The Stroke Con­nec­tion

Wellness Update - - What Doctors Know And Your Should, Too! -

The brain needs blood and oxy­gen. When that doesn’t hap­pen and that cru­cial nour­ish­ment can’t reach the brain — ei­ther be­cause of a clogged artery or a burst ves­sel — brain cells start to die. For peo­ple with high blood pres­sure, the force of blood push­ing against the ar­ter­ies as the heart pumps blood is too high. That causes grad­ual dam­age to the ar­ter­ies, in­clud­ing those to the brain. A weak­ened blood ves­sel may rup­ture in or near the brain, or scarred ar­ter­ies may be­come blocked by a clot or plaque buildup. Then there’s atrial fib­ril­la­tion. That’s when stroke risk in­creases be­cause the rapid heart­beat al­lows blood to pool in the heart, which can cause clots to form and travel to the brain. High blood pres­sure is gen­er­ally con­sid­ered the most com­mon con­trol­lable risk fac­tor for stroke, but atrial fib­ril­la­tion is the most pow­er­ful, said Ralph L. Sacco, M.D., pro­fes­sor and chair­man of neu­rol­ogy at the Miller School of Medicine at the Univer­sity of Mi­ami and past pres­i­dent of the Amer­i­can Heart As­so­ci­a­tion. “Some­body with high blood pres­sure has al­most twice the risk of stroke than some­body with­out high blood pres­sure,” he said. “But some­one with atrial fib­ril­la­tion has more than five times the risk of stroke.” More than 76 mil­lion Amer­i­cans have high blood pres­sure. Atrial fib­ril­la­tion, on the other hand, af­fects far fewer Amer­i­cans — an es­ti­mated 2.7 mil­lion. “Be­cause high blood pres­sure is so fre­quent, af­fect­ing tens of mil­lions of peo­ple, it has a big­ger im­pact on the num­ber of strokes at­trib­uted to it,” Dr. Sacco said. “But atrial fib­ril­la­tion is a more po­tent risk fac­tor.” The two risk fac­tors are also re­lated to each other: High blood pres­sure is a risk fac­tor for atrial fib­ril­la­tion. Mid­dleaged men and women with high blood pres­sure are at in­creased risk for atrial fib­ril­la­tion later in life. “Then it be­comes a dou­ble whammy, where you have high blood pres­sure as well as atrial fib­ril­la­tion in­creas­ing your stroke risk,” Dr. Sacco said.

How to Re­duce Stroke Risk

Stroke is not in­evitable, even if you are among the mil­lions with high blood pres­sure or atrial fib­ril­la­tion. Pre­vent­ing or con­trol­ling high blood pres­sure and atrial fib­ril­la­tion can greatly lower your chances of hav­ing a stroke. Here’s how: • Don’t smoke. • Get reg­u­lar phys­i­cal ac­tiv­ity. • Main­tain a healthy weight. • Limit al­co­hol to no more than two drinks a

day for men or one drink a day for women. • Eat a healthy diet that is high in fruits, veg­eta­bles, and whole grains, in­clude low-fat dairy prod­ucts and limit salt, sat­u­rated fat, trans fat and choles­terol. • Mon­i­tor your blood pres­sure and

work to keep it at your goal. • Take your med­i­ca­tion as pre­scribed if you have

high blood pres­sure or atrial fib­ril­la­tion. Stroke preven­tion is of­ten the fo­cus of doc­tor­pa­tient con­ver­sa­tions in atrial fib­ril­la­tion, Dr. Sacco said. But for peo­ple with high blood pres­sure, “busy physi­cians don’t al­ways rank dis­cus­sions about pre­vent­ing stroke as high as we’d like,” he said. “We have so many very ef­fec­tive medicines to treat high blood pres­sure and atrial fib­ril­la­tion. If more pa­tients with high blood pres­sure and atrial fib­ril­la­tion are prop­erly treated, we’re op­ti­mistic the num­ber of pro­jected strokes will go down.” For more in­for­ma­tion on high blood pres­sure, atrial fib­ril­la­tion and stroke, please visit the Amer­i­can Heart As­so­ci­a­tion’s web­sites:, and www.stroke­as­so­ci­a­

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