It’s difficult to imagine the devastation that follows a
stroke until it hits you. Robbed in an instant of the most basic
human functions such as movement, swallowing and speech, the road
back to normal life can be agonisingly slow.
Most tragically, many of the 110,000 strokes that occur each
year in the UK could have been prevented if only those factors
which put a person at increased risk had been spotted. Such
factors, which also contribute to other types of cardiovascular
disease (CVD), are now easy to identify and treat, leading the
government to set a target in 2001 of a 40% reduction in deaths
from stroke and coronary heart disease by the end of this decade.
To reach this goal, medical experts have recently lowered the
recommended levels for blood cholesterol further than ever before.
Those at particular risk of CVD should now keep their total
cholesterol below 4mmol/L or reduce it by 25%, (whichever is lower)
and lower their LDL-cholesterol level to less than 2mmol/L, or
reduce it by 30%. And it isn’t just the professionals who
need to act. There are many things that you can do to lower your
risk of stroke.
Follow a healthy lifestyle
We all need to follow some simple lifestyle steps to keep the
cardiovascular system healthy.
- Get regular aerobic exercise: Ideally for a minimum of 30
minutes every day to a degree that leaves you out of breath.
- Don’t smoke: Chemicals in cigarette smoke, such as
nicotine and carbon monoxide, damage the heart and blood vessels
and greatly increase the risk of stroke.
- Alcohol can damage the heart so limit your intake to less than
21 units a week for men or 14 for women. This should be spread out
across the week rather than a sudden binge.
- Keep your weight healthy with a body mass index of less than
25kg/m2. Being overweight increases the risk of high blood pressure
and diabetes. Central obesity is particularly linked to
cardiovascular disease, so if you are an apple shape (waist
circumference greater than 102cm for men or 88cm for women), you
need to work especially hard to trim down.
Know your personal risks. It is essential to find out whether
you are at particular risk of stroke or CVD. All adults over the
age of 40 should have a full assessment, so if you haven’t
talked to your GP recently about your blood pressure or
cholesterol, now is the time for a check-up. Then deal effectively
with personal risk factors such as:
- High blood pressure: This is the most important risk factor for
stroke.
- Get your pressure checked regularly and take treatment
seriously. Normal levels are below 140/90mmHg (but those at
particular risk of CVD should aim lower no more than 130/80mmHg).
Regular exercise and losing weight if you are overweight can lower
blood pressure. For every 5kg weight loss, blood pressure will drop
by about 5mmHg and the risk of stroke or heart attack reduce by as
much as 20%.
- A family history of cardiovascular disease: You have a greater
risk of stroke if someone else in the family has had one, so be
vigilant.
- A previous stroke: Once you′ve had one, the risk of
another is much greater. A person who has transient ischaemic
attacks or mini-strokes (TIAs) is ten times more likely to have a
stroke.
- Abnormal blood fat levels: Cholesterol isn’t the only
type of fat in your blood that you need to worry about. You also
need to know the balance of different lipoproteins, which are
molecules that carry cholesterol around the body, and fats called
triglycerides.
- For those at high risk of stroke, total blood cholesterol
should be below 4.0mmol/l. In fact research suggests that the lower
the level, even below this recommendation, the greater the
protection from stroke.
- Low density lipoprotein (sometimes called LDL cholesterol, or
bad cholesterol) should be below 2.0mmol/l. Triglyceride levels
should be less than 1.5mmol/l.
- Diabetes: This hugely increases the risk of cardiovascular
disease. Good control of blood-sugar levels (whether you need
insulin or just tablets) is essential.
- Heart disease: Heart disease doubles the risk of a stroke. A
condition called atrial fibrillation is especially risky, because
the upper chambers of the heart beat irregularly and often very
fast. As a result, blood doesn’t flow smoothly through them
and clots can form. These can then be carried up into the arteries
of the brain, blocking them to cause a stroke. Treatment to slow
the heart or convert it back to a normal rhythm is therefore very
important.
Get your nutrition right.
Modern medicines can help to prevent stroke and CVD. British
doctors recently suggested that if everyone over 55 took a
polypill’ containing six different drugs, 80% of strokes and
88% of heart attacks could be prevented. The sort of drugs that
might be included are cholesterol lowering drugs (statins), aspirin
and blood-pressure lowering drugs.
Meanwhile, you can help yourself by choosing a healthy diet.
This includes a balance of different foods, high in fibre and low
in fat, especially saturated and trans’ fats. Eat at least
five portions of fresh fruit or vegetables daily.
The government recommends that you consume at least 450mg of
omega 3 fish oils per day to help maintain a healthy heart (the key
essential fatty acids are DHA and EPA). Consider a pure supplement
to ensure you get adequate amounts.
You may also consider folic acid supplementation: raised levels
of a substance called homocysteine may be important in the
development of arterial disease and have been linked to low levels
of folic acid and vitamins B6 and B12, as well as smoking and
inactivity.
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