Jul 7, 2018 | Healthy Tips
By Heidi Moawad, MD
You can make changes to reduce your risk of a stroke
Would you know if you were at risk of stroke? While there is no absolute way to know that you will or will not ever have a stroke in your lifetime, there are signs that you are at high risk of stroke. The good news is that you can do something about every one of these signs so you can significantly lower your stroke risk.
- Your Blood Pressure Is out of Control
If you consistently have high blood pressure or if you are trying to avoid actually finding out what your blood pressure is—that is bad news.
The good news is that high blood pressure can be managed with medication, diet, and lifestyle adjustments such as lowering stress and not smoking. Make sure you see your doctor to find out what your blood pressure is and, under your doctor’s supervision, start making changes.
- Your Blood Sugar Is High—or You Don’t Know What It Is
Erratic blood sugar, chronically elevated blood sugar, or uncontrolled diabetes can damage blood vessels, increasing your risk of stroke. Make sure to see your doctor regularly so that you can get appropriate diabetes screening and proper treatment through diet or medication, as necessary.
- You Smoke
Smoking is a hard habit to break. It is one of the most significant signs that you are at risk of having a stroke. The good news is that, despite the harmful stroke-causing impact of smoking, these effects amazingly reverse over time after you quit smoking.
- You Don’t Get Enough Exercise
Exercise is easy to ignore.
It can seem like a hassle. It can be tough to start exercising if you have aches and pains. But no matter what your health situation is—whether you are healthy or if you have already had a serious stroke—there are safe and easy exercises that can keep you fit while decreasing your stroke risk.
- You Have High Cholesterol
While American Heart Association recommendations for dietary cholesterol have changed in the past few years, you still need to maintain recommended levels.
Optimal levels are considered to be below 150 mg/dL for triglycerides, below 100 mg/dL for LDL, above 50 mg/dl for HDL and below 200 mg/dL for total cholesterol. These recommendations recognize that dietary cholesterol is not the cause of high blood cholesterol, but instead that dietary fat and genetic factors cause high cholesterol. It is a subtle difference that actually means a lot when it comes to diet and whether you need treatment.
- You Drink Too Much Alcohol
While one drink per day for women and two drinks per day for men is considered to be acceptable, drinking more can raise your blood pressure and triglycerides. That will contribute to hardening of the arteries (atherosclerosis) and increase your risk of stroke.
- You Are Obese
If you are obese, you have an increased chance of other stroke risk factors including high cholesterol, high blood pressure, and diabetes. The steps you can take to lose excess weight will reduce your risk, so it is wise to start eating a healthy diet and getting more exercise.
- You Don’t Take Your Medications
Most stroke risk factors can be managed, but that requires regularly taking your medications, refilling prescriptions and getting routine checkups in case any of your doses need to be adjusted.
Take good care of your health. You deserve it, even if it is a bit of a hassle.
- You Don’t Get Medical Attention for Your Heart Disease
If you have shortness of breath when you walk or exert yourself or if you experience chest pain, then you are running a huge risk of a stroke or a heart attack. Don’t delay getting medical attention if you ever experience chest pain.
- You Ignore TIAs
Most people wouldn’t recognize a transient ischemic attack (TIA). Take just a few minutes to familiarize yourself with stroke and TIA symptoms. If you have had any of these signs or symptoms, you need to get medical attention right away, because a TIA is the loudest warning sign that you are at risk of stroke.
A Word From Verywell
These 10 signs that you are at risk of a stroke are serious and should never be taken lightly. Make sure you get the right stroke preventative medical attention for yourself or for someone you care about.
View Article Sources
Jul 7, 2018 | Healthy Tips
Don’t ignore these important signs
Stroke is an emergency and requires immediate medical attention. The best treatments available for stroke, such as tissue plasminogen activator (TPA), are most effective the sooner they are given, and after a few hours, they may no longer be useful at all. For this reason, it’s critical that you recognize the symptoms of stroke and go to an emergency room immediately if you suspect you’re having one.
