Tag Archives: Coronary disease

Stroke

In this post I’ll be talking about Strokes (also known as Cerebral Vascular accidents). It is the fifth leading cause of death in the United States.  It also is a major cause of disability and in terms of treatment, missed work, etc costs an estimated $34 billion dollars a year in the U.S. alone. Although the risk for stroke rises as we age, according to the CDC website 34% of strokes were in people younger than 65.

There are two kinds of stroke. One is hemorrhagic, meaning that is caused by bleeding. The other is ischemic, meaning that it is caused by a a blockage in a blood vessel. The symptoms, however are determined by the location and size of the stroke. Symptoms include: Facial Droop, double vision, confusion, garbled speech, limb weakness (especially if it occurs on one side of the body), numbness, and headaches.

It is important that if one suspects he or she is having a stroke that medical care be obtained quickly. There is a 3 hour window of opportunity from the start of symptoms that ischemic strokes can optimally be treated with clot dissolving medications. More than three hours after the start of symptom and the likely hood of poor outcomes increases – and the riskier it is to use medications to try and unblock arteries.

An acronym used to keep in mind regarding stroke is the word FAST (Face – is the face symmetrical: is one side drooping? Arms – weakness in one arm. Speech – is it normal? Time – call 911 immediately if it seems someone’s having a stroke).

Ischemic strokes are the most common. Based on symptoms one can’t tell if a stroke is ischemic or hemorrhagic, so it’s better to get to a hospital quickly. At this point in time there may be fewer acute treatments to stop hemorrhagic strokes, but even then supportive treatment is available.

Sometimes symptoms resolve quickly (within a few minutes). This is called a Transient Ischemic Attack, or TIA. This should not be ignored because people who have had a TIA are at increased for having a major/bigger stroke.

Although there isn’t anything that can be done about some risk factors such as age, there are many things one can do to reduce the risk of having a stroke:

1) Control your blood pressure if you have high blood pressure.

2) Lower your cholesterol if you have high cholesterol.

3) Control your diabetes if you are diabetic.

4) If you smoke, stop. If you don’t smoke, don’t ever start.

5) if you have an irregular heart rate, talk to your doctor about whether you need to be on blood thinners as certain irregular heart rhythms increase your risk of ischemic strokes.

6) Exercise (this will help with numbers 1-3 above)

Four of the best things to do for your health.

Correlation between smoking and lung cancer in...

Correlation between smoking and lung cancer in US males, showing a 20-year time lag between increased smoking rates and increased incidence of lung cancer. (Photo credit: Wikipedia)

Four of the best things to do for your health.

1) Don’t start smoking. Stop smoking if you’ve already started.

 If someone asked you to pick up a habit that increased the risk of all of the following (and would cost you roughly $33-77 dollars a week depending on where you live, brand, etc), would you do so? Here are some of the things that smoking increases the risk of: lung cancer, colon cancer, bladder cancer, esophageal cancer, kidney cancer, pancreatic cancer, cervical cancer, vascular disease including aortic aneurysms and strokes. It increases the risk of fractures in post menopausal women. It increases the risk of low birth weights in infants. There is an increased chance of developing cataracts. For men in their 30s and 40s, it increases the risk of erectile dysfunction by 50%.

According to the CDC, smoking contributes to 443,000 deaths annually in the U.S.

2) maintain a healthy weight.

obesity raises the risk of multiple diseases: Diabetes Mellitus – type 2, high blood pressure, colon cancer (though the mechanism isn’t known how). It increases the risk of breast cancer (adipose tissue has an enzyme that converts testosterone to estrogen), osteoarthritis and more. There are no easy ways of doing this. At its simplest it means taking in the same amount of calories you expend. Granted if you’re overweight, you need to expend more calories than you take in.

3) Exercise

On top of helping maintain a healthy weight, excercise has many beneficial effects. Exercising reduces the risk of alzheimer’s disease, some cancers, it can improve mood, helps reduce blood pressure and can help prevent and treat diseases such as type 2 diabetes.  The suggested minimum is 150 minutes of moderate physical activity a week, which comes out to approximately 20 minutes a day. It can be something as simple as walking. The what of exercise (what kind) is less important than the regularity of actually getting exercise.

4) Have a healthy diet.

Potential health benefits of apple consumption...

Potential health benefits of apple consumption. (See Wikipedia:Apple#Health_benefits). Model: Mikael Häggström. To discuss image, please see Template talk:Häggström diagrams (Photo credit: Wikipedia)

Diet is the mainstay treatment in a lot of diseases. Whether it’s DM-2, high cholesterol, coronary heart disease (even if you’re on medication for any of these, maintaining an appropriate, healthy diet becomes no less important). In one study coming out of Lydon, France (known as the Lydon Study), people who were put onstandard treatment and who were switched to mediterranean diet with N-3 fatty acid supplementation (as opposed to just the  standard treatment) decrease their mortality after a heart attach by 66% (their mortality went from 17% down to 10%). This was independent of weight loss, decrease in cholesterol, etc. A dietary/lifestyle program promoted by Dr. Ornish which uses lifestyle changes, exercise and a vegetarian low fat diet (10-20% of calories from fat rather than the 20-30 used in the AHA step II diet) has been shown to reverse Coronary Heart Disease and is covered by medicare. A mediterranean style diet is also associated with decreased death from heart disease, a decreased risk of certain cancers as well as a decreased risk of dementia. At this point I won’t go into a huge discussion about diet (I’m likely to blog more about this in the future on multiple occasions).

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