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Stroke is the third leading cause of death in the U.S. and is very prevalent in our part of the country.  The purpose of this column is to inform Seabrookers of the risk factors and to discuss prevention strategies.

Risk Factors Which Cannot Be Changed
Many of the risk factors for stroke cannot be changed, but they can and should be carefully noted since as we discussed last month early diagnosis and treatment of a stroke can be life-saving and life-style preserving.  Increasing age (a risk factor we wish to continue!) is clearly related to stroke.  In fact, in people over the age of 65 the risk of stroke increases about 1 percent per year.  Being male is another major risk factor and in people over 65 the risk of stroke is about 20 percent higher in men than women.  Diabetes Mellitus is another stroke risk factor, and this is more important in women.  A very strong predictor of stroke is a prior history of stroke or symtoms such as transient iscehmic attacks (TIAs).

The presence of significant (greater than 60 percent) carotid artery obstruction (major arterial blood vessels leading from the aorta to the brain) with or without a bruit (sound audible with a stethascope) is predictive of a stroke.  Certain heart diseases, especially heart arrhytmias like atrial fibrillation carry increased risk of a stroke as does a family history of stroke.  
  
  
Risk Factors that Seabrookers Can Modify
The major purpose for writing this column is to give our neighbors some healthful hints.  With regard to stroke, which is such a deadly or potentially debilitating catastrophe it is vital that we do all that is known to reduce the risk of a stroke (see table.)

Hypertension is a very strong predictor of stroke.  Althought hypertension cannot be eliminated, it can be very successfully treated.  Hypertension is the most pwoerful, prevalent, and treatable risk factor for stroke.  In the elderly, isolated systolic (numerator in the blood pressure equation) increases risk directly.  The aim of patients and physicians is to control with diet, exercise and medications the blood pressure of hypertensive patients.  A reduction of blood pressure has a major effect on the reduction of stroke.  The successful treatment of blood pressure can reduce the incidence of stroke about 40 percent!

Ciagrette smoking is unhealthy.This is true for stroke as well as heart disease and cancer.  If you smoke, stroke reduction is another reason to stop.  Stopping smoking immediately reduces stroke risk, unlike with cancer where the risk of cancer remains high even in people who stop smoking.  The risk of stroke is directly linked to the number of cigarettes smoked per day probably due to the carbon monoxide produced and the increased coagulation of the blood. 

Antiplatelet therapy which generally is aspirin is indicated to prevent stroke.  One aspirin a day, just as this will protect against a heart attack, has proven very effective in preventing stroke.  Unless your doctor says you shouldn't take daily aspirin, you should.  Many patients who have had a TIA or stroke are placed on aspirin to prevent recurrence. 

Controversial preventive measures relate to estrogen therapy in post-menopausal women and alcohol in all of us.  The data seem to indicate that estrogen does not increase the risk of stroke and that moderate to light alcohol is helpful in preventing a stroke. 

Stroke, like many other health problems, is something that Seabrookers can prevent by adopting healthy life-style.  It's not enough to just live on our lovely island.
 
Stroke Risk Factors Reduction

HYPERTENSION - control high blood pressure
CIGARETTE SMOKING - cessation leads to immediate risk reduction
ANTIPLATELET Rx- one aspirin a day reduces most types of stroke
ALCOHOL - in moderation probably reduces stroke incidence
ESTROGEN - post-menopausal women can probably take safely

MUSCHealth.com Online Library Links:
Risk Factors for Stroke

Other Online Resources:
American Heart Association- Stroke Warning Signs
American Stroke Association
National Institute of Neurological Disorders and Stroke

Additional Online Resources Outside MUSCHealth.com:
(MedlinePlus, is an excellent source of health information from the world's largest medical library, the National Library of Medicine. Health professionals and consumers alike can depend on it for information that is authoritative and up to date. MedlinePlus has extensive information from the National Institutes of Health and other trusted sources on over 650 diseases and conditions.)

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