STROKES

Information and Advice

Sister Jane Locking

Reducing Your Risk Of Experiencing A Stroke

Stroke or cerebral vascular accident (CVA) is a devastating condition. It is the third most common cause of death worldwide, third only to cancer and ischaemic heart disease. In 2001, 66,726 people died from a stroke in the United Kingdom, of whom 20 per cent were less than 76 years old.

At present there is no effective medical intervention for treating a stroke, and hence prevention is of the utmost importance. Preventing strokes is now a priority. Many strokes are avoidable with a combination of lifestyle and medical interventions. Here at Elliott Hall Medical Centre we are beginning to set up systems to identify those patients who are either at risk of a stroke or have already experienced one. Currently we hope to invite all these patients to the clinic for a yearly review to reduce their risk by advising on adjustable factors or implementing interventions for those non-modifiable factors.

Risk factors for development of a stroke

1. Age

Unfortunately, the incidence of stroke increases with age, doubling with each decade after middle age. By 85 years one in four men and one in five women will have experienced some severity of a stroke. Thus it is imperative that the clinic targets our older patients to review their risk factors.

2. Blood pressure

Blood pressure is the single most important modifiable factor in the prevention of strokes.

Risk of stroke increases directly in line with increasing blood pressure, especially if a person's blood pressure systolic (top) reading is greater than 160mmhg and/or the diastolic (bottom) reading is greater than 90mmhg. Fortunately there is an abundance of medication available aimed at successfully reducing blood pressure to a more satisfactory level of 140/80mmhg or lower.

3. Previous history of TIA/Vascular disease

A previous history of stroke, transient ischaemic attacks (TIA), coronary heart disease, other types of cardiac disease or peripheral vascular disease all increase the risk of a stroke. When a patient visits the GP or Practice Nurse at Elliott Hall the computer can calculate a personal risk score incorporating all non-modifiable and modifiable factors.

4. Diabetes

If someone already has diabetes then they are at greater risk of developing a stroke. It is thus important to attend your yearly diabetic reviews and aim to maintain your blood sugar levels within normal ranges.

5. Atrial fibrillation

Atrial fibrillation is an important risk factor for stroke, giving an annual risk of 2 - 5 per cent.

Low density lipoprotein, which is a type of cholesterol, is a strong risk factor for the development of a stroke.

Health Promotion Interventions To Prevent Strokes

Modifiable factors to prevent the incidence of stroke are:

Diet

Aim to eat a diet which is low in salt (maximum of 5g a day).

Consume a diet which includes potassium-rich fruits and vegetables.

Aim to consume at least 5 portions of fruit or vegetables a day.

Reduce high intakes of saturated fat and glucose.

Eating oily fish two or three times a week may help to reduce the level of triglycerides (fatty substances found in the blood).

Alcohol

Regular heavy drinking has the effect of raising blood pressure. An alcohol binge can raise it to dangerously high levels and may trigger a burst blood vessel. Alcohol consumption should be moderate (maximum of 21 units a week for men and 14 units a week for women).

Smoking

Try to stop smoking. Smoking cessation therapy is offered to those with dffficulty in trying to give up. Smokers have almost a doubling of risk, while those who take illicit drugs like crack cocaine may have a seven-fold increased risk.

Weight

Try to reduce weight to within normal limits for your height.

Exercise

Aim to take part in exercise for at least 30 minutes a day at least five times a week, sufficient to induce mild breathlessness. A brisk walk, swimming, dancing and cycling are all excellent forms of exercise. It's never too late to start. Regular and frequent is preferable to a vigorous bout of exercise once a week. For example, take the stairs rather than the lift; walk to the shops rather than driving; get off the bus one stop early.

Blood pressure

Have your blood pressure checked regularly (at least yearly) by your Practice Nurse.

Further information can be gained by visiting the Stroke Association website at