Preventing a Stroke
- What is a Stroke?
- What are Warning Signs of a Stroke?
- What are Risk Factors for a Stroke?
- What Are the Treatable Risk Factors?
- Do You Know Your Stroke Risk?
If you're like most
Americans, you plan for your future. When you take a job, you
examine its benefit plan. When you buy a home, you consider its
location and condition so that your investment is safe. Today, more
and more Americans are protecting their most important asset--their
health. Are you?
Stroke ranks as the third
leading killer in the United States. A stroke can be devastating to
individuals and their families, robbing them of their independence.
It is the most common cause of adult disability. Each year more than
700,000 Americans have a stroke, with about 160,000 dying from
stroke-related causes. Officials at the National Institute of
Neurological Disorders and Stroke (NINDS) are committed to reducing
that burden through biomedical research.
What is a Stroke?
A stroke, or "brain attack,"
occurs when blood circulation to the brain fails. Brain cells can
die from decreased blood flow and the resulting lack of oxygen.
There are two broad categories of stroke: those caused by a blockage
of blood flow and those caused by bleeding. While not usually fatal,
a blockage of a blood vessel in the brain or neck,
called an ischemic stroke, is the most frequent cause of stroke and
is responsible for about 80 percent of strokes. These blockages stem
from three conditions: the formation of a clot within a blood vessel
of the brain or neck, called thrombosis; the movement of a clot from
another part of the body such as the heart to the neck or brain,
called embolism; or a severe narrowing of an artery in or leading to
the brain, called stenosis. Bleeding into the brain
or the spaces surrounding the brain causes the second type of
stroke, called hemorrhagic stroke.
Two key steps you can take
will lower your risk of death or disability from stroke: know
stroke's warning signs and control stroke's risk factors. Scientific
research conducted by the NINDS has identified warning signs and a
large number of risk factors.
What are Warning Signs of a Stroke?
Warning signs are clues your
body sends that your brain is not receiving enough oxygen. If you
observe one or more of these signs of a stroke or "brain attack,"
don't wait, call a doctor or 911 right away!
- Sudden numbness or weakness of face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Other danger signs that may
occur include double vision, drowsiness, and nausea or vomiting.
Sometimes the warning signs may last only a few moments and then
disappear. These brief episodes, known as transient ischemic attacks
or TIAs, are sometimes called "mini-strokes." Although brief, they
identify an underlying serious condition that isn't going away
without medical help. Unfortunately, since they clear up, many
people ignore them. Don't. Heeding them can save your life.
What are Risk Factors for a Stroke?
A risk factor is a condition
or behavior that occurs more frequently in those who have, or are at
greater risk of getting, a disease than in those who don't. Having a
risk factor for stroke doesn't mean you'll have a stroke. On the
other hand, not having a risk factor doesn't mean you'll avoid a
stroke. But your risk of stroke grows as the number and severity of
risk factors increases.
Stroke occurs in all age
groups, in both sexes, and in all races in every country. It can
even occur before birth, when the fetus is still in the womb. In
African-Americans, stroke is more common and more deadly--even in
young and middle-aged adults--than for any ethnic or other racial
group in the United States. Scientists have found more and more
severe risk factors in some minority groups and continue to look for
patterns of stroke in these groups.
What Are the Treatable Risk Factors?
Some of the most important treatable risk factors for stroke are:
- High blood pressure. Also called hypertension, this is by far the most potent risk factor for stroke. If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Some ways that work: Maintain proper weight. Avoid drugs known to raise blood pressure. Cut down on salt. Eat fruits and vegetables to increase potassium in your diet. Exercise more. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.
- Cigarette smoking. Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure; carbon monoxide reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood thicker and more likely to clot. Your doctor can recommend programs and medications that may help you quit smoking. By quitting, at any age, you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.
- Heart disease. Common heart disorders such as coronary artery disease, valve defects, irregular heart beat, and enlargement of one of the heart's chambers can result in blood clots that may break loose and block vessels in or leading to the brain. The most common blood vessel disease, caused by the buildup of fatty deposits in the arteries, is called atherosclerosis. Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you and your doctor should make a decision about aspirin therapy. A doctor can evaluate your risk factors and help you decide if you will benefit from aspirin or other blood-thinning therapy.
- Warning signs or history of stroke. If you experience a
TIA, get help at once. Many communities encourage those with
stroke's warning signs to dial 911 for emergency medical
assistance. If you have had a stroke in the past, it's important
to reduce your risk of a second stroke. Your brain helps you
recover from a stroke by drawing on body systems that now do
double duty. That means a second stroke can be twice as bad.
- Diabetes. You may think this disorder affects only the
body's ability to use sugar, or glucose. But it also causes
destructive changes in the blood vessels throughout the body,
including the brain. Also, if blood glucose levels are high at the
time of a stroke, then brain damage is usually more severe and
extensive than when blood glucose is well-controlled. Treating
diabetes can delay the onset of complications that increase the
risk of stroke.
Do You Know Your Stroke Risk?
Some of the most important
risk factors for stroke can be determined during a physical exam at
your doctor's office. If you are over 55 years old, a worksheet in a
pamphlet available from the NINDS can help you estimate your risk of
stroke and show the benefit of risk-factor control.
The worksheet was developed
from NINDS-supported work in the well-known Framingham Study.
Working with your doctor, you can develop a strategy to lower your
risk to average or even below average for your age.
Many risk factors for stroke
can be managed, some very successfully. Although risk is never zero
at any age, by starting early and controlling your risk factors you
can lower your risk of death or disability from stroke. With good
control, the risk of stroke in most age groups can be kept below
that for accidental injury or death.
Americans have shown that
stroke is preventable and treatable. In recent years, a better
understanding of the causes of stroke has helped Americans make
lifestyle changes that have cut the stroke death rate nearly in
Scientists at the NINDS
predict that, with continued attention to reducing the risks of
stroke and by using currently available therapies and developing new
ones, Americans should be able to prevent 80 percent of all strokes.
Office of Communications and Public
National Institute of Neurological Disorders and
National Institutes of Health
Bethesda, MD 20892
NINDS health-related material is provided for information
purposes only and does not necessarily represent endorsement by or
an official position of the National Institute of Neurological
Disorders and Stroke or any other Federal agency. Advice on the
treatment or care of an individual patient should be obtained
through consultation with a physician who has examined that patient
or is familiar with that patient's medical history.
Last updated September 30, 2004