Beware of stroke
Philippine Daily Inquirer
First Posted 20:24:00 03/07/2008
Filed Under: Health
MANILA, Philippines—Six out of 10 Filipinos 60 years and older has had a stroke. Next to heart disease, stroke is the leading cause of death in the Philippines.
Worldwide and in the country, stroke is the No. 1 one cause of serious long-term disability. The grief and suffering stroke causes bereaved relatives and the families of survivors are incalculable.
If stroke doesn’t kill you, it will maim you. And there’s no way to be sure you’ll survive its second attack.
Suffocating the brain
A person suffers a stroke when a blood vessel (artery) supplying his or her brain with oxygen and nutrients is either blocked by a blood clot or cholesterol plaque/fatty deposits (ischemic stroke), or ruptures and bleeds out (hemorrhagic stroke). About 8 out of 10 stroke incidents are ischemic in nature; hemorrhagic strokes are often secondary to high blood pressure.
Whether ischemic or hemorrhagic, a stroke cuts off the blood supply to a part of the brain, causing hundreds of thousands of oxygen-starved nerve cells to die within minutes. The end result is always the same: disability or death.
Recognize warning signs
The warning signs of stroke develop very abruptly and are often fleeting. Survival depends on quick recognition of warning signs and immediate medical attention at the nearest emergency room of a hospital with acute stroke care facilities. Every second counts; time literally means life. Paranoia is a good rule of thumb: take any warning sign, even the most transient one, seriously.
According to the Stroke Society of the Philippines (SSP), the 7 warning signs of stroke are sudden:
1. weakness on one side of the body
2. numbness of the face, arm or leg
3. loss of speech or trouble understanding speech
4. slurring of speech
5. trouble seeing, particularly in one eye, or double vision
6. dizziness, loss of balance or coordination
7. severe, unusual headache
Not all warning signs occur in every stroke; some people may exhibit only one or two signs.
In about 15 to 30 percent of patients, a full-blown stroke is heralded by a “minor or mini stroke,” what doctors call a transient ischemic attack (TIA). A TIA occurs when a blood clot temporarily clogs an artery leading to the brain; within 24 hours (usually within minutes), the blood clot blocking the artery is dislodged without causing any permanent effect aside from any of the said stroke warning signs. It is considered a warning sign and should not be ignored.
Reduce your risk
The only good thing about stroke is it can be prevented. There are three Rs one must remember in fighting stroke. Recognize the warning signs, React immediately, and Reduce your risk.
In warfare, knowing your enemy is the first step to victory. In beating stroke, knowing your risk factors is the key. A risk factor is a behavior or trait that increases your risk of stroke. The SSP provides a valuable guide on how you can reduce your risk:
Risk factors you can control
High blood pressure (Hypertension) is the single most important risk factor of stroke. Known as the “silent killer” because it usually has no symptoms, high blood pressure increases stroke risk by five to six times. Have your BP checked regularly; it should be less than 120/80 mm Hg.
People with diabetes mellitus are two to four times more likely to suffer a stroke compared to those without the condition. A person has diabetes mellitus if he or she has a fasting blood sugar (FBS) level of over 126 mg/dl. Untreated diabetes mellitus can lead to serious medical problems, including heart disease, stroke, kidney disease, blindness and limb amputations. Many people with diabetes also have hypertension, high blood cholesterol and are overweight—factors that increase their stroke risk even more.
Atrial fibrillation (AF) is a condition in which the heart’s upper pumping chamber quivers erratically instead of beating rhythmically. It promotes the formation of blood clots, which can break off from the heart’s blood circulation and enter the bloodstream. The clot can then lodge in an artery in the brain and cause a stroke.
Other heart diseases—People with coronary heart disease (diseased arteries in the heart) or heart failure have twice the risk of suffering from stroke than those with a healthy heart. Dilated cardiomyopathy (enlarged heart), heart valve disease (e.g. rheumatic heart disease) and congenital (present at birth) heart defects also increase stroke risk.
High blood cholesterol—Cholesterol is a soft, fat-like substance naturally found in the body and derived from foods we eat. Excessive levels of cholesterol can build up and clog the walls of arteries, reducing blood flow to vital organs such as the heart and brain. People with high levels of total cholesterol, LDL (bad) cholesterol, triglycerides and low level of HDL (good) cholesterol are at higher risk of heart attack and stroke.
Risk factors needing lifestyle change
• Smoking—People who smoke or nonsmokers who are constantly exposed to other people’s tobacco smoke have a higher risk of stroke. The nicotine and carbon monoxide in tobacco smoke reduce blood oxygen levels and damage the walls of blood vessels.
• Excessive alcohol intake—An average of more than two alcoholic beverages a day for men or more than one drink a day for women increases stroke risk.
• Physical inactivity—A sedentary lifestyle increases a person’s risk of becoming overweight and developing high blood pressure.
• Overweight and obesity—People who have excess body fat, especially when concentrated in the waist area, are at higher risk of developing health problems including high blood cholesterol, high triglycerides, diabetes, heart disease and stroke. Excessive eating without regular exercise is the main cause of obesity.
• Illicit drug use—The use of cocaine, metamphetamine (shabu) and marijuana is associated with an increased risk of stroke. Illicit drugs can contribute to the occurrence of a stroke by causing inflammation of blood vessels (vasculitis), an acute rise in blood pressure, vessel constriction (vasospasm), irregular heart rhythm (cardiac arrhythmia) and increased platelet aggregation.
Risk factors you cannot change
Unfortunately, like life’s inevitable scourges such as traffic jams and corruption in government, there are also stroke risk factors that you cannot change.
• Increasing age—Nobody can turn back the hands of time. While stroke does occur in people of all ages (including young adults and children), the older a person gets the higher his or her risk of stroke becomes.
• Gender—Stroke is more common in men than in women. However, more women die of stroke each year than men.
• Heredity and race—Your stroke risk is greater if you have a relative (parent, grandparent, sibling) who has had a stroke. African Americans and Asians have higher stroke risk than Caucasians.
• Previous stroke or TIA—A person who has had a stroke is 10 times more likely to suffer another stroke than someone who hasn’t suffered one. A TIA is also a strong risk factor and predictor of stroke.
How to prevent stroke
With your doctor’s guidance, evaluate your risk factors and modify your lifestyle accordingly. The SSP shares the following tips to help you prevent stroke:
• Get regular medical check-ups. Know your weight, height, blood pressure, blood sugar and blood cholesterol levels.
• Work with your doctor to control your medical risk factors.
• Quit smoking. No tobacco product is safe.
• If you drink alcohol, do so in moderation. Alcohol is harmful if taken in excessive amounts and can interfere with the efficacy of your medications. If you don’t drink, better not start.
• Make time for regular exercise. Perform moderate-intensity activities such as brisk walking that total at least 30 minutes on most or all days of the week. Choose an activity that you will enjoy and do regularly.
• Eat a well-balanced diet that is low in salt, saturated fat and cholesterol. Eat more fruits and vegetables, and less fried food and fatty meat.
• Achieve and maintain an ideal body weight.
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