Imagine feeling suddenly weak on one side of your body. You try to speak but the words are jumbled. Maybe your vision seems to be failing and you are so dizzy you can’t walk straight. Or out of the blue you have a severe headache — the worst you’ve ever experienced.
If you have any of these symptoms, call 911 because it’s likely you are experiencing a stroke. While quick treatment is important, there’s an even better way to avoid death or disability from this medical emergency — don’t have a stroke in the first place.
Stroke doesn’t strike most victims out of the blue. In fact, research from the University of California, Irvine (UCI), concluded an enormous number of strokes that bring people into emergency rooms are likely preventable.
UCI neurologist Mark Fisher, MD, and colleagues studied the records of 274 UCI Medical Center patients who survived ischemic strokes. Caused by a blockage in a blood vessel that interrupts the blood supply, ischemic strokes are the most common type of “brain attacks.”
The UCI researchers developed a 10 point scale of risks that can be modified — high blood pressure, high cholesterol levels, and the heart rhythm disturbance known as atrial fibrillation — and then looked to see if the patients who suffered strokes were effectively treated for these conditions. The risk assessment also noted whether people who had known heart or cerebrovascular disease were taking appropriate medication to prevent blood clots before they experienced a stroke.
The results of the study showed 76 percent patients who suffered from acute strokes had risk factors that, if controlled, could have offered some degree of stroke prevention. And for another 26 percent of acute stroke patients, their condition was likely highly preventable if only their risk factors had been treated.
Bottom line: While it’s true advances in treatment for acute strokes have improved patient survival and rehabilitation, stroke prevention doesn’t seem to be keeping up with stroke therapies.
"Stroke preventability and stroke treatability are closely associated," said Fisher, who headed the study. “These findings raise the question of whether resources for acute stroke treatment are being directed toward those patients whose strokes are, in fact, the most preventable."
If stroke prevention was pursued aggressively like stroke treatment, the number of strokes that could be avoided is potentially enormous. Consider that every year, nearly 800,000 Americans suffer either ischemic strokes or less common hemorrhagic strokes (caused by bleeding into or around the brain) and about 160,000 die from stroke-related causes, according the National Institute of Neurological Disorders and Stroke (NINDS).
In addition to being the fourth leading cause of death in this country, stroke is the most common cause of adult disability in the U.S. Stroke survivors can face ongoing problems, including paralysis on one side of the body and thinking, learning, and speaking difficulties.
Some risk factors for stroke can’t be altered — including advancing age, sex (men are more likely to have a stroke than women), race (African-Americans are at increased risk), and family history. However, many risk factors can be controlled or eliminated. For example, working with your doctor to keep blood pressure, diabetes, and cholesterol levels under control and monitoring and treating certain cardiac conditions that raise stroke risk are all ways to lower the odds you’ll have a stroke, according to the NINDS.
Taking responsibility for your health and living a healthy lifestyle by maintaining a proper weight, avoiding alcohol and drugs known to raise blood pressure, and getting regular exercise are also ways to reduce your stroke risk. Smoking cessation is important, too. Cigarette smoking almost doubles the risk of ischemic stroke and increases the odds of having a hemorrhagic stroke by four-fold. And if you are over 50, the NINDS recommends talking to your doctor about whether aspirin therapy, which can lower the risk of ischemic stroke, is right for you.
Scientists at the NINDS predict that reducing the modifiable risks of stroke and using currently available therapies and other treatments that are in development could prevent the vast majority — 80 percent — of all strokes in Americans.
Visit the NINDS web site for more information on how to prevent strokes and a do-it-yourself worksheet to compute your personal stroke risk — and what to do to lower the odds you’ll ever suffer a stroke.
April 22, 2016
Christopher Nystuen, MD, MBA