Symptoms of a Stroke
Stroke symptoms begin suddenly, and can include any of the following:
- Difficulty walking:This may be due to lack of balance, weakness, clumsiness, or dizziness.
- Difficulty communicating:You may not understand what other people are saying. You may not be able to form the words you would like to say and lose your ability to write. Your speech may become slurred and difficult to understand.
- Numbness or weakness on one side of the body or face: This may range from total paralysis to a more subtle difference between keeping your left and right arms raised high. Weakness of your face may give one side a drooping appearance.
- Loss of coordination on one side of the body: While your limbs may be strong, you may not have the coordination to do something you could before, such as hold a spoon or button a clasp. In rare cases, a body part may develop abnormal, spontaneous movements.
- Difficulty with vision: This may include seeing double or vision loss in one or both eyes.
- Severe headache: Most strokes do not cause headache, but if the headache has sudden onset, is severe, or is associated with vomiting or decreased consciousness, it may be due to stroke.
- Seizure: Most of the time, seizures are not due to stroke. On the other hand, strokes are the most common cause of new seizures in someone over the age of 50 who has no history of prior seizures.
How Long Symptoms Last
Symptom duration depends on the size and severity of the stroke. Symptoms may last less than an hour, but they can also remain for a lifetime. Even if the physical damage left by a stroke doesn’t resolve with treatment, sometimes the brain can “rewire” itself to find new pathways for information to travel in order to regain function. The longer a symptom lasts, the more likely it is that it will remain permanent. It’s usually best to address problems caused by a stroke as soon as possible.
What to Do If the Symptoms Go Away
Even if your symptoms go away, an evaluation as soon as possible is still warranted. Transient ischemic attacks (TIAs) are a type of stroke caused by a temporary loss of blood flow to part of the brain. For example, a clot may have lodged in an artery and blocked blood flow, but has now broken up and passed through. Although blood flow may have restored itself, you are at an increased risk of having another episode with permanent symptoms.
What to Do If You Think You’re Having a Stroke
Dial 911. If you’re unable to speak clearly, get someone to help you. The sooner you get to the emergency room, the better the chances that your stroke will not have long-term consequences.
Aspirin and Other Medication
Don’t worry about taking aspirin or other medication. It’s more important to get to an emergency room right away. About 85 percent of strokes are ischemic, meaning that a clot has stopped blood from moving to parts of the brain. These strokes are helped by medications like aspirin. However, 15 percent of strokes are caused by bleeding into the brain, in which case aspirin makes things worse. It’s best to be evaluated to know what type of stroke you might be having before taking any medicine.
What Happens in the Emergency Room
When you arrive at the emergency room, doctors will want to quickly decide if you are likely having a stroke and if it’s safe to give you a blood thinner like TPA.
They may ask the following questions to help guide their decision-making:
- When were you last feeling normal? Did you wake up with these symptoms, or do you remember the exact time they started?
- What is your medical history? Do you have stroke risk factors such as diabetesor smoking? Have you ever had a stroke before?
- Do you have a bleeding or clotting disorder?
- Have you had bleeding in your brain before? Have you had recent surgery or physical trauma?
- What medications do you take?
- Do you have metal anywhere in your body, such as surgical clips or hardware? Are you claustrophobic? These questions are important to determine the safety of an MRI.
Remember, stroke is an emergency, and every minute counts. It’s best if you are seen in the emergency room within an hour of your first symptoms. If you have any doubts about whether you might be having a stroke, you need to speak with a medical professional right away.
View Article Sources :
- Mayo Clinic Staff. Stroke. Mayo Clinic. Updated November 11, 2017.
- Ropper AH, Samuels MA, Klein JP. Adams and Victor’s Principles of Neurology.10th ed. McGraw-Hill Education; 2014.
Jul 7, 2018 | Healthy Tips
By Mark Stibich, Ph.D. | Reviewed by Richard N. Fogoros, MD
Controlling blood pressure and losing weight can make a difference.
