A wide variety of factors can increase the risk of stroke. It is possible to have inherited an increased genetic predisposition to having a stroke, illustrated by family history. Aging is another factor that increases risk. However, there are many risk factors that are treatable. Awareness of these factors allows one the opportunity to take steps in order to reduce the overall risk of stroke.

What is a stroke?

A stroke occurs when blood circulation to the brain or part of the brain is interrupted, which can cause brain cells to die from the decreased blood flow and resulting lack of oxygen and nutrients. Although less common, a stroke can also result from bleeding into the brain

Types of strokes:

Strokes are mainly caused by either a blockage of blood flow, or bleeding into the brain.

Ischemic stroke: The most common type of stroke (about 80%), an ischemic stroke results from a blockage in a blood vessel in the neck or brain. Such blockages can result from the formation of a blood clot (thrombus) in a blood vessel that reduces the flow of blood to the brain, a condition known as thrombosis; or from the movement of a clot (blood or other substance) from another part of the body that gets stuck in a blood vessel and largely obstructs the flow of blood to the brain, a condition called embolism; or the severe narrowing of an artery leading to the brain or situated inside the brain, a condition known as stenosis. (Stenosis means narrowing.)

Transient ischemic attacks (TIA’s): Often called a “mini-stroke”, these are brief episodes of stroke symptoms due to a temporary decrease in blood supply to the brain, but with no permanent damage. TIA’s are usually warning signs of underlying conditions that may lead to a stroke.

Hemorrhagic stroke: A hemorrhagic stroke occurs when a weakened blood vessel bursts and then bleeds into the brain. Pressure from the leaked blood can cause damage to brain cells and the affected area would be unable to function properly. A burst blood vessel can be caused by a number of factors, such as trauma from an accident, uncontrolled high blood pressure, weak spots in a blood vessel wall, and from a severe ischemic stroke.

Signs of a stroke:

According to Harvard Medical School the acronym F A S T can help to recognise the symptoms of a stroke, which often affects just one side of the body:

F: Face drooping. Can the person smile? Is the smile uneven?

A: Arm weakness. Is one arm weak or numb? If the person raises both arms, does one drift down?

S: Speech difficulty. Is the person’s speech slurred? Can they repeat simple sentences you give them?

T: Time to call an ambulance or seek urgent medical attention if the person shows any of these symptoms, even if the symptoms go away. Check the time so you know when the symptoms began.

Ways to prevent a stroke:

There are various ways to reduce the risk of a stroke, before a stroke has the chance to occur. Most risk factors are treatable and can prevent the complications of temporary or permanent disabilities resulting from a stroke.

• High blood pressure is the biggest contributor to the risk of stroke. Monitoring and treating high blood pressure in order to not exceed 140/90 (ideally it should be in the region of 135/85) play an important part in reducing the risk of stroke. Avoiding highly saturated fatty foods (oxidised LDL build-up in the arteries narrows blood vessels) and reducing total salt intake (salt increases blood pressure) to less than a half teaspoon, coupled with an exercise regime and eating a healthy diet, which includes fruits and vegetables to increase potassium in the diet, can help to naturally lower blood pressure.

• Losing weight in the case of obesity can lower the risk of a stroke, as high blood pressure (and diabetes) are linked to obesity.

• Getting regular, preferably daily, exercise contributes to the lowering of blood pressure and a reduced risk for stroke.

• Excessive alcohol consumption can increase the risk of stroke by more than three times, due to the resulting high blood pressure and the risk an irregular heartbeat, a condition known as atrial fibrillation. Alcohol is high in calories, and also contributes to weight gain. Reducing a high intake of alcohol to having only one or a maximum of two drinks per day, lowers the risk of stroke.

• In the event of atrial fibrillation, (more common in the elderly) the irregular heartbeat can cause clots to form in the heart, and these clots can travel to the brain and result in a stroke. Medical treatment should be sought when heart palpitations or shortness of breath occurs.

• The high blood sugar in the event of diabetes can damage blood vessels over time and increase the risk of clots forming. Exercise, a healthy diet and medication can keep diabetes in check and lower the risk of stroke.

• The chemicals in tobacco smoke thickens the blood, damages blood vessel walls and increases the likelihood of plaque build-up in the arteries, which increase the risk of clot formation. Nicotine causes your blood vessels to constrict, which limits the amount of blood that flows to your organs. Carbon monoxide from smoking results in a reduction in the levels of oxygen being carried by the red blood cells to the brain. Smoking increases the risk of both ischemic and hemorrhagic stroke. Quit smoking to reduce the risk of stroke significantly.

The aging process is inevitable for all of us, plus a possible genetic susceptibility; however, there are so many lifestyle factors that we can control in order to prevent or lower one’s risk for a stroke.

Sources:

Memorize the warning signs of a stroke. Published 15 February 2018. Daily Health Tip. Harvard Medical School. (www.health.harvard.edu)

7 Things you can do to prevent a stroke. Information updated 22 August 2018 and published again 2 April 2020. Healthbeat. Harvard Medical School. (www.health.harvard.edu)

Brain basics: Prevent stroke. Updated 19 January 2020. National Institute of Neurological Disorders and Stroke. National Institutes of Health. (USA). (www.ninds.nih.gov)

Prevention. Stroke. Reviewed 15 August 2019. HHS. (UK). (www.nhs.uk) Stroke. Published online. Mayo Clinic. (www.mayoclinic.com)

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