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Preventing Stroke Means Looking at Overall Health

April 30, 2013

Stroke Professionals Say It's Never Too Late for Stroke Prevention

For victims of stroke, it may feel like this insidious disease comes from out of nowhere. But the truth is that many "silent" conditions that contribute to stroke risk may have been developing for years - decades even - before a stroke happens.

The good news, according to Dr. Ash Jain, medical director of Washington Hospital's Stroke Program, is that by taking a comprehensive look at other disease processes - and managing them with the help of your health care team - you can significantly reduce your stroke risk.

Visit the doctor; get smart about stroke

According to Dr. Jain, community members can start with a visit the doctor to identify any underlying risk factors. The second step is to get them under control sooner rather than later. Why? Because your blood vessels will thank you for it.

"Uncontrolled hypertension, high blood glucose levels and hyperlipidemia (high blood cholesterol) cause damage to blood vessels throughout the body, including the brain," Dr. Jain explains. "When blood vessels - from capillaries to arteries and veins - are compromised, it leads to an increased risk of stroke."

"The only way to effectively diagnose and treat these disease processes is to visit your primary care physician, who can monitor your blood sugar, cholesterol and blood pressure. In total, by keeping these risk factors under control, you can greatly reduce your risk of stroke."

Dr. Jain says that patient education - like the free Stroke Education Series at Washington Hospital - is a critical component of stroke prevention, mainly because not enough people know how destructive stroke is, and they don't realize how preventable it is.

"Stroke is a devastating disease that takes many by surprise, because it often has few warning signs," Dr. Jain says. "Our program has committed all of its resources to ensure positive outcomes for community members, beginning with community education and increasing awareness - because the best possible outcome is never to have a stroke in the first place."

To minimize overall stroke risk, Dr. Jain adds that:

  • Fasting blood sugar should be less than 100.
  • Blood pressure should be less than 140 (systolic) over 90 (diastolic).
  • Total cholesterol should be less than 150.

Other risk factors for stroke that can be impacted through lifestyle change include smoking, a sedentary lifestyle, and an unhealthy diet.

"If you already have problems with circulation in the body - like blockages in the heart, legs, or other areas - then you have to be very aggressive in management, as the chance of having a stroke is much higher," Dr. Jain says.

Circulation problems, or pain in your extremities that comes on with exercise and dissipates with rest, can indicate peripheral vascular disease (PVD) and should be evaluated by a physician. On the other hand, even if you feel perfectly fine - but you haven't been to the doctor recently - Dr. Jain says it's a good idea to make an appointment to make sure your blood pressure, blood sugar, and cholesterol levels are within healthy levels.

In addition, he says that many strokes are caused by irregular heart rhythm, which may feel like an irregular heart beat or palpitation. These irregularities, called arrhythmias, cause as many as 30 percent of strokes, according to Dr. Jain.

"They are difficult to diagnose at times and require special testing," he says. "So if you have these symptoms, seek help from a cardiologist and make sure you discuss with the doctor your concerns."

The overall lesson, he says, is to take action early by identifying risk factors and managing them with the help of your health care team.

"Many times it's easy to ignore these things, because most of the risk factors for stroke build up over time with few discernable symptoms," he points out. "I never want to see a patient in the ER for a stroke that didn't have to happen."

Is it too late for me?

Doug Van Houten, R.N., clinical coordinator of Washington's Stroke Program, says it's never too late to take steps toward preventing stroke. To illustrate his point, he uses the analogy of retirement savings.

"Somebody who is sixty years old might say it's too late to save for retirement," he points out. "They might say, 'If I haven't saved as much as possible by 60, should I bother saving now?' Well, it's not going to be the same as if you had done it all along, but you have to do it - because it can make a difference in the quality of your retirement."

He says the exact same lesson applies to stroke. The sooner you start, the better your chances are of not having a stroke. But even small changes, regardless of your age or current health status, can have an impact on overall health.

"In a very large study, they saw measurable improvement in stroke risk, as well as overall heart disease reduction, with average changes in blood pressure of just eight to 10 points," Van Houten says. "The important thing is to make the changes you can now and do it as soon as you can by focusing on continued improvement as opposed to perfection. By aiming for continued improvement, you will reap the benefits."

By making important lifestyle changes, he says there are several benefits, including:

  • Some people will no longer be diabetic if they lose excess weight, get regular exercise and begin to eat right.
  • Those with hypertension may bring their blood pressure down to normal by reducing sodium intake and losing weight.
  • Smokers begin to improve the condition of their lungs and cardiovascular system when they stop smoking.

However, Van Houten admits that making lasting changes to a healthier lifestyle can take a good deal of creativity and motivation. Fortunately, during the upcoming Stroke Education Series talk next Tuesday, May 7, he will share numerous tips on how to get started.

"For exercise, I tell people two things," he says. "First, if you don't schedule exercise, it's not going to happen. We're too busy otherwise. Second, most people get a lunch break. Today, I had a class from 7 a.m. to 3:30 p.m., and I only had a half hour, but I brought my lunch. After I ate, I had twenty minutes to go for a walk.

"There's time to walk on your lunch break if you really think about it."

When it comes to food, he suggests keeping healthy, portable snacks on hand to avoid an afternoon visit to the vending machine for a candy bar or cookies. And if you've been looking for motivation to change your lifestyle, Van Houten says now is the time.

"It might be a class like this that's the impetus that pushes you over the edge and gets you into that healthy lifestyle that you've been contemplating," he says. "This class is all about being positive and reaching your goals."

Prevention starts here

To learn more about how disease processes like diabetes and hypertension impact stroke risk, and how to lower your risk through healthy lifestyle changes, make sure to attend the upcoming free stroke seminar focusing on prevention. The class will be held from 6 to 8 p.m. on Tuesday, May 7, in the Conrad E. Anderson, M.D. Auditorium located at 2500 Mowry Avenue (Washington West) in Fremont.

To register, call Health Connection at (800) 963-7070 or visit www.whhs.com.