Lancet called INTERSTROKE confirmed that people can reduce their risk of having a stroke by making lifestyle changes. The study found that modifiable risk factors are responsible for 88 percent of stroke risk. The excellent news here is the “modifiable” part of the equation — most of these factors can be completely avoided, or at least modified.
That’s great, you say until you look at the list. Most of us know that stopping smoking and losing weight are no-brainers for improving your health, and many of us would have done these things years ago if we knew how to go about it strategically. Learning how important lifestyle changes are for reducing stroke risk can be motivational.
Major health improvements can be made if the goals are specific, measurable, attainable, realistic and time-based, also known as S.M.A.R.T. goals for lifestyle change.
Here are the top 10 ways to cut your risk of stroke by almost 90 percent:
- Control Your Blood Pressure
While there are medications to control hypertension (high blood pressure), lifestyle change is a key component of keeping blood pressure down. Following the DASH Diet and avoiding salt can help.
- Stop Smoking
Smoking not only increases the risk of stroke, it is estimated to subtract 10 years from one’s lifespan.
Getting tips, strategies, stories, and encouragement from people who have successfully quit smoking can be inspirational. And if that doesn’t help, consider how smoking results in premature aging.
- Lose Weight, Especially Around Your Abdomen
You might be surprised at how easy it is to incorporate easy weight loss methods into your life.
Not only can you find yourself dropping pounds, but by slowing down and being more mindful of your food, you may also find yourself enjoying meals much more.
- Manage Your Diabetes
People with diabetes are at a higher risk of stroke than the general population. This risk is much higher when the diabetes is poorly-managed and blood glucose levels are elevated over long periods. It is important to take your diabetes seriously (even if you don’t feel “bad” from high blood sugar), which involves sticking to your treatment strategies, among other things. This will not only go a long way in reducing your risk of stroke but also will help bring down the likelihood of other complications.
- Get Active
We know we should be exercising, but many of us simply don’t like it and when you don’t like to do something, it is very easy to find lots of excuses not to do it. Instead of starting from a place of trying to do something you simply hate to do, why don’t you wipe the slate clean and look at exercise from a new perspective? Learn to like, even love, exercise, and it will be much easier to commit to an exercise habit.
- Improve Your Diet
There are many opinions about what exactly constitutes a healthy diet, which often leaves the average person confused to the point that they give up.
However, there are some things that are pretty universal here — more vegetables, less trans fats, fewer trips through fast food restaurants. Add fruit to increase your longevity and adopt an overall longevity diet plan.
- Limit Alcohol, Avoid Binge Drinking
Clearly, drinking heavily is bad for your health, but much research shows that two or fewer drinks per day can be good for you, especially red wine. Any more than that starts working against you and harming your health. Heavy drinking also increases stroke risk by 45 percent and there is a link between alcohol and brain aging.
- Improve Your Good Cholesterol
The idea here is to improve your HDL (good cholesterol) to LDL (bad cholesterol) ratio more HDL and less LDL is the idea.
The goal is to have your HDL/LDL ratio above 0.3, with the ideal being above 0.4. Of course, there are medications, such as statins, that can help you do this, but there are some lifestyle changes to be made as well, even fun ones, such as eating more dark chocolate or fish.
- Manage Heart Disease
As we age, our hearts have to adapt to our changing bodies our arteries lose flexibility, our heart walls thicken and it becomes harder for our hearts to keep up with increased demand. All of these things (and others) are made worse when we have heart disease, such as coronary artery disease, angina or other problems that can lead to heart attacks. There are several approaches to managing heart disease, which involves medications, diet, and exercise many of the same things that will also reduce the risk of stroke.
- Avoid Stress, Treat Depression
We know that we feel worse when we are “stressed,” but there is also significant evidence that stress impacts the frequency of negative health events, like a stroke. Depression also has serious physical consequences and can lead to victims neglecting their health.
