“RISK factor modification is essential for stroke prevention — and, while it’s great to treat any risk factor, it’s best to treat them all,” says Louis Klebanoff, M.D., vice chair of the Department of Neurology at Weill Cornell, in an article recently published in the Weill Cornell Medical College Women’s Health Advisor.
Taking control of these modifiable risk factors will lower your risk for stroke.
More than 53 percent of the 795,000 annual strokes in the U.S. occur in women — for nearly 77,000, the stroke is fatal, adds the health letter.
While stroke doesn’t kill, it is likely to leave a neurological deficit:
“The inability to speak, walk or care for oneself are possible outcomes and reasons stroke is a leading cause of disability and nursing home admissions,” says Dr. Klebanoff.
“We would much rather prevent these events than deal with the consequences.”
Certain risk factors are involved in 90 percent of strokes — medications and lifestyle changes can lower the risk, as well as blunt the effect of other risk factors specific to women, including the use of oral contraceptives and hormone replacement therapy.
The American Heart Association and American Stroke Association issued guidelines for stroke prevention in women — the top 10 risk factors to address include:
1. Hypertension — The higher your blood pressure, the higher your risk of stroke — the relationship is so strong that lowering blood pressure to normal is one of the most effective strategies for preventing strokes.
A healthy diet, regular exercise, and medications may all help normalize blood pressure.
2. Diet — Diets that are high in salt or low in fruits (particularly citrus), vegetables and potassium increase stroke risk — high-salt diets often increase blood pressure, which can be worsened by lack of potassium.
High alcohol consumption, obesity and poor nutrition can also increase stroke risk — the Dietary Approaches to Stop Hypertension (DASH) diet was developed to lower blood pressure.
And, a Mediterranean-style diet based on fish, legumes, fruits, vegetables, olive oil and nuts has been shown to lower stroke risk.
3. Physical inactivity — Physically active women have a 25 to 30 percent lower risk of stroke than inactive women — guidelines recommend moderate-to-vigorous aerobic activity for 40 or more minutes a day on three or four days of the week, but some activity is better than none.
4. Dyslipidemia — A high total cholesterol level is a risk factor for stroke in women of all ages — treatment with statins can reduce this risk.
The lower the LDL cholesterol, the lower the risk.
5. Obesity — Where fat is stored is more important than the total number of extra pounds — in different studies, abdominal fat and a higher waist-to-hip ratio increased the stroke risk in women.
6. Diabetes — Even when diabetes is well controlled, it’s a risk factor for stroke.
7. Smoking — The more cigarettes you smoke, the higher your risk of stroke.
8. Migraine — In women under age 45, migraines are associated with stroke — smoking and oral contraceptives further increase the risk.
9. Atrial fibrillation (AF) — Having AF, an irregular heart rhythm, can increase the risk of stroke up to five times — if you have AF, discuss medical or surgical treatment with your doctor.
10. Certain heart conditions — Many heart conditions increase stroke risk — if you have had a heart attack or have any form of heart disease, ask your doctor what steps you can take to reduce the risk of having a stroke, says the heart letter.
While some may find the thought of making lifestyle changes unpleasant, in reality, several of these risk factors are very easy to modify — “High blood pressure should be treated and monitored.
Atrial fibrillation should be treated with anti-coagulants, which are significantly more effective than aspirin for stroke prevention.
Smoking cessation should be addressed,” says Dr. Klebanoff.
“All of these efforts are much easier than living with the aftereffects of stroke.”
Nevertheless, in concluding, Dr. Klebanoff cautions, “Not all strokes can be prevented, no matter how hard you work to reduce your risk. That’s why it’s important to know the warning signs of stroke and seek treatment within three hours.”
The signs of stroke include:
• Sudden, severe headache
• Sudden loss of vision or blurry vision
• Weakness or numbness on one side of the body and/or face
• Sudden trouble walking, dizziness, loss of balance
• Difficulty speaking, slurred speech