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STROKES: prevention, early detection
Aug 26, 2009

REDUCE RISK for “SILENT STROKES”
-adapted from an article in Care2's Caring.com to assist readers who are caring for elderly relatives.
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In the publication Stroke: Journal of the American Heart Association, researchers report that almost 11% of seemingly healthy, middle-aged study participants had some brain damage from one or more “silent” strokes. The researchers also found a correlation between silent stroke and cardiovascular risk factors, such as high blood pressure, atrial fibrillation, and thickening or partial blockage of the carotid arteries. Other risk factors include smoking, diabetes, and heart disease
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Also known as silent cerebral infarction, a silent stroke is a true stroke that causes actual brain injury without any noticeable symptoms. People who’ve had a silent stroke have a higher risk of having more strokes, and are more likely to suffer from vascular dementia later in life. BUT...early detection and treatment of cardiovascular risk factors can decrease the risk of stroke.
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10 STROKE PREVENTION STRATEGIES 
Over the course of a lifetime, stroke affects an estimated four out of five families.
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1. CONTROL BLOOD PRESSURE
High blood pressure means a high risk of stroke.
Prehypertension (120/80 to 139/89) or hypertension (140/90 mm Hg or higher) - medications will be prescribed and the blood pressure needs regular monitoring. It is also possible to monitor blood pressure at home.
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2. MANAGE STRESS & DEPRESSION
A parent’s emotional and psychological state can have a very real effect on his physical health. Minimizing stress, anger, and depression is an important aspect of maintaining good cardiovascular health and avoiding a stroke. Help your parents get out, make new friends, or join in stimulating activities. If your parent is having difficulty with his mood, try these:
-Reduce caffeine and alcohol
-Try meditation or yoga
-Play relaxing music
-Walk outdoors.
If you’re still concerned, talk to his doctor. Depression is a serious but treatable illness.
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3. REDUCE THE RISK OF BLOOD CLOTS
Ask your parents’ doctor about medications that can reduce their risk of developing blood clots. The most commonly recommended medication is aspirin, which is inexpensive and can be taken at a low dose (81 milligrams is the usual recommended dose). If your parents have other medical issues, the doctor may prescribe a more potent drug.
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4. CONTROL OTHER MEDICAL CONDITIONS
If your parents have atrial fibrillation (an abnormal rhythm involving the upper two chambers of the heart), diabetes, heart valve disease, or vascular disease, they have a much greater risk of stroke. These medical conditions require careful management. Make sure their doctor knows about any such conditions and is treating them appropriately.
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5. REVIEW MEDICATIONS
Talk to the doctor about medications that might increase your parents’ stroke risk. Hormone replacement therapy (HRT), rosiglitazone (for diabetes), and COX-2 inhibitors (for controlling arthritis pain) are all examples of medications that may increase your parents’ risk of stroke. Review their medications with their doctor and ask if there are less risky alternatives.
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6. KNOW THE EARLY WARNING SIGNS 
Signs of a transient ischemic attack (TIA) or ministroke:
-Sudden numbness or weakness of the face, arm, or leg–especially on one side of the body
-Sudden confusion, trouble speaking or understanding
-Sudden trouble seeing out of one or both eyes
-Sudden difficulty walking, loss of balance or coordination, dizziness
Notify the doctor immediately.
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7. CHOLESTEROL LEVELS 
Total cholesterol should be no more than 200 mg/dL
HDL (good cholesterol). LDL (bad cholesterol) should be below 70 mg/dL - high levels of LDL mean greater risk of strokes
Cholesterol levels must be checked regularly. A low-fat diet and regular exercise may help, but if cholesterol levels don’t respond to lifestyle changes, medication may have to be prescribed.
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8. HEART-HEALTHY DIET
-Base the meals on whole grains, vegetables, fruits, fish, poultry, lean meats, and low-fat or fat-free dairy products.
-Fat intake (total fat between 25 and 35 percent of daily calories, saturated fat less than 7 percent, and trans fat less than 1 percent),
-Cholesterol intake (less than 200 milligrams per day if LDL levels are high, less than 300 milligrams per day if they aren’t), 
-Sodium intake (less than 1,500 milligrams per day for high blood pressure, less than 2,300 milligrams per day otherwise).
-Alcohol: daily drinks limited to Women 1 Men 2.
-Dietary fibre intake: 25-30 grams every day.
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9. REGULAR EXERCISE
Vital for general cardiovascular health and is key to preventing a stroke. Minimum 30 minutes x 5 days a week e.g. park farther away from the store and walk the extra distance, or take the stairs instead of the elevator.
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10. STOP SMOKING
Smoking is one of the biggest risk factors for stroke. Just living with a smoker increases the risk of stroke by 30%. 
Here are a few ways you can help:
-Ask your parents what they think would make it easier for them. They may have suggestions you haven’t thought of.
-Encourage them to talk about their feelings and what they’re going through. Smoking may be a comforting lifelong habit; let them mourn a little. Don't nag or yell if they slip up...it’s more effective to remind them that you love them no matter what.
-Be positive and encouraging — and vent your frustration to a friend instead.
-Help them avoid situations that trigger the desire for a smoke. e.g. if they’re used to having a cigarette after meals, try going for a short walk outside instead.
-Be understanding during withdrawal symptoms. Try not to take it personally if they’re especially irritable, short-tempered, and tired.
-Quit smoking yourself. If you must smoke, don’t smoke around your parents. Not only will it make quitting more difficult for them, but the secondhand smoke will increase their risk of heart attack.
-If your parents find it too difficult to quit on their own, talk to their doctor. Nicotine replacement therapy, support groups, and counseling may all be helpful.
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Caring.com was created to help readers care for their aging parents, grandparents, and other loved ones.
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Posted: Aug 26, 2009 7:49am

 
 
 
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