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10 February, 2010

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Stroke - the risk factors

Stroke is the interruption of blood to the brain. This may be due to blockage of a blood vessel in the brain or rupture of a blood vessel, causing bleeding in the brain or into the space surrounding the brain. The most common type of stroke is ischaemic, caused by a blood clot blocking an artery or blood vessel. The brain cells in the immediate area die and those in the surrounding areas are affected by the reduced blood flow. Once brain cells die, their functions die with them.

Stroke is the second most common cause of death in Australia – over 50,000 strokes happen every year. Stroke is influenced by different risk factors. Some of these – age, gender and family history – are beyond your control. However, you can substantially reduce your overall risk by making healthy changes to your diet and lifestyle.

TIA or transient ischaemic attack
A transient ischaemic attack (TIA) is often called a ‘mini stroke’. It is a powerful warning that a severe stroke may follow. The symptoms are identical to those of a full stroke, but disappear in a few minutes and last no longer than 24 hours. A TIA can appear hours, days, weeks or months before a full stroke. Just like full strokes, TIAs need emergency treatment and should not be ignored.

Warning signs
Stroke is a medical emergency. The longer a stroke remains untreated, the greater the degree of stroke-related brain damage. The warning signs of both stroke and TIA include:

Sudden blurred or decreased vision in one or both eyes
Numbness, weakness or paralysis of the face, arm or leg
Difficulty speaking or understanding
Dizziness, loss of balance
Difficulty swallowing
Severe headache.

High blood pressure
Blood pressure is a measurement of the force your blood puts on blood vessel walls as it travels through your body. High blood pressure is medically known as ‘hypertension’ and is one of the most important risk factors in stroke.

Normal blood pressure is around 120/80. High-normal blood pressure is between 120/80 and 140/90. If your blood pressure is consistently over 140/90, you have high blood pressure. The levels for normal blood pressure are a guide only. In general the lower your blood pressure, the lower your risk of stroke. Your doctor can talk to you about your blood pressure and risk of stroke and may recommend treatment if required.

You can control hypertension by reducing your weight, exercising regularly, eating a low salt, low fat and high fibre diet, and taking antihypertensive medication (if necessary).

Cigarette smoking
Smoking can increase your risk of stroke by increasing blood pressure and reducing oxygen in the blood. Seek advice on how to quit smoking by calling the Quitline on 137 848.

Diabetes
Diabetes can damage your entire circulatory system and is a risk factor for stroke. Type 1 usually occurs from a young age and is treated with insulin injections. Type 2 usually occurs from 30 years of age onwards and is treated with either tablets or, in some cases, insulin. Talk to your doctor about controlling diabetes if you are diabetic.

Other important risk factors
Other factors that can increase your risk of stroke include:

High cholesterol
High cholesterol is a contributing factor to blood vessel disease, which often leads to stroke. To reduce cholesterol in your blood, eat foods low in saturated fat. Choose lean meats and low fat dairy products, and limit your intake of eggs. Your doctor may prescribe medication to lower your cholesterol but diet changes and exercise are still important.

Obesity
Being overweight or obese can increase the risk of stroke. Too much body fat can contribute to high blood pressure and high cholesterol and may lead to heart disease and type 2 diabetes. If you are unable to maintain your weight within recommended levels, ask a doctor or nutritionist for help.

Alcohol
Your risk of stroke can be reduced with moderate alcohol intake (one to two glasses a day). Excessive amounts of alcohol can raise blood pressure and increase your risk of stroke.

Diet and exercise
A diet low in fat and salt will reduce your risk of stroke. Eating a balanced diet of fresh foods (wherever possible) is recommended. Avoid processed or canned foods as they can be high in sodium, or salt. Check a food’s sodium content in the list of ingredients on the label (low salt food has a level of less than 120mg/100g).

A good balance between exercise and food intake is important to maintain a healthy body weight. People who participate in moderate activity are less likely to have a stroke. Try to build up to at least 30 minutes of moderate physical activity most days of the week. Talk to your doctor about an exercise program – people with high blood pressure should avoid some types of exercises.

Irregular pulse (atrial fibrillation)
You are more at risk of stroke if you have an irregular pulse due to the condition atrial fibrillation (AF). Your doctor can diagnose this condition and advise you on how best to manage this if it happens. If you experience symptoms such as palpitations, weakness, faintness or breathlessness, it is important to see a doctor for diagnosis and treatment.

Risk factors beyond your control
Stroke is influenced by some risk factors that are outside a person’s control. These include:
Age – the majority of people who suffer from stroke are 65 years or older.
Gender – men are at higher risk than women.
Family history – a family history of cerebrovascular disease may make you more susceptible to stroke.

Statistics on stroke
Australians will suffer more than a million strokes in the next ten years:

One in three people die within a year of having a stroke.
Stroke kills more women than breast cancer.
Almost one in five people who experience a stroke are under the age of 55.
Men are more likely to suffer a stroke and at a younger age.

Where to get help

Your doctor
An accredited practising dietitian, contact the Dietitians Association of Australia
National Stroke Foundation Tel. (03) 9670 1000 or 1800 787 653
Quitline Tel. 137 848

Things to remember
Stroke may occur due to blockage of a blood vessel in the brain or rupture of a blood vessel, causing bleeding in the brain or into the space surrounding the brain.
Many strokes are avoidable and can be caused by unhealthy diet and lifestyle choices.
Some of the major risk factors for stroke include high blood pressure, cigarette smoking and diabetes. You might also be interested in:
Blood pressure (high) - hypertension.
Early death - how to reduce your risk.
Early death in Victoria - causes.
Stroke - signs and symptoms.
Stroke - the after effects.
Stroke and high blood pressure.
Stroke and migraine.
Stroke can occur in children.
Stroke is a brain attack.
Stroke prevention.
Stroke prevention for high risk groups.
Stroke risk - quiz.

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