A stroke is a serious neurological condition caused by the disruption of blood flow to the brain. It can lead to brain damage and is one of the leading causes of death and disability worldwide.
Dr Arup Sen, consultant physician in stroke, geriatric and general internal medicine explains how strokes occur and how we can reduce our risk through lifestyles changes and/or medical intervention.
“There are considered to be two types of stroke. The most common type, affecting around 85 per cent of stroke patients, is ischemic stroke. This is when a blood clot travels to the brain and blocks a blood vessel, which then causes damage to the part of the brain supplied by that blood vessel. Stroke is associated with the sudden onset of neurological symptoms which then last longer than 24 hours. Transient ischemic attacks, or TIAs, occur due to the same mechanism as ischaemic stroke, but the symptoms last less than 24 hours (most usually resolving after a few minutes to hours). The less common type of stroke is a haemorrhagic stroke, which is due to bleeding in the brain from a ruptured blood vessel.
Stroke can cause a variety of symptoms, depending on which part of the brain is affected. Commonly, stroke can cause sudden onset weakness in the arm (and/or leg) on one side of the body, facial drooping and/or speech disturbance. When any of these symptoms occur, it is important to call 999 as soon as possible, so that any long-term damage can be limited. In fact, the acronym FAST (Facial drooping, Arm weakness, Speech difficulties, Time to call 999), is useful to remember so that if these signs occur, you can seek medical assistance as soon as possible.
Although having a stroke is more common in the older population, they can occur at any age, and are occurring more commonly in younger adults due to factors such as high blood pressure, diabetes, and the increasing frequency of obesity (due to lifestyle factors such as lack of exercise, poor diet, and so on).
Stroke risk reduction through lifestyle changes
The best way to divide risk factors for stroke is in terms of modifiable and non-modifiable risk.
Modifiable risks include smoking, alcohol consumption, diet, exercise, and stress management. By making lifestyle changes, you can make a real difference to your risk of a stroke.
Smoking tobacco, recreational drug use and excessive alcohol consumption all have a negative impact on the body, so avoiding these lifestyle factors can reduce your stroke risk.
Eating a healthy, balanced diet is important in reducing your risk of a stroke, for example a Mediterranean style diet which typically includes plenty of fruit, vegetables, pulses, nuts, whole grains, and fish. It also uses unsaturated fats like olive oil. Meat (particularly red meat), sugar, and saturated fat consumption should be limited.
With exercise, you should try and increase your cardiovascular fitness, which is any activity that gets your heart rate up. Examples include brisk walking, running, rowing, cycling, and swimming. In fact, swimming is one of the better options, particularly as you get older, as it is very gentle on the joints. If you are starting a new exercise programme, remember to start gently and build up your level of fitness over time to help the body get used to this new level of activity and minimise the chance of injury.
The invention of wearable technology like smart watches can really help with monitoring your progress with lifestyle changes and highlight any potential areas for concern. They can also be very motivational in making changes in the first place.
If you find you are suffering from stress, there are many ways you can help manage this including mindfulness, meditation, or even having a hobby that takes your mind away from your day-to-day stresses.
Good sleep quality and sleep hygiene are also really important and can be improved by going to bed at a reasonable hour, reducing/avoiding caffeine intake, avoiding large meals prior to sleeping and avoiding screen time (for example, your Phone or TV) an hour before bed.
Risk reduction when you already have an increased risk of stroke
Non-modifiable risks are not in our immediate control and include things like ageing and genetics.
However, stroke risk can still be reduced, through making the lifestyle choices mentioned previously, and with medical intervention if required.
If there are concerns regarding high blood pressure, which is a major risk factor for stroke (both ischaemic and haemorrhagic), then an easy step is investing in a home digital blood pressure monitor, which can be bought in store or online. This will give you a good steer on whether your blood pressure is within a healthy range. If you become concerned that your readings are high, then you can liaise with your GP/specialist, who can offer advice on whether lifestyle changes will help, or whether you can be prescribed medication to lower your blood pressure.
Your GP/specialist can also offer simple blood tests to check for high cholesterol or diabetes, particularly if you fall into a high-risk category. As with blood pressure, there are prescribed medicines you can take
to help with both conditions. These may help if lifestyle changes are already in place but are not making enough of a positive impact on your results.
Reducing further risk after a stroke
If you have already had a stroke or TIA, then unfortunately you are at risk of it happening again. The risk of having a second event is particularly high in the first few days or weeks following the initial episode, and patients may be put on a high dose of blood thinning medication for the initial period (such as Aspirin) following an ischaemic stroke. Cholesterol lowering medications (such as statins) are also commonly prescribed following an ischaemic stroke. However, addressing lifestyle factors simultaneously with the use of medication is the key to overall long-term stroke reduction.
Seeking further advice on stroke risk
If you have any concerns about your stroke risk, or other health related conditions that may be indicators of a future stroke, then please make an appointment with your GP/specialist. Prevention is always the best line of defence.
To enquire about our neurology service, please call us on 020 3448 4260, email uclh.private.enquiries@nhs,net or use our 24 hour chat box.
