstinence from smoking will decrease the risk for stroke. In addition, recent studies have shown that second-hand smoke exposure increases the risk for stroke.
Obesity and physical inactivity are highly associated with increased risk of stroke. Therefore, maintaining a normal body weight and regular, moderate-intensity physical activity are recommended. Moderate intensity exercise is considered exercise that is at least 20 minutes in duration and intense enough to not be able to complete a sentence without taking a breath. Currently we recommend patients try to get 30 minutes of moderate physical activity at least three times per week, if not daily.
Alcohol consumption: Should patients choose to drink alcohol, the most updated dietary guidelines for Americans recommend up to one drink a day for women, or two drinks a day for men, is safe and associated with a decreased risk of most forms of stroke. Alcohol consumption greater than these quantities will actually increase the risk for stroke.
Treating a Stroke Quickly is of utmost IMPORTANCE!
Here is the window of time for stroke victims: Most patients presenting to the hospital within 4.5 hours of the last time they were felt to be normal and were without stroke-like symptoms are candidates for intravenous clot dissolving therapy. Some patients presenting to the hospital within 24 hours of symptom onset may be a candidate for clot extraction therapies. We encourage patients who feel they may have had a stroke, even within the last several days, to seek emergent evaluation at the hospital so they may have an expedited workup to establish not only if they have, in fact, had a stroke, but also to identify the type of stroke and the best therapies to prevent them from having further strokes.
Know the Symptoms— F.A.S.T!
FAST is an acronym used to help remember the most common symptoms patients may experience if they are having a stroke, and what to do if they have these symptoms.
F: Face drooping. Ask the person to smile, and see if one side is drooping. One side of the face may also be numb, and the smile may appear uneven.
A: Arm weakness. Ask the person to raise both arms. Is there weakness or numbness on one side? One arm drifting downward is a sign of one-sided arm weakness.
S: Speech difficulty. People having a stroke may slur their speech, or have trouble speaking at all. Speech may be incomprehensible. Ask the person to repeat a simple sentence and look for any speech abnormality.
T: Time to call 911! If a person shows any of the symptoms above, even if the symptoms went away, call 911 and get the person to a hospital immediately.
A key feature of all stroke symptoms is their sudden onset, developing over seconds to minutes. The symptoms themselves can include weakness on one side of the body or of one limb, numbness on one side the body or of one limb, incoordination of one or more limbs, double vision, loss of vision in one area, difficulty with balance, vertigo, facial droop, slurred speech, or headache.
Q. What are TIAs and how can they affect my health?
TIAs refer to transient ischemic attacks. These represent a lack of oxygenated blood flow to an area of the brain, but which is not sustained long enough to kill brain cells. Stroke is when actual death of brain cells occur. True TIAs would not leave patients with permanent or ongoing symptoms after they have resolved because no actual death of brain cells occurred. However, TIAs are considered a warning sign of potential disease being present, which if untreated, could lead to a stroke. Even if symptoms have resolved, patients should seek emergent medical attention so the potential causes for TIAs, such as artery disease or heart diseases, can be identified and treated before they result in a stroke and permanent death to brain cells.
Phillip P. Amodeo, M.D., is a board-certified neurologist at Southeast Georgia Physician Associates-Neurology
High Blood Pressure
By Tracey R.H. Price, M.D., Board-Certified Internal Medicine
Hypertension, defined as a systolic blood pressure in excess of 140 mm Hg or a diastolic blood pressure higher than 90 mm Hg, is an increasing public health concern. Consistent high blood pressure can lead to heart disease, heart failure, stroke and vision loss.
Q. What are symptoms of high blood pressure?
High blood pressure is usually asymptomatic, hence the reason it’s called the “silent killer.” Usually when it becomes symptomatic it has caused damage to organs in your body. For this reason, early detection is important. When extremely high, it can sometimes cause visual changes, chest pressure or pain, or headache. If this happens contact your medical provider.
Q. How detrimental is stress to high blood pressure?
Stress can manifest itself in the body in many different ways; elevated blood pressure is just one of them. There are many ways to manage stress, such as exercise (running, tai chi, swimming), reading, meditation, counseling, or participating in a relaxing activity.
Q. Are there ways to manage your blood pressure naturally?
Yes, this can include:
Exercise: Aerobic physical activity can lower blood pressure by 4-9 mm Hg. This should be done at least 30 minutes at least 5 days a week.
Low Sodium Diet: DASH diet, i.e. one rich in fruits, vegetables and low-fat dairy products
Weight Loss: every 20-pound loss can lower blood pressure by 5-10 mm Hg
Decrease in alcohol intake: Limit alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women. Having more than three drinks each day is associated with elevated blood pressures.
Tracey R.H. Price, M.D., is a board-certified internal medicine physician at Southeast Georgia Physician Associates-Primary Care.