New national guidelines aim to prevent strokes
The American Stroke Association recently updated its guidelines for prevention strategies and screening recommendations. More than half a million people in the United States have their first stroke each year, according to the ASA.
“These guidelines are centered around the primary prevention of stroke, meaning preventing someone’s first stroke,” said Mitchell Wilson, MD, a neurologist based at Cape Cod Hospital.
There are two types of strokes, he said. “There’s the ischemic variety where there’s a blockage of blood flow and lack of oxygen going to parts of the brain. Then there’s the bleeding or hemorrhagic type of stroke, where a ruptured blood vessel leads to blood in the brain. The ischemic strokes account for about 80 percent of all strokes, and the hemorrhagic type is about 20 percent.”
Updated for the first time in 10 years, the ASA guidelines encourage healthcare providers to screen people for stroke risk factors, including obesity, high blood pressure, elevated cholesterol and high blood sugar.
“Some people might not know this, but women actually have a higher risk of stroke throughout their life than men,” said Dr. Wilson. “That is largely because they have a greater life expectancy. So, if you live for a longer amount of time, there’s a greater chance that something will happen to you like a stroke.
“It’s also important to consider that while women and men share some stroke risks, there are risk factors that are unique to women. If they’re identified, there should be further evaluation for any vascular risk factors.” These include premature menopause (before age 40), early menopause (before age 45), use of oral contraceptives, high blood pressure during pregnancy and pregnancy-related complications, such as preterm birth.
Preventive Measures to Reduce Risk
Healthy lifestyle changes could prevent up to 80 percent of first strokes, according to the ASA. The new ASA guidelines stress the need for 150 minutes per week of moderate physical activity or 75 minutes of vigorous aerobic activity.
“Physical activity has a multitude of benefits, but certainly there’s good evidence that exercise is particularly important in reducing someone’s risk of having a stroke,” said Dr. Wilson.
“Some of the important measures that people can do to reduce the risk of having a first-time stroke are things that probably won’t be a big surprise to many people,” said Dr. Wilson. “These are things like eating well, regular exercise, avoiding or quitting smoking, getting a good night’s sleep, and then managing risk factors like cholesterol, blood pressure and diabetes.”
BE FAST to Identify the Signs of a Stroke
When someone has a stroke, whether it’s the ischemic or hemorrhagic type, there are typical symptoms, he said. “They can help either people experiencing the stroke or their family members or other members of the community to identify that a patient may be having a stroke,” he said. “The BE FAST acronym is helpful for people to remember the most common symptoms and signs of a stroke.”
The BE FAST guideline helps you remember that timely treatment is the key to saving someone’s life or quality of life.
B – Balance: Is the person experiencing a sudden loss of balance or coordination?
E – Eyes: Is the person having a sudden change in vision or trouble seeing
F – Face: Ask the person to smile. Does one side of the face droop?
A – Arms: Ask the person to raise both arms. Does one arm drift downward?
S – Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T – Time: If you observe any of these signs, call 9-1-1 immediately.
“We need to reinforce the notion that time is brain,” said Dr. Wilson. “When someone’s having a stroke, it’s an emergency and they need to be brought into the emergency department as soon as possible.”
