There are two general categories of stroke, hemorrhage, and ischemia. In some ways, these are opposite conditions. Hemorrhage is marked by too much blood in the closed cranial cavity, while ischemia is characterized by too little blood (to supply enough oxygen and nutrients) to a part of the brain. About 20 percent of strokes are due to brain hemorrhage, while 80 percent are secondary to ischemia.
The lifetime risk of stroke for adult men and women (25 years of age and older) is approximately 25 percent. The highest risk of stroke is in East Asia, Central Europe, and Eastern Europe. Worldwide, stroke is the second most common cause of mortality and the second most common cause of disability.
Enough statistics. A stroke can be one of the most devasting illnesses. Today, my charge is to provide you with some tools to lower your risk of suffering from a fatal or debilitating stroke.
I begin by offering that there are some things that you cannot change, including your age and a family history of stroke. But even if you have a risk factor, you may still be able to drop your chances of suffering from a stroke.
We begin with lifestyle choices that can affect your risk of stroke.
- Tobacco. Smoking tobacco is the leading risk factor for stroke. If you smoke, quit. There is nothing more essential to lowering your chances of having a stroke.
- Alcohol. If you drink, try to limit alcohol to no more than one standard drink per day if you are a female and two per day if you are a male.
- Weight. Controlling your weight is essential to minimizing your risk of stroke. Extra weight can put stress on our circulatory systems. It can lead to other risk factors (such as diabetes, high blood pressure, high cholesterol, and sleep apnea) — Check-in with a health professional to determine an optimal weight for you.
- Salt. Approximately one-third of people are sensitive to the sodium component of salt. Consuming excessive salt can raise blood pressure in the arteries, raise blood pressure, and increase heart disease and stroke risk.
- Exercise. Avoid being sedentary.
- Eat well. Try to eat more unprocessed foods — such as fruits, vegetables, and whole grains — to fill yourself with food that takes a long time to digest. Whole foods offer vitamins, minerals, and fiber and tend to be lower in salt — which is better for your blood pressure, too.
Let’s end by looking at some underlying medical conditions that can add to your risk of stroke. If you have high blood pressure, consider a low-salt diet with lots of fruits and vegetables. Exercise regularly and take any blood pressure medicines as directed by a healthcare professional.
High cholesterol can cause fatty plaques that can drop blood flow in the arteries. This atherosclerosis can lead to a stroke. If diet and exercise are insufficient to drop your cholesterol levels down enough, your doctor may offer drugs that lower cholesterol and can markedly lower your risk of stroke.
Diabetes can increase the risk of having a stroke four-fold. In fact, up to two-thirds of individuals with diabetes will die of a stroke or heart attack. Monitoring blood sugar levels (and careful use of insulin) is essential for those with type 1 diabetes. For type 2 diabetes, diet and exercise are essential. Also, managing cholesterol and high blood pressure is a good idea. Selected individuals may need medications.
Next, we come to atrial fibrillation. A-fib is an irregular heart rate and is a significant cause of strokes. Atrial fibrillation affects as many as 2.2 million Americans and increases stroke risk by four to six times on average. The risk increases with age. Fortunately, medications are often helpful (both to help with the atrial fibrillation but also to thin the blood and selected patients).
Finally, talk to your doctor. Some higher-risk individuals may benefit from taking aspirin. Thank you for joining me today. I am off for a one-hour walk.