How to Prevent Stroke?

How to Prevent a Cerebrovascular Accident (Stroke)

If you're like most Americans, you plan for your future. When you accept a job, you examine the pension plan of the company. When you buy a house, considering its location and condition so that your investment is secure. Today, more and more Americans are protecting their most important asset, ie health. And you?

Strokes are the third leading cause of death in the United States. A stroke can be devastating for those affected and their families, robbing them of their independence. It is the most common cause of disability in adults. Each year more than 500,000 Americans have a stroke and about 145,000 die from causes related to it. The officers of the National Institute of Neurological Disorders and Stroke (NINDS, for its acronym in English) have committed to reducing that burden through biomedical research.

What is a Stroke?

Stroke or "brain attack" occurs when blood flow to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two broad categories of stroke: those caused by a blockage of blood flow and those caused by bleeding. Although usually not fatal, a blockage of a blood vessel in the brain or neck, called an ischemic stroke is the most common cause of a stroke and is responsible for approximately 80 percent of strokes. These blockages stem from three conditions: the formation of a clot in a blood vessel in the brain or neck, called thrombosis; the movement of a clot from another part of body and heart to the neck or the brain known as embolism, or a narrowing severe an artery in the brain or leading to it, called stenosis. Bleeding in the brain or the spaces surrounding the brain causes the second type of stroke, called hemorrhagic stroke (commonly known as stroke).

There are two important steps you can take to reduce your risk of dying or becoming incapacitated by a stroke: know the warning signs of stroke and control risk factors. Scientific research conducted by the NINDS has identified warning signs and a large number of risk factors.

What are the warning signs of a stroke?

The warning signs (or symptoms) are the signs that your body sends the brain not getting enough oxygen. If you observe one or more of the following symptoms of a stroke or brain attack, do not wait, call your doctor or 911 immediately!

Numbness, weakness or sudden paralysis of the face, arm or leg, especially on one side of the body.
Sudden confusion, trouble speaking or understanding speech.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, or loss of balance or coordination.
Severe headache, sudden and unknown cause.

Other warning signs that may occur include double vision, drowsiness and nausea or vomiting. Sometimes the warning signs last only a few minutes and then disappear. These brief episodes, known as transient ischemic attacks (TIA, for its acronym in English), sometimes called "mini-strokes." Although brief, they identified a serious hidden condition that does not go without medical help. Unfortunately, as they disappear, many people ignore them. Do not do it! Paying attention can save your life.

What are the risk factors for stroke?

A risk factor is a condition or behavior that occurs most often in people who have or may have a higher risk of contracting a disease than in those without. Having a risk factor for stroke does not mean you have a stroke. On the other hand, not having a risk factor does not mean you will not have a stroke. However, your risk of stroke increases with the number and severity of risk factors you have.

Strokes occur at any age in both sexes and all races from all countries. These may occur even before birth when the fetus is still in the womb. In African Americans, stroke is more common and more deadly in young adults and middle-aged than in any other ethnic or racial group in the United States. Scientists continue to find more risk factors as well as more severe in some minority groups and continue to search for similar patterns for stroke in these groups.

Some of the most important risk factors for stroke that can be addressed are:

-High blood pressure

Also called hypertension, is by far the most powerful risk factor. If your blood pressure is high, you and your doctor should create an individual strategy to lower the normal range. Some things that work are:

Maintain a healthy weight.
Avoid using drugs known to increase blood pressure.
Reduce use of salt.
Eating fruits and vegetables to increase potassium in your diet.
Exercise more.

Your doctor may prescribe medicines that help reduce blood pressure. Controlling blood pressure will also help prevent heart disease, diabetes and kidney failure.

-Smoking cigarettes

Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, the major artery in the neck that supplies blood to the brain. Blockage of this artery is the main cause of stroke in Americans. Also, nicotine raises blood pressure, the carbon monoxide of cigarettes reduces the amount of oxygen that blood can carry to the brain, and cigarette smoke thickens the blood, making it more likely to clot. Your doctor can recommend programs and medications to help them quit smoking. Quitting smoking at any age reduces your risk of lung and heart diseases and several types of cancer including lung cancer.

-Heart disease

Common cardiac disorders such as coronary heart disease, valve defects, irregular heartbeat and enlargement of the chambers of the heart can result in blood clots that can dislodge and block blood vessels in the brain or that go to it. The most common disease of the blood vessels caused by fatty deposits in the arteries is called atherosclerosis. Your doctor will treat your heart disease and may also prescribe medications such as aspirin, which helps prevent blood clots. Doctor may recommend surgery to clean a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you should talk with your doctor to make a decision about aspirin therapy. The doctor can assess your risk factors and help you decide whether you would benefit from therapy with aspirin or other blood thinners.

Warning symptoms or a history of stroke.

If you experience a TIA, seek help immediately. Many communities encourage those with signs of a stroke call 911 for emergency medical assistance. If you have had a stroke in the past, it is very important to reduce the risk of a second attack. Your brain helps you recover from a stroke by drawing on body systems that now do double duty. This means that a second attack may be twice as bad.

Diabetes

You may think this disorder affects only the body's ability to use sugar, or glucose, but also causes harmful changes in blood vessels throughout the body, including the brain. Furthermore, if the levels of glucose in the blood are high at the time of the attack, usually the brain damage is more severe and extensive than when blood glucose is under control. Treating diabetes can delay the onset of complications that increase the risk of stroke.

Do you know your risk for stroke?

You can identify some of the most important risk factors for stroke during a physical exam in the doctor's office. If you are over 55 years, the worksheet included in this booklet can help you calculate your risk for stroke and show the benefit of controlling risk factors.

The worksheet was developed based on the well-known Framingham study, sponsored by NINDS. With your doctor, you can develop a strategy to decrease the risk to normal or even below normal for their age.

You can control many risk factors for stroke, some with great success. Although the risk is zero at any age, if you start early and controlling their risk factors, you can reduce your risk of dying or becoming disabled because of a stroke. With good control, you can keep the risk of stroke in most age groups, below than that for accidental injury or death.

The Americans have shown that strokes can be prevented and treated. In recent years, a better understanding of the causes of stroke has helped Americans to make changes in lifestyle that have reduced by almost half the rate of death from stroke.

More than a million stroke survivors suffer little or no long-term disability due to the attack. However, another two billion will live for the rest of their lives with limitations due to paralysis, loss of speech and poor memory. NINDS scientists predict that if we continue to focus attention on reducing the risk of strokes and using the now available therapies and developing new, Americans should be able to prevent 80 percent of all strokes.

Since Congress ordered its creation in 1950, the NINDS has grown to become the largest sponsor of neurological research in the United States. The majority of research funded by the NINDS are conducted by scientists in public and private institutions such as universities, medical schools and hospitals. Government scientists also conduct a variety of neurological research in laboratories and the different branches of the NINDS own. These investigations range from studies of the structure and function of individual brain cells to try on new diagnostic tools and treatments for neurological disorders.

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