Preventing Stroke

  • Published
  • By Greg Chadwick
  • Air Force Materiel Command Health and Wellness Team

About 800,000 people suffer a stroke each year in the United States. Stroke is the fourth leading cause of death in the U.S., and it’s the most common cause of adult disability.

Up to 80% of strokes can be prevented through healthy lifestyle changes, and working with your health care team to control health conditions that raise your risk for stroke.

To protect yourself and your loves ones from the serious effects of stroke:

  • Learn your risk factors.
  • Reduce your risk factors.
  • Learn the warning signs of stroke.
  • Know what to do if you notice warning signs.

What is a stroke?

A stroke is your brain’s equivalent of a heart attack, happening when there’s an issue with blood flow to part of your brain. This most commonly happens because of a blocked artery or bleeding in your brain. Without a steady supply of blood, the brain cells in that area start to die from a lack of oxygen. Strokes are a life-threating emergency, and immediate medical attention is critical to prevent permanent damage or death.

What are risk factors for a stroke?

You can reduce your risk of stroke. Start by becoming aware of your risk factors. A risk factor is a condition or behavior that occurs more frequently in those who have, or are at greater risk of getting, a disease than in those who don’t.

Stroke risk factors fall into three categories:

  1. Those you can’t control.
  2. Those you can change, treat or control with your healthcare provider’s help.
  3. Those you can modify by changing your lifestyle behaviors.

Risk factors you can’t control:

Increasing age. Stroke occurs in all age groups, including children. But the older you are, the greater your risk of stroke. The likelihood of having a stroke nearly doubles every 10 years after age 55.

Gender. Men have a higher risk for stroke in young and middle age, but rates even out at older ages, and more women die from stroke. Men generally do not live as long as women, so men are usually younger when they have their strokes and therefore have a higher rate of survival.

Race. People from certain ethic groups have a higher risk of stroke. African Americans have the highest overall risk of stroke of any ethnic or other racial group in the U.S. An important risk factor for African Americans is sickle cell disease, which can cause a narrowing of arteries and disrupt blood flow.  

Family history of stroke. Stroke seems to run in some families. Members of a family might have a genetic tendency for stroke risk factors, such as an inherited predisposition for high blood pressure (hypertension) or diabetes. The influence of a common lifestyle behaviors among family members could also contribute to familial stroke.

Risk factors that can be treated or controlled:

High blood pressure, or hypertension. High blood pressure is the leading risk factor for stroke. Blood pressure is the force of blood against artery walls. It is measured in millimeters of mercury (mm Hg) and recorded as two numbers – systolic pressure (when the heart beats) over diastolic pressure (when the heart relaxes between beats). Both numbers are important.

Your blood pressure changes throughout the day based on your activities. It is lower during sleep and higher with physical exertion. A healthy systolic blood pressure is less than 120 mm Hg. A healthy diastolic pressure is less than 80 mm Hg. Your blood pressure is high when you have consistent systolic readings of 130 mm Hg or higher, or diastolic readings of 80 mm Hg or higher.

Blood pressure levels

Blood Pressure Category

Systolic and Diastolic Pressure (mm Hg)

Normal

Less than 120 systolic pressure AND Less than 80 diastolic pressure

Elevated

120 to 129 systolic pressure AND Less than 80 diastolic pressure

High Blood Pressure Stage 1

130 to 139 systolic pressure OR 80 to 89 diastolic pressure

High Blood Pressure Stage 2

140 or higher systolic pressure OR 90 or higher diastolic pressure

Hypertensive Crisis 
 

Higher than 180 systolic pressure OR Higher than 120 diastolic pressure
Contact your provider immediately.

 

High blood pressure is dangerous because it makes the heart work too hard, and the high force of the blood flow can harm arteries and organs such as the heart, kidneys, brain, and eyes.

If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to normal range. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.

Diabetes mellitus. People with diabetes often have high blood pressure, high blood cholesterol and are overweight. This increases the risk of stroke even more. Diabetes can cause destructive changes in the blood vessels throughout the body, including the brain. Treating diabetes can delay the onset of complications that increase the risk of stroke. 

Cholesterol imbalance. Low-density lipoprotein cholesterol (LDL) carries cholesterol (a fatty substance) through the blood and delivers it to cells. Excess LDL can cause cholesterol to build up in blood vessels, leading to atherosclerosis. Atherosclerosis is the major cause of blood vessel narrowing leading to both heart attack and stroke.

