Stroke – what you should know

Did you know that one in six people will have a stroke at some time in their life?   Most are over 65, but stroke can strike at any age. Even young people and children can be affected.

It’s a fact that stroke is the biggest cause of acquired disability and the third biggest cause of death in Ireland.  Stroke can happen at any age. One third of strokes happen in people under sixty-five years of age. Your risk of having a stroke is increased by certain things in your lifestyle which you can change, such as stopping smoking and managing your weight.  Your risk of stroke is also increased by certain things which you cannot change, such as your age and family history. Some people are more at risk of having a stroke if they have certain medical conditions. It is important that these conditions are carefully monitored and treated.

The good news is that by making small changes to your lifestyle and by taking medications for certain conditions as directed by your doctor, you can reduce your risk of stroke.


Life style factors – risk for stroke that you can change

Everyone should know the life style factors that can affect the risk of stroke:

  • High blood pressure (Hypertension) – High blood pressure or hypertension is the leading cause of stroke. High blood pressure causes your blood vessels to lose their elasticity. The stiffening and narrowing of arteries can result in a blockage or clot forming.  The weakening in the walls of small vessels can cause bleeds to occur. Clots and bleeds can cause strokes.
  • High cholesterol – Cholesterol is a type of fat found in your blood. You need a certain amount of cholesterol in your body. There are two main types of cholesterol – HDL or good cholesterol and LDL or bad cholesterol. Good cholesterol mops up the cholesterol left behind in your arteries and carries it to the liver where it is broken down. Bad cholesterol sticks to the walls in your arteries making them narrow. If an artery to the brain is completely blocked it can cause a stroke.
  • Smoking – Smoking doubles your risk of stroke. Smoking causes your blood vessels to narrow and makes your blood more likely to clot.  Fatty deposits build up faster in the blood vessels of smokers compared to non-smokers.  Second-hand smoke also increases your risk of stroke. Five years after you stop smoking your risk of a stroke is similar to that of a non-smoker.
  • Poor diet – A diet high in salt increases your risk of developing high blood pressure. Eating foods high in saturated fats (butter, hard margarine, lard, cream, fatty meat, cakes, biscuits and chocolates) can raise your cholesterol levels. Too many extra calories in your diet can lead to weight gain, obesity, high blood pressure and Type 2 diabetes mellitus.
  • Alcohol – Drinking too much alcohol raises your blood pressure and can cause damage to your liver and heart.
  • Physical inactivity – Not being active on a regular basis increases your risk of stroke by 50%.
  • Diabetes – If you have diabetes you have a greater risk of stroke. Diabetes occurs when your blood sugar (glucose) is too high. Insulin, a hormone produced by your body, helps to control your blood glucose. If your body does not produce enough insulin, or your body does not respond well to insulin the sugar levels in your blood rise.
  • Atrial fibrillation (irregular heartbeat) – Atrial fibrillation causes an irregular heart-beat. This can cause blood to clot. A blood clot can enter your bloodstream and get stuck in a blood vessel supplying your brain. This blockage may then cause a stroke to occur.


Risk factors for stroke that you cannot change

Then there are others risks that you can’t do anything about, but still should be aware of:

  • Age – As you get older your blood vessels harden and become less elastic which puts you at increased risk of stroke and heart disease. Two thirds of strokes occur in people aged 65 years and older.
  • Gender – Stroke is more common in men under 75 years of age than in women of the same age. However, in those over 75 years of age more women than men have strokes.
  • Family history – You are more at risk of having a stroke if one or more of your parents, grandparents, sisters or brothers have had a stroke.
  • Ethnicity (race) – People of African, Asian and African-Caribbean have higher risk of having high blood pressure and diabetes which are risk factors for stroke.
  • Medical conditions – A number of medical conditions increase your risk of stroke. Your doctor may prescribe medications to manage these conditions.
  • Other diseases of the heart – Having heart disease or heart failure increases your risk of stroke. Dilated cardiomyopathy (enlarged heart) and disease of the heart valves also increases the risk of stroke.


How can you reduce your risk of stroke?

By making small changes to your lifestyle you can reduce your risk of having a stroke and can prevent repeat strokes.

  1. Know your blood pressure: The only way to find out if you have high blood pressure is to have it measured. If you are over 30, you should have your blood pressure checked every two or three years.   A number of factors combine to cause high blood pressure. These include age, family history, eating too much salt, not eating enough fruit and vegetables, drinking too much alcohol, being overweight and not taking enough physical activity.  Your blood pressure can be measured by your doctor.
  2. Medication: If you have been prescribed medication for high blood pressure, you will usually have to take it for your whole life. Medication that lowers blood pressure prevents early ageing of the blood vessels and heart and reduces your risk of stroke.
  3. Manage or reduce cholesterol: Your cholesterol can be measured by your doctor. If you need to change any aspects of your cholesterol, your doctor will advise you on changes in lifestyle and may recommend medication.
  4. Stop smoking: Stopping smoking will almost halve your chances of having a stroke regardless of how long you have been a smoker, or how old you are. Within 24 hours of stopping smoking, your risk of having a stroke begins to fall.


What do do if you suspect you or someone else is having a stroke

It is essential to call for help (dial 999 and ask for an ambulance) if you suspect you or someone else is having a stroke.  According to Dr John Thornton, Director of the National Thrombectomy Service , Beaumont Hospital Dublin, “the symptoms of stroke can be completely reversed and cured if you get to treatment within the first few hours”.

The signs and symptoms of a stroke vary from person to person, but usually begin suddenly.

As different parts of your brain control different parts of your body, your symptoms will depend on the part of your brain affected and the extent of the damage.

The main stroke symptoms can be remembered with the word FAST:

Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.

Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.

Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.

Time – it’s time to dial 999 immediately if you notice any of these signs

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