Stroke: It’s the third leading cause of death in the United States with 140,000 people dying yearly. As the leading cause of serious, long-term disability in the United States, about 600,000 strokes are first attacks, and 185,000 are recurrent attacks. This week’s blog post will touch on the basic pathology behind a stroke, warning signs and what we can do for prevention.

What is a Stroke?

A stroke occurs when the blood circulation to the brain fails. Because neurons (brain cells) rely on oxygen, a lack of blood flow to the brain can cause brain cell death. Strokes are categorized in two broad categories: Ischemic or Hemorrhagic Strokes. An Ischemic stroke results from the blockage of a blood vessel in the brain or neck and is the more common type. Bleeding into the brain is called a hemorrhagic stroke.

What are warning signs/ symptoms?

There are several symptoms and signs of stroke that you should watch out for. If you or a loved one experiences these symptoms, it is imperative to call 911 right away. Many stroke treatments are extremely time sensitive. For example, TPA , a medication used to dissolve clots in ischemic strokes, can only be used within a few hours of symptom onset. This list below describes some symptoms to watch out for:

1. Sudden numbness or weakness of face, arm, or leg, especially on one side of the body

2.  Sudden confusion, or trouble talking or understanding speech

3. Sudden trouble seeing in one or both eyes

4.  Sudden trouble walking, dizziness, or loss of balance or coordination

5. Sudden severe headache with no known causes

6. 

The figure above is a quick and easy mnemonic you should use to help you spot a stroke! By remembering the FAST signs, you could save a loved one’s life.

What are risk factors?

Because strokes are caused by either the blockage of blood vessels or bleeding into the brain, there are several known risk factors for stroke. You can take an active role in stroke prevention by paying attention to the following things. The following is a list provided by the National Institute on Neurological Disease and Stroke.

• High blood pressure, or hypertension

• Hypertension  is by far the most potent risk factor for stroke. Hypertension causes a two-to four-fold increase in the risk of stroke before age 80.  If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Some ways that work: Maintain proper weight. Avoid drugs known to raise blood pressure. Eat right:  cut down on salt and eat fruits and vegetables to increase potassium in your diet. Exercise more. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.

• Cigarette smoking

•  Cigarette smoking causes about a two-fold increase in the risk of ischemic stroke and up to a four-fold increase in the risk of hemorrhagic stroke.  It has been linked to the buildup of fatty substances (atherosclerosis) in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure; carbon monoxide from smoking reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood thicker and more likely to clot. Smoking also promotes aneurysm formation. Your doctor can recommend programs and medications that may help you quit smoking. By quitting, at any age, you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.

• Heart disease

• Common heart disorders such as coronary artery disease, valve defects, irregular heart beat (atrial fibrillation), and enlargement of one of the heart’s chambers can result in blood clots that may break loose and block vessels in or leading to the brain. Atrial fibrillation—which is more prevalent in older people—is responsible for one in four strokes after age 80, and is associated with higher mortality and disability. The most common blood vessel disease is atherosclerosis. Hypertension promotes atherosclerosis and causes mechanical damage to the walls of blood vessels. Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you and your doctor should make a decision about aspirin therapy. A doctor can evaluate your risk factors and help you decide if you will benefit from aspirin or other blood-thinning therapy

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• Warning signs or history of TIA or stroke. 

• If you experience a TIA, get help at once. If you’ve previously had a TIA or stroke, your risk of having a stroke is many times greater than someone who has never had one. Many communities encourage those with stroke’s warning signs to dial 911 for emergency medical assistance. If you have had a stroke in the past, it’s important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by asking the unaffected brain regions to do double duty. That means a second stroke can be twice as bad.

• Diabetes

•  In terms of stroke and cardiovascular disease, having diabetes is the equivalent of aging 15 years. You may think this disorder affects only the body’s ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain. Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Hypertension is common among diabetics and accounts for much of their increased stroke risk. Treating diabetes can delay the onset of complications that increase the risk of stroke.

• Cholesterol imbalance

•   Low-density lipoprotein cholesterol (LDL) carries cholesterol (a fatty substance) through the blood and delivers it to cells.  Excess LDL can cause cholesterol to build up in blood vessels, leading to atherosclerosis.  Atherosclerosis is the major cause of blood vessel narrowing, leading to both heart attack and stroke.

• Physical inactivity and obesity

• Obesity and inactivity are associated with hypertension, diabetes, and heart disease.  Waist circumference to hip circumference ratio equal to or above the mid-value for the population increases the risk of ischemic stroke three-fold.

If you are looking to optimize your health and decrease your stroke and cardiovascular risk factors, take an active role in your health and embrace the power of prevention! The Center for Natural and Integrative Medicine is here to support you on your road to wellness!