Atrial fibrillation. Atrial fibrillation (AFib) means the heart’s upper chambers (atria) quiver instead of beating effectively. This lets the blood pool and clot within the atria. If the clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results. Patients with AFib are at five times the increased risk for stroke.

Risk factors that require lifestyle change

The most common, modifiable lifestyle behaviors that can help reduce stoke risk include healthy nutrition, regular physical activity, healthy weight and sleep, and avoiding tobacco.

Choose healthy foods and drinks. Choosing healthy meal and snack options, while limiting others, such as saturated fats, added sugars, and alcohol can help you prevent stroke.

Excessive dietary intake of salt (sodium) can cause blood pressure to be high because sodium causes the body to retain excess fluid, leading to an increase in blood pressure. The main source of sodium in the diet is salt.

The National Institutes of Health recommends that people without hypertension consume less than 2,300 milligrams (mg) of sodium per day. This roughly equates to one teaspoon. People with hypertension should consume less than 1,500 mg of sodium per day to manage their condition.

Most processed foods and pre-prepared meals contain high amounts of sodium. Limit the following foods which are high in sodium:

  • ready meals
  • canned soups
  • canned vegetables
  • potato chips
  • marinades and sauces

For more information on healthy diet and nutrition, see dietaryguidelines.gov website.

Maintain a healthy weight. If you have too much body fat, especially at the waist, you have a higher risk for health issues including stroke, heart disease and high blood pressure.

The body mass index (BMI) uses height and weight to find out whether a person is overweight or obese. A BMI of 25 or higher is considered overweight.

BMI doesn’t take into account your muscle mass, bone density, or body composition. Even if two people have the same BMI, their amount of excess body fat may differ.

To find out if your weight is in a healthy range, calculate your BMI here.

Get regular physical activity. More active men and women have a 25%-30% lower risk of stroke than those who are least active. Physical activity has been shown to lower cholesterol, help maintain a healthy weight and lower blood pressure - all factors that can reduce stroke. Even just moving around for 10 minutes every hour is better than sitting for an extended period of time. Participate in aerobic exercise (brisk walking, running, biking, or swimming) for at least a few minutes at a time throughout the week.

The U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans recommends that adults get at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity (or a combination of both), preferably spread throughout the week. Also, include muscle-strengthening activity (like bodyweight resistance or weight training) at least twice a week.

Treat obstructive sleep apnea (OSA). OSA is a sleep disorder that causes you to stop breathing for short periods several times during sleep. OSA has been linked to higher rates of stroke, high blood pressure, and coronary artery disease.

Don’t smoke and avoid secondhand smoke. Cigarette smoking increases the risk of stroke. The nicotine and carbon monoxide in tobacco smoke reduce the amount of oxygen in your blood. They also damage the walls of blood vessels, making clots more likely to form.

If you smoke cigarettes, you can find resources to help you on your journey to a smoke-free life at Smokefree.gov website.

Signs and symptoms of stroke

A stroke is medical emergency. It’s crucial to get medical treatment right away. Getting emergency medical help quickly can reduce brain damage and other stroke complications.  

Signs and symptoms of stroke include:

  • Trouble speaking and understanding what others are saying. A person having a stroke may be confused, slur words or may not be able to understand speech.
  • Numbness, weakness or paralysis in the face, arm or leg. This often affects just one side of the body. The person can try to raise both arms over the head. If one arm begins to fall, it may be a sign of a stroke. Also, one side of the mouth may droop when trying to smile.
  • Problems seeing in one or both eyes. The person may suddenly have blurred or blackened vision in one or both eyes. Or the person may see double.
  • Headache. A sudden, severe headache may be a symptom of a stroke. Vomiting, dizziness and a change in consciousness may occur with the headache.
  • Trouble walking. Someone having a stroke may stumble or lose balance or coordination.

Seek immediate medical attention if you notice any symptoms of a stroke, even if they seem to come and go or disappear completely. Think "FAST" and do the following:

  • F-Face. Ask the person to smile. Does one side of the face droop?
  • A-Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise?
  • S-Speech. Ask the person to repeat a simple phrase. Is the person's speech slurred or different from usual?
  • T-Time. If you see any of these signs, call 911 or emergency medical help right away.

 

Call 911 or your local emergency number immediately. Don't wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.

If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.

Comprehensive information on how to lower stroke risk can be found at the Centers for Disease Control and Prevention website at cdc.gov.