11 Ways to Prevent Stroke INSIDE It’S Never Too Late to Strike out Against a Potentially Devastating Brain Attack
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VOLUME 21 • NUMBER 7 MARCH 2011 11 ways to prevent stroke INSIDE It’s never too late to strike out against a potentially devastating brain attack. Fish oil questioned as treat ment for heart disease . 3. ike close cousins, heart disease and the growth of artery-clogging plaque, or the Eating fish is a better strategy than stroke share a common lineage. Both development of atrial fibrillation. This long gulping pills. emerge from a mix of nature (genes), gestation means it is often possible to avoid a Hybrid heart surgery Lnurture (upbringing and environment), and stroke by fighting arterial corrosion. expands options . 4. personal choice (smoking, exercise, etc). Collaborative approach aims to For most of us, personal choice largely de- Two types of stroke improve cardiac care. termines whether a stroke lies ahead. New A stroke occurs when blood stops flowing to Transfusion and heart surgery: guidelines on the prevention of stroke sug- part of the brain. Cut off from their supply of Only when needed . 5. gest that a healthy lifestyle can cut the risk of oxygen, brain cells begin dying within min- Unnecessary blood transfusion can having one by 80%. No drug, device, or other utes. Sometimes the damage is fatal—stroke do more harm than good. intervention can come close to doing that. is the fourth leading cause of death in the Heart beat . 6–7. The term “stroke” conjures up a frightening United States, accounting for almost 135,000 Crashing stock market and heart bolt out of the blue. It certainly feels that way deaths each year. Most of the time, stroke isn’t attacks; Eyelids as windows into when it happens. But the sudden onset be- a killer. The American Heart Association es- the heart; Double-chamber pace- maker helps heart failure; Stay lies a stroke’s decades-long development due timates that there are more than six million lean, live longer; Rheumatoid to slow but steady damage to blood vessels, stroke survivors in the United States. Although arthritis and heart disease some have no physical or mental reminders of the attack, many have long-lasting speech loss, Ask the Doctor . 8 Different types of stroke Why does my blood pressure rise paralysis, or other problems. In fact, stroke is Hemorrhagic stroke in the afternoon? and Is high a leading cause of disability—nearly one in potassium a problem? three survivors is permanently disabled, and many more need long-term care. Brain tissue Ischemic strokes occur when a blood clot Bleeding in or other debris blocks a blood vessel in the the brain brain or one leading to it. These account for Ischemic stroke more than 80% of strokes. The rest are hem- orrhagic strokes. These occur when a blood Ischemic (oxygen- vessel in the brain bursts. The bleeding (hem- deprived) orrhaging) deprives downstream brain cells WHAT’S New Clot brain tissue of oxygenated blood and can also damage 2011 Annual Report on Carotid cells by increasing pressure inside the brain. Prostate Diseases arteries Though ischemic and hemorrhagic strokes Understanding Depression require different treatments once they appear, There are two main types of stroke. Ischemic Special Health Reports strokes are more common and occur when a blood efforts to prevent them are very similar. from Harvard Medical School clot blocks an artery in the brain. In some cases, To order, call 877-649-9457 the clot develops in the vessel itself (thrombotic Three types of risk (toll-free) or visit us online at www.health.harvard.edu. stroke). In other cases, the clot forms in the heart You can change some, but not all, of the fac- or in an artery that carries blood to the brain; the tors that increase your odds of having a stroke CONTACT US clot breaks off and travels to the brain, where it (see “Risk factors for stroke” on page 2). lodges in a small artery (embolic stroke). Hemor- Write to us at rhagic strokes occur when an artery in the brain Nonmodifiable risk factors include your [email protected] ruptures, releasing blood into the brain tissue. age, gender, genes, birth weight, and race or For customer service, write us at © Harriet Greenfield Harriet © ethnicity. A 60-year-old African American [email protected] This Harvard Health Publication was prepared exclusively for ntavares - Purchased at http://www.health.harvard.edu/ Editor in Chief Thomas H. Lee, MD 11 ways to prevent stroke continued Editor P.J. Skerrett [email protected] Risk factors for stroke tack is even better. Here are 11 things you Associate Editor Richard T. Lee, MD can do to stay stroke-free: Editorial Board Eugene Braunwald, MD Factors you can’t change William P. Castelli, MD • Know and control your blood pressure. • Age Lawrence H. Cohn, MD • Don’t smoke; stop if you do. Roman W. DeSanctis, MD • Gender Stephen E. Goldfinger, MD • Race/ethnicity • Lose weight