Bottom Line
By taking steps to improve in these areas, you will no doubt feel better along the way. In addition to reducing your risk for stroke, you will also reduce your risk of heart attacks.
Sources :
O’Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral hemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. The Lancet, Early Online Publication, 18 June 2010
Jul 7, 2018 | Healthy Tips
What counts as normal and high blood pressure for women?
By Marian Anne Eure
Nearly 50 million Americans have high blood pressure. Older women are particularly likely to develop high blood pressure. More than half of all women over age 60 have it.
Others who are at a high risk
of developing high blood pressure are African Americans, those who are overweight, have a family history of high blood pressure, and those whose normal blood pressure is naturally high.
What Exactly Is High Blood Pressure?
Blood is pumped by the heart through vessels to bring oxygen and nutrients to the body. Blood pressure is the force of the blood against the vessel walls. The higher the pressure, the harder the heart is working.
Blood pressure often goes up and down during the day. When it goes up and stays high, then it is high blood pressure. The medical term is hypertension.
An easy test measures blood pressure. It uses an inflatable cuff around an arm. If the pressure is high, the test will be repeated over several days to get an accurate reading. You probably have had such a test on a visit to your doctor.
Measuring High Blood Pressure
The test gives two numbers: The systolic pressure is the pressure of blood in the vessels as the heart beats. The diastolic pressure is the pressure of the blood between heartbeats. The numbers are usually written as a fraction with the systolic above or to the left.
An example is 120/80 mm Hg (millimetres of mercury), a normal adult blood pressure.
Both numbers count. Your blood pressure is high if the systolic pressure is 140 or above, or the diastolic pressure is 90 or above, or both are high.
“The Silent Killer”
If you do not know your blood pressure, you should have it taken.
Those with high blood pressure often do not feel sick. In fact, high blood pressure is often called “the silent killer,” because it may cause no symptoms for a long time. But untreated, it can damage the kidneys and raise the chances of stroke, heart attack or other cardiovascular (heart and blood vessel) problems. It causes three of every five cases of heart failure in women. Heart failure is a severe condition in which the heart cannot adequately supply the body with blood.
Women who have both diabetes and high blood pressure are at an even higher risk of stroke, heart and kidney problems than those who have only high blood pressure.
Are You In Control?
You may be surprised to learn that many women take blood pressure drugs but still have high blood pressure. This is especially true for older women.
Why? There are numerous reasons. Some women may not take their drugs as prescribed, whether incorrect amounts or at the wrong times. For others, a drug may not lower their blood pressure enough.
To prevent stroke, heart attack or heart failure, blood pressure must be controlled to below 140/90.
So make sure you’re in control of your high blood pressure. Talk with your doctor and ask about your blood pressure level.
If it is too high, ask about adjusting your drug and making lifestyle changes that will bring your blood pressure to below 140/90.
Taking Control
Of women with high blood pressure, 3 out of 4 know they have it, and yet fewer than 1 in 3 are controlling it.
All women can and should take steps to control their high blood pressure. This is especially important for women who have heart disease. When blood pressure is lowered, the heart does not work as hard. Women who have had a heart attack are less likely to have another if they reduce their high blood pressure.
You can control your blood pressure with these steps:
- Lose weight if you are overweight
- Become physically active
- Choose foods low in salt and sodium
- Limit your alcohol intake
- If prescribed, take high blood pressure pills
These lifestyle steps also help prevent high blood pressure, so both you and your family can follow them together for healthy benefits.
https://www.verywellhealth.com/
Jul 7, 2018 | Healthy Tips
By Craig Weber, MD |
Hypertension does not usually cause any noticeable symptoms. When it does, you might experience dizziness, shortness of breath, headaches, and nosebleeds, which could indicate that your blood pressure is rising. Complications such as heart disease, stroke, and kidney failure can occur if long-term hypertension is not adequately treated. A hypertensive emergency, which is an uncommon and dangerous event, may cause blurry vision, nausea, chest pain and anxiety.
