Strokes can be deadly or debilitating, but also highly preventable

By Laurence Ufford, M.D., and Darlene Boyce, C.N.P., A.N.V.P.- B.C.

Every 40 seconds, someone suffers a stroke, the leading cause of serious long-term disability and the fifth leading cause of death in the U.S. Every three to four minutes, someone dies from stroke. But what’s most important to know about those grim statistics is that the vast majority of strokes can be prevented through basic lifestyle changes and closer attention to well-known risk factors.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain can’t get the blood and oxygen it needs, so brain cells die – at the rate of two million cells per minute. Timing is everything. Depending on how quickly a patient arrives at the hospital, the result can range from relatively minor short-term effects to major long-term paralytic disability or death. Sadly, at least two-thirds of stroke victims wait too long to get themselves in for treatment that could save their lives or dramatically reduce disability. 

But when it comes to stroke, the first thing to focus on is prevention. It really comes down to simple things like quitting smoking, eating right, managing your weight, exercising, seeing your doctor regularly and taking your prescribed medications. 

Your stroke prevention checklist should include these seven steps:

1. Lower your blood pressure and cholesterol. Hypertension or high blood pressure is by far the leading risk factor for stroke. Monitoring and treating your pressure – keeping it below 140/90 or whatever your doctor advises – is the biggest difference you can make. High cholesterol is another major risk. Be sure to take whatever medications your doctor prescribes for both conditions.  Also discuss a daily aspirin regimen. Reduce salt in your diet, avoid high cholesterol foods and eat 4 to 5 cups of fruits and vegetables every day.

2. Treat diabetes.  Having high blood sugar damages blood vessels over time, making clots more likely. Keep your blood sugar under control as directed by your doctor. Use diet, exercise and medicines to keep your level within recommended range.

3. Quit smoking. Smoking accelerates clot formation by thickening your blood and increasing the buildup of plaque in your arteries. Quitting smoking is one of the most critical lifestyle changes you can make to reduce your stroke risk.

4. Lose weight. Obesity, often accompanied by high blood pressure and diabetes, raises your risk of stroke. If you're overweight, losing as little as 10 pounds can significantly lower your risk. Work with your doctor to create a personal weight loss strategy.

5. Be more active. Exercise contributes to losing weight and lowering blood pressure, and on its own is a stroke reducer. Exercise at a moderate intensity (even a brisk walk around the block) at least five days a week.

6. If you drink — do it in moderation. Studies show that drinking one 5-ounce serving of alcohol daily may actually decrease your risk of stroke. But once you start drinking more than two, your risk rises dramatically.

7. Treat atrial fibrillation. This form of irregular heartbeat causes clots to form in the heart and possibly travel to the brain, triggering a stroke. If you have been diagnosed with A-Fib, stick to the treatments. You may need to take a blood thinner such as warfarin (Coumadin) or the newer oral anticoagulants.

While we say those steps are basic and straightforward, that doesn’t mean it’s always easy.  Making any lifestyle changes can be a real challenge, but the price of ignoring them could be your life. 

Even if you follow all those steps, strokes can still happen.  F.A.S.T. is any easy way to recognize and react to symptoms: Face drooping. Arm weakness. Speech difficulty = Time to call 911. 

Laurence Ufford, M.D, is Division Chief of Neurology at Berkshire Medical Center, where Darlene Boyce, an Adult Nurse Practitioner and Board Certified Acute Neurovascular Practitioner, is the Neurology Service Manager and Stroke Program Coordinator.