Timing Is Essential When You Have A Stroke

by Noel Peterson, MD, FACC, FASE
Eastern Cardiology, Greenville, NC
Director of Women’s Cardiovascular Disease and Preventative Cardiology for the East Carolina Heart Institute

Each year strokes kill 130,000 people in the United States. Nearly three quarters of all strokes occur in persons over the age of 65. However, the risk of stroke doubles each decade over the age of 55. In Pitt County 48.9 people out of every 100.000 will die from a stroke each year. It is the 3rd leading cause of death in our county. More than 220,000 adult North Carolinians have a history of stroke.  Don’t be a statistic!

N.C. is part of the Stroke Belt, an 8- to 12-state region (typically including Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee) that historically has had substantially higher stroke death rates than the rest of the nation. The eastern counties of N.C. are part of the Buckle of the Stroke Belt, the coastal plains region of Georgia (Ga.), South Carolina (S.C.), and North Carolina (N.C.) that has consistently had the very highest stroke death rates in the nation for at least the past 30 years. Stroke is a leading cause of serious, long-term disability in the United States. Only 10% of patients who have had a stroke have a full recovery. 25% of stroke victims are left with minor impairments, 40% have moderate or severe impairments requiring special care, 10% require a nursing home or long-term care facility, and 15% of people die shortly after having a stroke.

What is a stroke?

Strokes are acute events mainly caused by a blockage that prevents blood from flowing to the brain. The most common reason is due to build-up of fatty deposits on the inner walls of the blood vessels that supply the brain. Strokes can also be caused by bleeding from a blood vessel in the brain or from a blood clot.

What are the risk factors for stroke?

There are certain lifestyle (or behavioral) risk factors that increase our risk for stroke. There are things that we can control to prevent us from having a stroke. These include things such as:

1. Unhealthy diet

2. Physical inactivity

3. Tobacco use

4. Harmful use of alcohol

The effects of making poor lifestyle choices and having these behavioral risk factors cause the following effects on our bodies:

1. Increased blood pressure

2. Increased blood sugar

3. Increased blood lipids (cholesterol)

4. Overweight and obesity

Having these behavioral risk factors increases your risk for developing some of the common medical conditions that are associated with increased risk for stroke. Such as high blood pressure (hypertension), obesity, atrial fibrillation/atrial flutter, sleep apnea, and diabetes.

What are the signs and symptoms of a stroke?

1. Sudden weakness of face, arm, or leg most often on one side of the body.

2. Numbness of face, arm or leg, especially on one side of body

3. Confusion, difficulty speaking or difficulty with comprehension

4. Difficulty seeing (one or both eyes)

5. Difficulty walking, dizziness, loss of balance or coordination

If you develop any of these signs and symptoms – CALL 911 IMMEDIATELY!!!!! Time is brain. Essential clot busting therapies can only be given within 3 hours of onset of symptoms. DO NOT call your primary care doctor or wait for a call back from your doctor’s office or the on-call doctor. DO NOT go to the emergency room in a personal vehicle – essential meds can be given in the ambulance and the paramedics will alert the stroke team so that they will be able to meet you as you arrive at the hospital. Above all – DO NOT lie down to rest to see if you will feel better when you wake up – you will have permanent disability from a stroke.

What can you do to reduce your risk?

1. Stop smoking: 15.8% men and 12.2% of women continue to smoke.

2. Manage blood pressure: 46% of adults have high blood pressure.

3. Reduce blood sugar: 9.4% of Americans have type 2 diabetes and 35% have pre-diabetes.

4. Control cholesterol: 40% of Americans have total cholesterol of 200mg/dL or higher, 12% are over 240mg/dL.

5. Stress Management: Learn to say no. Avoid over-commitment. Engage in relaxation techniques, exercise, massage, yoga. Take time for yourself every day.

6. Lose weight: 71.6% of adults and 32% of children are overweight/obese.

7. Eat better: 0.6% of children and 1.5% of adults consume an ideal healthy diet.
Clean eating – avoid processed foods, consume whole foods (foods that have not been changed from their natural state) – shop the perimeter of your grocery store. Eat a diet high in veggies, lean protein or plant based protein source, whole grains, fruits. Limit red meat and dairy. Decrease consumption of sugar – especially sugar sweetened beverages.

8. Get Active: 1 in 3 adults reported no physical activity outside of work. Increase both cardio and physical activity. Minimum of 30 minutes of cardiovascular exercise at least 5-6 days/week (minimum of 150 minutes of cardio per week). Plus 10,000

Less than 3% of Americans have a healthy lifestyle, which means that less than 3% of Americans meet the measurable characteristics that reduce a person’s risk for heart disease and stroke.  Even small lifestyle changes can help to reduce your risk of stroke and heart disease.

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