Stroke

There are many factors to consider when assessing risk for stroke. Some risk factors are nontreatable and some are treatable, and there are other factors that protect against stroke. The first step is to have a medical assessment of risk. If risk factors are managed and protective, and factors are enhanced in accordance with medical advice, then chances of having a stroke will decrease.

Nontreatable risk factors include age, gender, family history, and ethnicity. In general, the greater the age the greater the risk for stroke; however, it is important to note that someone young or seemingly healthy may still be at risk for stroke. Stroke has been documented as early as when a child is still in the womb. Such cases are less common, but the important point is that it is never too soon to be aware of risk factors for stroke.

Traditionally stroke has been associated with men. This is not the case at all. From the ages forty-five to seventy-five, men tend to have more strokes than women, but from ages fifty-five to eighty-five, women assume similar risks to men. While initially the number of strokes for men may be slightly higher than for women, the effects on women tend to be more devastating. Many more men recover from stroke than do women. Heart attack and stroke account for more deaths in women than any other disease. The notion that stroke is gender-specific is a dangerous one. Both sexes need to be aware of risk factors for stroke.

Hypertension, diabetes, and a history of heart disease are three main factors considered when taking a family medical history. Hypertension and diabetes are often inherited, and are both risk factors; heart disease may suggest a tendency to have hardening of the arteries (atherosclerosis). While individuals cannot escape their family history, they can use it to their advantage by making their doctor aware of conditions in their family that put them at risk for stroke.

Similarly, ethnicity cannot be controlled. Studies have shown stroke to be an important concern for Asian and African-American populations, whose risk for stroke is slightly higher than for Caucasians.

With medical advice, the following treatable risk factors can be managed and the chance for stroke reduced.

High blood pressure makes the muscular wall of blood vessels thicker. When the walls cannot thicken any more to accommodate the increasing blood pressure, they become brittle. This can result in the blood vessel closing off or rupturing, thus causing bleeding in the brain.

Smoking is a risk factor for all types of stroke as well as for heart disease. It directly damages the lining of the arteries. Smoking breaks down the elastin that gives the blood vessels flexibility. For a person who smokes, the risk of sudden death from heart attack doubles.

Homocystenemia leads to hardening of the arteries and increased clotting of the blood. High levels of the natural chemical homocysteine in the blood can be treated with vitamin B-6, vitamin B-12, and folate.

High cholesterol builds up deposits in the lining of the blood vessels, making it more difficult for blood to flow through and increasing the chances of a blockage resulting in stroke.

Diabetes damages the lining of blood vessels, which can lead to stroke.

Weight is an indirect risk factor for stroke. In general, a healthy body weight improves overall health and reduces the potential risk for disorders, such as high blood pressure, high cholesterol, and diabetes that may lead to stroke.

Heart disease can lead to clots forming on damaged areas of the heart and then finding their way to the brain, resulting in stroke.

Prior strokes increase the risk for later strokes. The medical history may indicate that a continued risk for stroke, but with medical attention the risk may be reduced.

TIAs are the body’s way of warning that a person is at risk for stroke. Those affected should seek medical attention immediately.

Chiropractic treatment involving vigorous twisting of the neck can shear the lining of the arteries in the brain, potentially leading to stroke. Individuals who are at risk for stroke may want to consider the type of treatment they receive.

Oral contraceptives used to contain a higher dose of estrogen, which could increase the chance of stroke. Low-estrogen contraceptives do not put women at risk for stroke unless they also smoke; in that case, the combination increases the chances for stroke.

Medications in rare cases, have been linked to heart valve damage, high blood pressure, seizures, heart attack, stroke, and death. Using medication only when necessary and following instructions, are important because misuse of a ‘‘safe’’ medication can increase the risk of stroke.

Substance abuse can cause stroke. Cocaine increases blood pressure dramatically and if the individual has weakened blood vessels, a major stroke will follow. Heroin inflames the blood vessels, thus increasing the risk for stroke. Contaminated needles are also a concern because they can cause an infection in the heart valves that will produce clots that go to the brain.

Migraine headaches do not necessarily warn of a stroke, but it has been documented that people who suffer from migraine with visual symptoms (classical migraine) are at a slightly higher risk for stroke. The combination of migraine headaches and either smoking or taking birth control pills can also increase the risk for stroke.

Stress is unavoidable for most people, but the degree of stress and how an individual handles stress are important factors in controlling the risk for stroke. Studies have indicated that stress and the way it is handled is an indirect factor for stroke based on elevated blood pressure and progression of atherosclerosis.

Enhancing protective factors can also reduce the risk for stroke. These factors include diet, exercise, estrogen, and aspirin. A doctor will be able to give more individualized information. Not every patient will benefit by taking aspirin as a preventive measure, nor will all women require estrogen replacement therapy.

A healthy diet, reducing alcohol consumption, and a moderate exercise plan are good ideas for prevention of many medical diseases, including stroke and heart disease. Again, it is a good idea to meet with a medical professional before making major changes so that the patient can be advised how to proceed and what to be aware of.