Frequent Symptoms
Overall, the vast majority of people who have hypertension, which is described as chronically high blood pressure (>130 mm Hg or diastolic pressure >80 mm Hg), do not experience any symptoms of the condition. It is usually diagnosed in the doctor’s office with a simple blood pressure measurement using a blood pressure cuff.
Symptoms that do occur, if present, may indicate temporary fluctuations or elevations in blood pressure, and can be related to the timing of medication doses. Generally, the symptoms of hypertension can happen at any time, do not last for long, and may recur. They include:
Recurrent headaches: Headaches are fairly common among people with or without hypertension. Some people with hypertension notice changes or worsening of headaches when medications are skipped or when the blood pressure becomes higher than usual. Headaches associated with hypertension can be mild, moderate, or severe and can be of a throbbing nature.
Dizziness: People with hypertension may notice dizziness in relation to medication doses and blood pressure fluctuations.
Shortness of breath: Hypertension can cause shortness of breath as a result of the effect on the heart and lung function. Shortness of breath is more noticeable with physical exertion or exercise.
Nosebleed: You may be more prone to nosebleeds if you have hypertension, although, in general, nosebleeds are not a classic sign of high blood pressure.
Rare Symptoms
Extremely high blood pressure that occurs suddenly is more likely to produce noticeable symptoms than chronic hypertension. However, it is important to know that even very high blood pressure may not produce symptoms.
Severe high blood pressure is defined as systolic pressure of >180 mm Hg or a diastolic pressure of >120 mm Hg. People with severe high blood pressure can develop symptoms quickly, including:
Blurry vision or other vision disturbances: Blurred vision and vision changes are warning signs that you could be at risk of a serious health problem, such as a stroke or a heart attack.
Headaches: Headaches associated with very high blood pressure tend to be throbbing in nature and can develop rapidly.
Dizziness: The dizziness of very high blood pressure is described as vertigo (a sensation that the room is spinning).
Nausea, vomiting or loss of appetite: Nausea associated with severe hypertension can develop suddenly and may be associated with dizziness.
Hypertensive Urgency
A type of high blood pressure without serious symptoms is called hypertensive urgency. Hypertensive urgency is defined as a systolic blood pressure of >220 mm Hg and a diastolic blood pressure of >120 mm Hg. This blood pressure is considered high enough to put you at serious risk of sudden, life-threatening events.
In situations of hypertensive urgency, there is no organ failure or other immediately critical conditions, but these conditions could quickly develop if the blood pressure isn’t quickly brought under control.
Complications
Untreated hypertension causes serious complications, including organ damage. Less commonly, a condition called a hypertensive emergency, which may also be called a hypertensive crisis or malignant hypertension can occur.
Hypertensive Emergency
A hypertensive emergency, unlike the similar sounding hypertensive urgency, is characterized by serious, life-threatening complications. A hypertensive emergency means that the blood pressure is >180 mm Hg or the diastolic pressure is >120 mm Hg, and that end-organ damage is occurring. Signs and symptoms can include shortness of breath, anxiety, chest pain, irregular heart rate, confusion, or fainting.
Aneurysm Rupture
An aneurysm, which is a bulge in the wall of an artery, can form due to a number of causes. Aneurysms can occur in the aorta, brain, and kidneys. Hypertension contributes to aneurysm formation, and sudden elevations of blood pressure can increase the risk of an aneurysm rupture—a serious event that can be fatal.
Vascular Disease
Hypertension increases the risk of vascular disease, characterized by atherosclerosis (hardening and stiffening of the blood vessels) and narrowing of the arteries. Vascular disease can involve the blood vessels in the legs, heart, brain, kidneys, and eyes, causing a range of disabling or life-threatening symptoms.
Heart Disease
Hypertension contributes to the development and worsening of coronary artery disease, cardiac arrhythmias, and heart failure.
Kidney Failure
Hypertension can affect the kidneys, as their blood vessels become less able to function effectively; permanent damage is possible.
Respiratory Disease
Respiratory disease can develop as a consequence of heart disease, manifesting as shortness of breath with exertion.
