Are You At Risk For A Stroke?
You’re eating oatmeal regularly to lower cholesterol. You’re also keeping an eye
on your blood pressure, and maybe even taking a statin drug. You’re sure you’re
doing everything you can to prevent cardiovascular disease and a stroke.
But if you’re female, middle-aged and overweight, your expanding
waistline represents a danger you’ve probably never considered.
Research
presented at the International Stroke Conference in February 2008 revealed a
significant increase in strokes among middle-aged women. Comparing two federal
health surveys – one conducted from 1988 to 1994 and another from 1999 to 2004 –
the later survey showed a threefold increase in strokes among women ages 35 to
54.
Surprisingly, the typical variables – high blood pressure, blood
cholesterol, smoking and diabetes – didn’t change much between the two study
periods.
What did change?
Women in the later study were heavier,
with an average body mass index (BMI) of about 28.7, up from about 27.1. For a
woman who is 5 feet 4 inches tall, that represents a change from 158 pounds (BMI
of 27.1) to 167 pounds (BMI of 28.7). The women’s average waist size went up too
– about 1.6 inches.
A spare tire also endangers men. Research published
in the Archives of Internal Medicine in 2002 showed that men with a BMI of 30
(considered obese) or higher had twice the stroke risk of men with a BMI of less
than 23.
This article will outline ways to shed the fat, enhance your
fitness and minimize your risk of a stroke.
Understanding Strokes
Strokes occur when a blood vessel that carries blood to the brain is blocked
by a clot or when a blood vessel breaks and blood leaks into the brain.
Each year about 780,000 U.S. adults have a stroke. About 150,000 people
die from a stroke annually, and those who survive often experience long-term
disability.
The odds of having a stroke double each decade after age 55.
And although men are more likely to have a stroke, more women die from one.
African-Americans are at much higher risk, in part because of greater rates of
high blood pressure, diabetes and obesit
Key risk factors for a stroke
include:
- Prior heart attack, stroke or transient ischemic attack (a “warning stroke”
that does not cause lasting damage)
- Family history of stroke
- High blood pressure
- Smoking
- Diabetes
- Artery disease
- Atrial fibrillation, a disorder in the heart’s rhythm
- Heart disease
- Sickle-cell disease
- High total blood cholesterol and low HDL (good) cholesterol
- Obesity
- Sedentary lifestyle
- Abuse of alcohol, cocaine, amphetamines or heroin
Taking oral
contraceptives also increases the chances of a stroke. Women over 35 who take
birth-control pills and smoke are especially endangered. Pregnant women
experience a temporarily greater risk as well.
Successful treatment of a
stroke depends on an immediate response – within three hours of the onset. The
American Stroke Association uses the phrase “Give Me 5” to teach the warning
signs of stroke:
- Walk – is the person’s balance off?
- Talk – is speech slurred or face droopy?
- Reach – is one side weak or numb?
- See – is vision all or partly lost?
- Feel – does the person have a severe headache?
Call 911
immediately if you or someone else experiences any of these signs.
Eat Better To Avoid A Stroke
A healthy food plan includes
plenty of vegetables and fruits and is low in fat and refined carbohydrates. It
turns out that such a diet is also ideal for losing fat, decreasing blood
pressure and reducing the risk of a stroke.
There’s no need to go out
and buy the latest diet book. The DASH eating plan – Dietary Approaches to Stop
Hypertension – developed by the National Heart, Lung and Blood Institute (NHLBI)
is available online at no charge. To download “Your Guide to Lowering Your Blood
Pressure With DASH,” which includes recipes, or a condensed version, visit
www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm.
DASH limits
dietary sodium – which is correlated to high blood pressure – as well as
saturated fats, trans fats and cholesterol. At the same time, it encourages
higher intakes of:
- Vegetables and fruits
- Whole grains rather than refined carbs
- Lean meat, poultry and fish
- Fat-free or low-fat dairy
- Beans, seeds and nuts
“NHLBI studies have shown that the DASH
eating plan can significantly lower high blood pressure, even within the first
few weeks,” said NHLBI director Elizabeth G. Nabel, M.D., when the updated plan
was released in 2006. And lowering your blood pressure can help you decrease
your risk of having a stroke.
