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Avoiding the #3 killer in the United States

By Janet Benavente, Colorado State University Extension Agent

Our greatest asset, good health, is threatened by two sometimes silent killers, heart disease and stroke, the number one and three causes of death in the United States. These two diseases share many of the same risk factors and together are the number one cause of adult disability. The National Institute of Health (NIH), the Surgeon General of the United States, The Centers for Disease Control (CDC), and the American Heart Association (AHA) have set a goal to reduce the death rate from stroke, so that by 2010 fewer than 20 of every 100,000 U.S. residents will die from stroke each year. Currently that number 30 of every 100,000.

Actions toward this goal include preventing the development of risk factors and improving detection and treatment of risk factors for heart disease and stroke. But for these to work, people need a greater understanding of what a stroke is, what stroke risk factors are, and what stroke warning signs are.

The NIH describes a stroke as a “brain attack” that occurs when blood circulation to the brain fails. Brain cells die from decreased blood flow and the lack of oxygen that follows. About eight of ten strokes are caused by blockage of blood flow. Bleeding in the brain, or in the spaces surrounding the brain, causes two of every ten strokes.

Stroke risk factors are usually divided into two categories, controllable and uncontrollable. The uncontrollable risk factors are:

  • Age - Stroke risk doubles with every decade past age 55.

  • Gender - Males have a slightly higher stroke risk than women.

  • Family History - If parents or grandparents have experienced a stroke this may increase your risk.

  • Personal history of diabetes - People with diabetes have a higher stroke risk.

  • Race - African Americans and Hispanics have a two to three times higher stroke risk than most other groups.

Having one or more of these risk factors doesn’t mean a person will have a stroke, but it does suggest the need for following medical recommendations and paying close attention to lifestyle.
The controllable risks factors related to life style choices are:

  • Weight - Excess weight strains the circulatory system and increases likelihood of high cholesterol, high blood pressure, and diabetes.

  • Blood pressure -The National Health and Nutrition Examination Survey and CDC define high blood pressure as systolic blood pressure over 140 or diastolic blood pressure over 90. About one in three American adults are in this category.

  • High cholesterol and heart disease - High cholesterol increases risk of heart disease and heart disease increases risk of blockage of blood vessels.

  • Tobacco use - A person’s stroke risk is doubled when they are a smoker.

  • Alcohol use - More than two drinks a day may increase stroke risk by three times.

Lifestyle changes and medical intervention can help control disorders like diabetes, high blood pressure and high cholesterol that increase the risk of stroke. Lifestyle choices that prevent or control diabetes, high blood pressure and high cholesterol include:

  • At least fifteen minutes of moderate exercise per day.

  • Eating more whole grains and five to nine servings of fruits and vegetables daily.

  • Choosing an eating pattern that provides fewer than 30% of total calories from fat.

  • Matching food intake with energy output by reducing serving sizes and increasing exercise.

Controllable risk factors related to following medical recommendations are:

  • Previous strokes or Transient Ischemic Attack (TIA)- TIA’s are sometimes called mini-strokes. They indicate a serious condition that needs medical attention. One of three people who have TIA’s will go on to have a stroke. People who have had strokes are ten times more likely to have another, according to the National Stroke Association.

  • Atrial fibrillation (irregular heartbeat) -Untreated atrial fibrillation increases stroke risk by four to five times.

According to the NIH and the National Stroke Association, the signs of a stroke may vary depending on the side of the brain that is affected and how severely the brain is injured. Each person may have different stroke warning signs and often there is no pain. The most common signs are:

  • Sudden numbness of the face, arm, or leg

  • Sudden confusion, trouble speaking, or understanding speech

  • Sudden trouble seeing in one or both eyes

  • Sudden trouble walking or dizziness

  • Sudden severe headache with no known cause

  • Drowsiness

  • Nausea or vomiting

Seek medical help immediately if you or someone you know has any of these signs, even if they last only a few minutes. Treatment is most effective when a stroke is recognized quickly. For more information about stroke risk and stroke prevention talk with your medical provider and visit www.nhlbi.nih.gov; www.americanheart.org; www.ninds.nih.gov; http://www.health.gov/healthypeople; or www.healthfinder.gov. For information in Spanish, visit http://www.healthfinder.gov/espanol.
If you are interested in more information about how to make lifestyle changes related to food, contact your local Colorado State University Extension office.




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