Stop a Stroke Before It Strikes

BY LINDA WASMER ANDREWS

At age 31, Tedy Bruschi already had an enviable résumé as a pro football player and three-time Super Bowl champ. But in 2005, he added an even more important achievement: stroke survivor.

A stroke takes place when blood flow to part of the brain is disrupted. Just days after playing in his first Pro Bowl, Bruschi was at home when he began having blurred vision and numbness on one side of his body. His wife called 911 for what turned out to be a mild stroke.

The risk for a stroke rises when people get older. As Bruschi discovered, though, a stroke can hit at any age. Fortunately, his story had a happy ending. After eight months of rehabilitation, he became the only player in National Football League history to return to the field after having a stroke.

Anatomy of a Stroke

There are two main types of stroke. Ischemic strokes, the most common type, occur when a blood clot blocks a blood vessel in the brain. Hemorrhagic strokes occur when a weakened blood vessel within the brain breaks. In both cases, the disruption in blood flow causes brain cells to start dying. As cells die, you begin to lose the abilities controlled by that part of the brain. Depending on the region of the brain and the extent of the damage, the result could be lasting problems with speech, movement or memory.

Left untreated, several medical conditions can lay the groundwork for a stroke. “If you have one of these conditions, following your doctor’s treatment advice is a critical step in reducing your stroke risk,” says Mitchell Elkind, M.D., an assistant professor of neurology at Columbia University.

High blood pressure (hypertension)

damages blood vessels, including those in and around the brain. This makes the blood vessels more vulnerable to both blockage and breaking. High blood pressure increases stroke risk by four to six times compared to people with normal blood pressure.

High cholesterol

can lead to a buildup of fatty deposits inside the arteries. These deposits narrow the arteries, making it easier for them to become clogged. If a clot blocks a blood vessel that feeds the brain, a stroke ensues.

Atrial fibrillation

occurs when the heart’s upper chambers beat rapidly and erratically. This allows blood to pool in the heart, where it may form clots. If a clot breaks loose and travels to the brain, it can cause a stroke.

Diabetes

involves a buildup of glucose (sugar) in the blood. Over time, this can damage blood vessels, including those that supply the brain. People with diabetes are twice as likely as those without the disease to have a stroke or heart disease.

Transient ischemic attacks (TIAs)

result from temporary interruptions in blood flow to the brain. They produce strokelike symptoms, but since brain cells don’t actually die, TIAs don’t cause lasting damage. TIAs are important early warnings, however, since one-third of people who have such attacks go on to have a full-blown stroke. If you have a TIA, you can turn the odds in your favor by seeing a doctor at once and getting treatment for the underlying cause.

An Ounce of Prevention

Some risk factors for having a stroke are beyond your control. For example, your risk is higher if you’ve had a prior stroke or a heart attack, or if an immediate relative has had a stroke. African- Americans, American Indians and Mexican-Americans have a higher than average risk. And, of course, the probability of having a stroke goes up with age. But that doesn’t mean there’s nothing you can do, even if you fall into a high-risk group. Your lifestyle choices can improve your odds.

• If you smoke, quit. “This is probably the single most important thing people who smoke can do to reduce their risk,” says Dr. Elkind. The nicotine and carbon monoxide in cigarettes damage blood vessels, making clots more likely. As a result, smokers have twice the stroke risk of nonsmokers. The good news: Your risk starts to drop as soon as you stop smoking. Within five years, it may be about the same as that of someone who has never smoked.
• Drink alcohol in moderation, if at all. In a recent study published in the journal Stroke, Dr. Elkind and his colleagues looked at the drinking habits of 3,176 adults. They found that moderate alcohol intake was linked with a decreased risk for ischemic stroke. “But alcohol is a double-edged sword,” says Dr. Elkind. Heavier drinking is linked to an increased risk for stroke and other serious diseases. The American Heart Association (AHA) recommends no more than one alcoholic drink a day for women and no more than two for men.
• Stay active and maintain a healthy weight. Being inactive or obese increases the risk for high blood pressure, high cholesterol, heart disease, diabetes and stroke. To cut your risk, all it takes is at least 30 minutes of moderate activity on all or most days of the week. “You don’t have to run five miles to get a preventive benefit,” says Dr. Elkind. “A brisk, half-hour walk is enough to help.”
• Choose a low-sodium, low-fat diet. Good eating habits can help keep your blood pressure and cholesterol levels in check. For healthy individuals, the AHA advises eating less than 2,400 milligrams of sodium (6 grams of salt) daily. The AHA also recommends limiting foods that are high in saturated fat or cholesterol. These include full-fat milk and dairy products, fatty meats and egg yolks. Better choices are beans, nonfat or low-fat milk and dairy products, fish, skinless poultry and lean meats. You should also limit trans fat and partially hydrogenated vegetable oils, found in some margarines and baked goods, for instance.

Stroke is the third leading cause of death in the United States. It’s also a major cause of severe, longterm disability. But many strokes can be prevented with lifestyle changes and, if needed, medical treatment for underlying conditions. Talk with your doctor about reducing your stroke risk. The more you know, the less likely it is that a stroke will strike you.



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