The first risk factor that
I want to discuss is high blood pressure. High blood pressure
is the number 1 risk factor for stroke. High blood pressure
is very frequent, usually running in families, and it’s a problem we
can do something about. It can be easily detected. People with high
blood pressure don’t often know it -- it doesn’t cause symptoms. In
fact, it is often referred to as 'the silent killer'. Many people think
that headaches are frequently associated with high blood pressure. This
is not typically the case. So it is extremely
important to get your blood pressure tested. If you have high blood
pressure, you can often lower it by simply modifying your diet: Losing
weight, reducing fat intake, reducing overall calories. Reducing salt
intake is important for some people. These dietary changes, along with
a little exercise, can really help to reduce high blood pressure. Of
course, sometimes you do need medicine to lower your blood pressure. It
is not uncommon to need more than one medicine. If you do need to take
medicine, take it every day and follow the prescribing directions.
These medicines are extremely important in lowering your blood pressure
and your risk of stroke.
let's move forward to something more seductive: smoking. Smoking
is an important risk factor for stroke. It increases one's
risk almost twofold. Just to put things in perspective, the number of
Americans who die annually due to smoking-related causes is
approximately equal to the number of deaths that would result if three
jumbo jets crashed every single day for a year. The encouraging news is
though, that there is a lot of good scientific data that shows that
those who can quit smoking can reduce the risk of stroke. So remember,
it is never too late to quit. Also, encourage your spouses and family
members to quit as well. There is clear evidence that exposure to other
people's smoke--passive smoking--is also dangerous. The bottom line is
that smoking, either by you or anyone in your household, is simply bad
news. If you do it, quit. If you haven’t, don’t start.
have all probably heard some good things and bad things about alcohol.
Let's start with the good news. It appears that if you drink a little
bit--mild to moderate drinking--you can actually reduce your risk of
stroke. My colleagues and I just completed a study in which we found
that moderate alcohol use is associated with a significantly decreased
risk of ischemic stroke. Ischemic stroke is the most common type of
stroke and occurs when a blood clot blocks a blood vessel in the brain.
This risk reduction was seen in a multi-ethnic population, including
Caucasians, African-Americans, and Hispanics, and was independent of
hypertension or smoking. The bad news is that heavy alcohol use
increases the risk of stroke. The more you drink, the worse the risk of
stroke. However, heavy drinkers who cut back to no more than two drinks
a day can reduce this risk. Of course, these studies are not implying
that physicians should recommend to their patients to have two drinks a
day in order to reduce their risk of stroke. No study has shown a
benefit in recommending alcohol use to people who don't drink. What the
studies are suggesting is that among those people who are moderate
drinkers, continued consumption might provide a reduction of ischemic
stroke risk. However, they may have other medical conditions that need
to be considered which may be aggravated by alcohol. Therefore, every
patient's situation is different and the risk and benefits of alcohol
must be balanced.
people are aware of the overall benefits of physical activity. Getting
patients to do it is the hard part. I would like to emphasize is that
you don't have to be a marathon runner to benefit from exercise. Doing some
physical activity can reduce the risk of stroke. Walking is just as
good as running. Walking briskly for 20 minutes a day, 3 days a week,
is something that can really make a difference. Elderly people and
younger adults benefit from physical activity in similar ways. These
benefits are far reaching, and can improve your entire cardiovascular
profile, including positively affecting cholesterol levels.
levels of HDL, the good cholesterol, can reduce your risk of heart
attack and stroke. The other type of cholesterol, LDL, is the kind that
actually can build up in arteries, and increase the risk of heart
attack and stroke.
High cholesterol can run in
families. Some people, regardless of diet, have high cholesterol. Most
people do not require medicine to control their cholesterol. However,
not everybody can do it with dietary changes. We recognize that. And
that’s why there are good medications out there, for people who may
need it. These cholesterol-reducing medications can also reduce the
chance of death, heart attack, and stroke.
hope that I demonstrated that there is a great deal each one of us can
do to reduce our risk of getting a stroke. If we would even just focus
on one risk factor, such as hypertension, or smoking, for example, we
can really make a difference in our lives.
Let's look at it on a broader scope.
There are at least 750,000
strokes per year in the United States.
the entire population was controlled, we would
eliminate approximately 308,125 strokes
we all reduced cholesterol levels,
we would eliminate about 125,000 strokes.
- If the entire country stopped smoking, almost 76,875 strokes
would not occur.
- If we treated every case of atrial
fibrillation, a special medical condition of the heart that
we did not discuss above, we would eliminate at least 58,750
we eliminated heavy alcohol use,
and consumed only a moderate amount of alcohol, about 29,375 strokes
would be eliminated.
These numbers give us an idea
of how much we can really do to decrease our stroke risk. Given the
reduction in stroke, based on the numbers above, nearly 80% of strokes
could be prevented by living a healthy lifestyle.
what the risk factors
what you can to modify your lifestyle.
a healthy weight.
a healthy diet.
of the good things that can be done, that can be enjoyable, and that
you can adopt into your day-to-day routines.
you need medications, don't forget to take them as prescribed.
you have serious diseases like atrial fibrillation or diabetes, make sure
you manage it.
that even small changes can make big differences.