Depending on your size and whether you
need to maintain or lose weight, DASH indicates precisely how many servings from
each major food group you need every day.
Lose Fat To Reduce The Risk
Of A Stroke
A safe, healthy rate of fat loss is one to two pounds a
week. That might seem like a snail’s pace, but studies prove that those who
reduce weight slowly are more likely to keep it off. And people who keep the
weight off reduce their risk of a stroke.
Most people can achieve a one-
to two-pound weekly loss by adding 30 minutes of exercise, such as walking, five
or six days a week and by cutting daily calories by 300 to 500.
If you
drink sugary sodas and consume junk food on a daily basis, eliminating those and
eating a balanced diet may be enough to start the fat loss.
If you’re
eating right and exercising but reach a plateau, make sure you’re not consuming
too many calories. Measure or weigh your food and count calories for a week or
two to make sure you’re not eating more than you think – a common phenomenon for
dieters.
Ever-larger meals at restaurants have left most people with
portion distortion and no idea of reasonable serving sizes. Dieticians train
clients to reduce overeating by visually comparing portions to everyday objects.
A three-ounce serving of meat, poultry or fish, for example, is about
the size of a deck of cards. A half-cup serving of potatoes, rice or pasta is
about half the size of a baseball.
Finally, you’ll experience a major
improvement in health and a reduction in disease risk by losing even 5 percent
to 10 percent of your current weight, according to the National Heart, Lung and
Blood Institute.
Get Active To Prevent Strokes
U.S.
scientific organizations agree that to stave off disease, maintain weight and
stay healthy into old age, adults should get at least 30 minutes of moderately
intense physical activity on most days of the week.
A 2008 study
presented to the International Stroke Conference concluded that both men and
women with higher levels of cardiovascular fitness enjoyed about a 40 percent
lower stroke risk than those who were least fit.
Start by setting goals
that are specific, attainable and forgiving, advises the National Heart, Lung
and Blood Institute. A good example is deciding to walk 30 minutes, five days a
week.
If it’s too hard to take 30 minutes at a time, break up the
activity into two 15-minute or three 10-minute bouts. The health benefits are
just as significant.
More ways to increase your activity, courtesy of
the American Heart Association:
- Do your own housework
- Rake leaves, dig in the garden or mow the grass with a walk-behind mower
- When possible, walk or bike to run errands
- Stand or pace while talking on the phone
- Park at the far end of parking lots
- Schedule walking meetings with employees or clients
- Take stairs, not elevators
- Plan active vacations that include hiking, swimming or rowing
See Your Doctor For Stroke Risk Factors
As you work to
improve your nutrition and exercise habits, stay in touch with your doctor so
she can monitor other risk factors that can lead to a stroke.
Have your
blood pressure (BP) checked every year or two if it’s normal. Have it checked
more frequently if you have a family history of high blood pressure or if your
BP is greater than 120/80. A BP of 140/90 or more is considered high risk.
Know your blood cholesterol numbers. Total blood cholesterol should be
200 mg/dL or lower; 240 or higher is high risk.
For good cholesterol, or
HDL, a higher number is better. A level of 60 or above is ideal; high risk is
less than 40 for men, less than 50 for women.
LDL, or bad cholesterol,
should ideally be less than 100; 160 or more is high, and 190 or greater is very
high.
In addition, taking low-dose aspirin may reduce the risk of
stroke, although it can increase the chances of developing an ulcer. Ask your
doctor whether aspirin therapy is right for you.
For More
Information
For more information on increasing fitness, losing weight
and reducing your risk of a stroke, visit these Web sites:
Choose to Move is an initiative for women from the American Heart
Association
www.choosetomove.org/
My Start Online from the American Heart Association includes information on
workplace fitness
www.mystartonline.org/
Obesity Education Initiative from the National Heart, Lung and Blood
Institute offers a menu planner, a BMI calculator and tips on portion
control
www.nhlbi.nih.gov/NASE/oei/index.htm