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Family Health Magazine
FAMILY MEDICINE

Stroke: It's a brain attack
Reduce your risk, recognize the symptoms

A stroke is a brain attack. It happens when blood flow to a part of the brain is cut off. Brain cells in the injured area become damaged or die due to lack of oxygen. The effects of stroke depend on the location and size of the affected area.

Strokes affect us physically, emotionally, behaviourally and socially. They affect the ability to think and learn. A serious stroke can cause paralysis, impulsive behaviour, mood swings, poor judgment, and the loss of ability to recognize and use familiar objects. Some stroke survivors are no longer able to live an independent and active life.

Stroke is the leading cause of adult disability in Canada, and the third leading cause of death. Although most strokes occur in people over the age of 65, about a quarter of strokes affect Canadians between 30 and 60 years of age. The good news is that stroke is one of the most preventable of all life-threatening health problems. By using our heads, we can make better lifestyle choices to protect our brains from attack.

Ways to protect your brain

High blood pressure

High blood pressure (hypertension) is the single most important stroke risk factor that you can help control. There are rarely any outward signs that high blood pressure is a problem. Make sure your blood pressure is regularly checked by a health care professional.

Moderate exercise is a good way to control your blood pressure. Canada’s Physical Activity Guide to Healthy Active Living suggests fitting 60 minutes of physical activity into your daily routine. You can do it 10 minutes at a time, but aim for at least an hour a day. If you have been inactive and would like to begin an exercise program, talk with your doctor about the best way to get started.

Limit salt. Too much salt really does affect your blood pressure. In addition to putting the salt shaker away, choose fresh over processed or prepared foods. Processed and prepared foods often have hidden high salt levels.

If you are already being treated for high blood pressure, be sure to follow the directions given by your doctor.

Atrial fibrillation

Atrial fibrillation is a heart rhythm disorder that increases the risk of blood clots developing in the heart. It can cause stroke. If you have been diagnosed with atrial fibrillation, follow your doctor’s guidance.

Diabetes

Those with diabetes are at a much higher risk of stroke since over time, high levels of blood glucose can damage the blood vessels leading to the brain. If you have diabetes, it is essential to take medication exactly as prescribed and manage your diet to keep blood glucose levels under control. If you find blood glucose control a challenge, talk to a health care professional about strategies that may work better for you.

Cholesterol

Researchers believe that high cholesterol plays a role in blocking the arteries leading to the brain. To control your cholesterol, limit the amount of fat in your diet. When you do eat something with fat, choose good fats like olive oil over bad fats like butter. Avoid transfats like hydrogenated vegetable oil altogether. Have a health professional check your cholesterol. If your levels are not within normal limits, talk to your doctor about how to get your levels balanced.

Healthy weight

While you are getting your cholesterol under control, you are probably trying to maintain a healthy weight. Losing extra weight helps control other stroke risk factors. The best way to lose weight is to combine healthy eating with regular, moderate exercise.

Smoking

Think twice about lighting up that cigarette! Smokers have twice the stroke risk of non-smokers. It is hard to do, but quitting smoking is worth the effort. If you stop, within five years your risk of having a stroke may be the same as for someone who never smoked at all.

It is especially important for women over the age of 35 who smoke and take high-estrogen birth control pills to speak to their doctors about alternatives. They may be at a far greater risk of stroke.

Birth control pills

Fortunately, most birth control pills on the market today are lower in estrogen and so safer than in previous years. However, there is still a risk for some women who take the pill. It can increase the chance of high blood pressure and blood clots, raising the risk of stroke.

Alcohol

There is no evidence that drinking in moderation increases your risk of stroke. However, drinking too much increases the risk. Healthy adults should have only two drinks or less per day. Men should not have more than 14 standard-size drinks each week, while women should not have more than nine. A standard-size drink equals about five ounces (140 mL) of wine, one bottle of beer, or 1.5 ounces (40 mL) of spirits.

Some factors cannot be changed

Not all risk factors for stroke can be controlled by your decisions. For instance, your chance of having a stroke increases as you age. Most stroke victims are over 65. Your risk is higher if immediate family members, such as your grandparents, parents, brothers or sisters, had a stroke before the age of 65.

Men have a slightly higher risk of stroke than women. However, many women die from stroke because they live longer than men. Often those around them do not recognize the signs of stroke until it is too late.

Canadians of First Nations and of African, Hispanic and South Asian descent are also at a higher risk because of their higher rates of high blood pressure and diabetes.

If you have already experienced a stroke or mini-stroke (transient ischemic attack – TIA), your chance of having another is higher.

Transient ischemic attacks: are they signs of worse to come?

You bet they are. Transient ischemic attacks (TIAs), or mini-strokes, are a warning system for future strokes. TIAs are minor strokes that briefly interrupt blood supply to the brain. About one-third of those who have a TIA will have an acute stroke at some time in the future. Recognizing the symptoms of TIA and seeking immediate medical treatment are key steps in preventing more serious health problems later on.

TIA symptoms occur suddenly and are like those of stroke but do not last as long. Symptoms usually disappear within a few minutes, but may last up to 24 hours.

Warning signs of TIA are:

• weakness or numbness of the face, arm or leg on one side of the body
• dimness or loss of vision, particularly in one eye
• difficulty speaking or trouble understanding speech
• sudden severe headache with no known cause
• unexplained dizziness, unsteadiness or sudden falls, particularly with any of the other signs.

To find out more ways to protect your brain from a stroke, visit the Canadian Health Network (CHN) at www.canadian-health-network.ca.