When to See a Doctor
It is important to go to your regular check-ups with your doctor. Hypertension is a common condition and, if caught, can be treated with medication to prevent complications. However, if you experience any of the symptoms of hypertension, such as frequent headaches, recurrent dizziness, nosebleeds, shortness of breath, nausea or vomiting, don’t wait—speak to your doctor immediately.
Hypertension requires regular visits with your doctor to monitor your progress. If you are already on blood pressure medication and experience any related side effects, contact your doctor to see if your regimen needs to be adjusted.
When to Go to the Hospital
A hypertensive emergency requires immediate emergency medical care. The symptoms of a hypertensive emergency include:
Severe headaches
Chest pain
Palpitations
Shortness of breath
Severe dizziness or feeling faint
Vision changes
Weakness, numbness, tingling in the arms, legs, or face on one of both sides
Trouble speaking or understanding words
Confusion or behavioural changes
Do not attempt to lower extremely elevated blood pressure in yourself or someone else. While the goal is to reduce blood pressure before additional complications develop, blood pressure should be reduced over the course of hours to days, depending on severity. It is important not to lower blood pressure too quickly, because rapid blood pressure reductions can cut off the supply of blood to the brain, leading to brain damage or death.
Jul 7, 2018 | Healthy Tips
By Craig Weber, MD
Diabetes and high blood pressure are related diseases that feed one another and tend to get worse with time. In biological terms, the relationship between diabetes and high blood pressure is a type of positive feedback loop, where one step causes the second step and that second step “feeds back” to cause more of the first step.
The Feedback Loop
The most well-studied example of the self-reinforcing relationship between diabetes and high blood pressure takes place in the kidneys.
The kidneys are the body’s most important long-term blood pressure regulator. By balancing the amount of salt and potassium in the body, the kidneys ultimately control how much fluid is excreted as urine. This fluid regulating function helps modulate long-term blood pressure by physically controlling how much liquid is present in the blood vessels. Carrying out this function depends on a constant flow of blood across delicate capillary structures known as glomeruli (singular: glomerulus). The glomeruli are the filtering units of the kidney.
The high blood sugar levels associated with diabetes damage capillaries, including those that comprise the glomeruli. Through a complex series of steps, excess blood sugar actually causes the walls of capillaries to thicken and, in some cases, degrade entirely. While the precise mechanisms underlying this process are too complicated to discuss in detail, the end result is that the glomeruli become thicker, and are tricked into thinking that they aren’t receiving enough blood.
As a result, the kidneys respond by raising blood pressure to restore “normal” blood flow through the glomeruli. Because they have been damaged, the glomeruli essentially require a permanent increase in blood pressure in order to continue filtering the blood. As time goes on, continued exposure to elevated sugar damages the glomeruli more, leading to ever-increasing blood pressures as the kidneys try to correct the situation.
Its Effects on Other Organs
These elevated blood pressures have widespread effects on the other organ systems of the body, including the muscles and insulin-secreting areas of the pancreas. In the muscles, higher pressure causes blood vessels to contract. As a result, less blood flows through the large muscle areas of the body.
This leads to a decrease in the size of muscle cells and a decrease in the amount of sugar that those cells absorb from the blood. Because less sugar is being absorbed from the blood, the level of free sugar in the blood rises. This free sugar ultimately makes its way to the kidneys, where it contributes to further glomerular damage. Altered blood flow through the pancreas, as a result of autoregulation, can also lead to a decrease in insulin production, raising the blood sugar even higher.
Prevention
Because diabetes and high blood pressure are so strongly self-reinforcing, it is vitally important to maintain tight control of both blood sugar and blood pressure. Even modest elevations of either in patients suffering from both diseases can quickly lead to an exaggerated amount (an “amplified” amount) of damage. This is the primary reason that treatment goals for blood sugar are more rigorous in the setting of high blood pressure and treatment goals for blood pressure are more rigorous in the setting of diabetes.
