Checkup on Health: Be prepared for rapid response to stroke
By Piero Verro, M.D.
Every minute of every day someone in the United States has a stroke.
And while symptoms of a heart attack are common knowledge, most Americans may not recognize a stroke or know what to do in the event one is occurring.
Like heart disease, strokes are a cardiovascular problem, occurring more frequently as people age. They occur either when a blood vessel in the brain bursts (a type known as a hemorrhagic stroke) or, more commonly, when a blood vessel becomes blocked (known as an ischemic stroke). Either way, unless blood flow is restored, brain cells in the area quickly die, leaving permanent disability.
Sometimes, a temporary blockage occurs, causing symptoms of a stroke only briefly. Known as a transient ischemic attack (TIA), it is often a harbinger of a serious stroke.
While everyone over age 50 should be knowledgeable about strokes, some groups are at especially high risk for having one, including African Americans, those who have a family history of stroke, smokers and people with diabetes.
What you can do
Not all risk factors can be controlled, but many can. Whatever your risk profile, reduce your chances by taking the following steps:
- Don’t smoke. Smokers have almost double the risk for ischemic stroke.
- Limit alcohol to no more than one to two drinks each day.
- Exercise daily. Aim for half an hour a day of brisk walking or an equivalent aerobic exercise.
- Eat heart-healthy. Take steps to achieve a low-salt, low-fat, high-fiber diet.
What to discuss with your doctor
You’ll need the help of your doctor to make other important changes to reduce your risk of stroke. Take the following check list with you to your next appointment:
- How is my blood pressure? High blood pressure is the primary cause of stroke. Work with your doctor to maintain an acceptable level of no more than 140/90 mm Hg. If side effects of blood pressure medications bother you, change to a different drug or use a lower dose and add another medication that works differently. Don’t give up!
- What is my cholesterol profile? Like with blood pressure, find a combination of diet, exercise and medications that brings you to acceptable levels: a total cholesterol less than 200 mg/dl, LDL below 130 mg/dl, and HDL above 35 mg/dl.
- If you have diabetes, aim for optimum control. Again, diet, exercise and medications are the keys.
- If you are over 50, you are due for a baseline EKG. Your doctor may mention that you have signs of atrial fibrillation, a defective movement of the heart’s upper chambers (the atria). It increases the likelihood of a stroke caused by a blood clot forming in the heart and traveling to the brain. In most cases, atrial fibrillation should be treated with the blood thinner, warfarin (Coumadin).
- If you have had a TIA or stroke recently, you should also discuss with your doctor the option of having a carotid endarterectomy. This procedure involves clearing fatty plaque from one or both carotid arteries, the main arteries that run up the neck on the way to the brain. The procedure is not without risks, and the potential benefits must be carefully considered for each individual. It is more likely to be worthwhile for those with severe artery disease, and for those who have recently experienced a stroke or TIA.
Recognize a stroke and act quickly
Don’t waste time trying to contact your regular doctor if you suspect stroke symptoms. Medications that can stop a stroke in its tracks and even reverse it are available, but must be administered within three hours of the onset of symptoms.
Most important of all, know the symptoms of a stroke. Don’t waste time trying to contact your regular doctor. Medications that can stop a stroke in its tracks and even reverse it are available, but must be administered within three hours of the onset of symptoms.
Symptoms of a stroke include:
- Sudden blurred or decreased vision, which may be in only one eye
- Sudden weakness of any part of the body
- Difficulty speaking or understanding conversation
- Dizziness or loss of coordination
- Sudden intense headache
If any one of these occur, call 911 at once. Because strokes don’t cause pain, many people with minor or only fleeting symptoms adopt a “wait-and-see” approach, a mistake that can lead to permanent disability or be fatal.