if needed. Samuel Z. Goldhaber, MD Caitlin Hosmer Kirby, MS, RD Factors you can change • Become more active. Jane W. Newburger, MD • Identify and manage atrial fibrillation. Patrick T. O’Gara, MD • High blood pressure Paul M. Ridker, MD • Lack of exercise • Be aggressive about treating a transient Harvey B. Simon, MD Walter C. Willett, MD, DrPH • Smoking ischemic attack (TIA, or mini-stroke). Peter Zimetbaum, MD • Diabetes • Treat circulatory problems like periph- Board members are associated with Harvard Medical School • High cholesterol eral artery disease, sickle cell disease, and affiliated institutions. They review all published articles. • Atrial fibrillation or severe anemia. Copy Editor Robin Netherton • Sickle cell disease Art Director Heather Derocher • Know and control your blood sugar Production Coordinator • Use of oral contraceptives Nicole Wall and cholesterol. Illustrator Harriet Greenfield • Obesity • Presence of other cardiovascular disease • If you drink alcohol, do so in mod- Subscription questions • Alcohol abuse eration. Phone: 877-649-9457 (toll-free) Email: [email protected] • Drug abuse • Adopt a healthy diet low in sodium and Online: www.health.harvard.edu/customer_service Harder to change or emerging evidence rich in potassium. Mail: Harvard Heart Letter • Know the warning signs of stroke (see P.O. Box 9308 • Obstructive sleep apnea Big Sandy, TX 75755-9308 • Migraine “Stroke warning signs” below) and re- Subscriptions $32 per year (U.S.) • Certain infections spond immediately. Bulk subscriptions Gum disease StayWell Consumer Health Publishing • Starting early is best. Acquiring 1 Atlantic St., Suite 604 • Blood markers like factor V Leiden, healthy habits in childhood, the early Stamford, CT 06901 lipoprotein(a), others teens, or young adulthood sets the stage 888-456-1222, ext. 31106 (toll-free) 203-653-6266 for a healthy adulthood and old age. But [email protected] man who weighed less than 5.5 pounds if you are tardy in joining the prevention Corporate sales and licensing at birth and whose father had a stroke party, it isn’t too late. Even small steps StayWell Consumer Health Publishing 1 Atlantic St., Suite 604 is far more likely to have a stroke in the now can improve your health. Stamford, CT 06901 next 10 years than a 45-year-old Asian [email protected] woman who weighed 8 pounds at birth Stroke warning signs Editorial correspondence and who has no family history of stroke. Email: [email protected] Letters Even though you can’t change these fac- : Harvard Heart Letter If you notice one or more of the signs 10 Shattuck St., 2nd Floor tors, they set your risk baseline. The Boston, MA 02115 higher it is, the more important it is to below in yourself or someone else, or you’re really worried that you or some- Permissions control the things you can change. Copyright Clearance Center, Inc. one you are with is having a stroke, call Modifiable risk factors are things that Online: www.copyright.com 911 or your local emergency number affect stroke risk over which you have right away: Published by Harvard Health Publications, some control. These range from high a division of Harvard Medical School • sudden numbness or weakness of the Editor in Chief blood pressure and diabetes to smoking Anthony L. Komaroff, MD face, arm, or leg, especially on one Publishing Director Edward Coburn and a salty diet. side of the body ©2011 Harvard University (ISSN 1051-5313) Many emerging risk factors are under investigation. These include migraine, • sudden confusion or trouble speak- Proceeds support the research efforts of Harvard Medical School. ing or understanding Harvard Health Publications obstructive sleep apnea (breath holding 10 Shattuck St., 2nd Floor, Boston, MA 02115 during sleep followed by explosive snor- • sudden trouble seeing in one or both The goal of the Harvard Heart Letter is to interpret eyes medical information for the general reader in a timely ing), gum disease, blood markers such as and accurate fashion. Its contents are not intended lipoprotein(a), and infection. • sudden problem with walking, loss of to provide personal medical advice, which should be obtained directly from a physician. We are interested balance, or coordination in comments and suggestions about the content; 11 strikes against stroke unfortunately, we cannot respond to all inquiries. • sudden, severe headache with no PUBLICATIONS MAIL AGREEMENT NO. 40906010 You can fight stroke on many fronts. A known cause. RETURN UNDELIVERABLE CANADIAN ADDRESSES TO: single thrust is good; a many-pronged at- CIRCULATION DEPT., 1415 JANETTE AVE., WINDSOR, ON N8X 1Z1 E-mail: [email protected] 2 | Harvard Heart Letter | March 2011 www.health.harvard.edu This Harvard Health Publication was prepared exclusively for ntavares - Purchased at http://www.health.harvard.edu/ Fish oil questioned as treatment for heart disease It may be okay for prevention. But eating fish is a better strategy than gulping pills.