Everything You Need to Know to Prevent Stroke

You've heard a lot about heart attacks, but strokes are lesser-known "brain attacks," and they're on the rise in women. Read on for the important advice these doctors give their loved ones--and now, you. By Lisa Mulcahy, REDBOOK.

Strokes aren't as out of the blue as you think

"Many young women I know aren't aware of what a stroke actually is, or that stroke may affect them, so whenever I get the chance, I share some important facts. First, here's why they are often referred to as a 'brain attack': The blood flow to the brain is interrupted, either by a blood clot or a broken blood vessel, resulting in brain damage. Women ages 35 to 64 are about three times more likely today to have a stroke than men of the same age group. And women have a higher risk of mortality from stroke than men do: 60 percent of women will die after having one. One reason the disease is on the rise in women has to do with weight gain, which raises stroke risk. That's why it's important to know your vital health numbers--such as your blood pressure, cholesterol, blood glucose levels, and pulse rate-and get the appropriate prevention or treatment if you do have a medical condition predisposing you to stroke. You hear of cases of otherwise healthy people having a stroke and might think they're a 'surprise' or out of the blue. But there's a lot you can do to help cut your risk." -Philip Gorelick, M.D., professor of translational science and molecular medicine at Michigan State University and medical director of Mercy Health Hauenstein Neurosciences in Grand Rapids, MI

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Beets are the best food you're not eating

"I encourage my friends to follow a 'brain-healthy' diet. What they're surprised to learn is that making beets a regular part of the menu may boost their brain. Here's why: Beets contain a high level of nitrite, a compound that helps regulate your blood flow and blood pressure. We're also finding that beets may actually increase blood flow to your brain, and may even stimulate growth of new blood vessels. In addition to telling my friends to up their beet consumption, I suggest following a healthy eating plan like the DASH diet. The acronym stands for Dietary Approaches to Stop Hypertension, but it basically means eating tons of fruits, veggies, lean meat, whole grains, and good fats. The Mediterranean diet, which is rich in fish, poultry, and vegetables and low in sugar and junk, is another smart choice." -Cheryl Bushnell, M.D., associate professor of neurology at Wake Forest Baptist Medical Center in Winston-Salem, NC

It drives me crazy when you pick up that salt shaker!

"I definitely get on my soapbox at the dinner table, because my wife and kids always love to salt the food on their plates. I warn them not to do it, every time. Too much salt leads to hypertension, which can cause an increase in your stroke risk. What always surprises me, too, is how most people never give a second thought to the sodium level that's in foods they eat all the time, because they never read a label in the grocery store. Processed foods are loaded with sodium, so you should avoid them whenever you can and reach for more natural foods. To cut your stroke risk, most people should eat between 1,500 and 2,300 milligrams of sodium per day--that's a teaspoon, max." -James Brorson, M.D., associate professor of neurology at the University of Chicago Medicine

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The birth control you're on may affect your risk
"I've been asked by a couple friends, 'Are birth control pills with estrogen going to give me a blood clot that could make me have a stroke?' My answer: It depends. Do you have a history of high blood pressure? If so, that could put you at risk. Do you smoke? There's another risk factor, and I recommend quitting right away. Do you get migraines with aura? That in itself is not going to cause significant risk, but if you combine it with the other factors, then yes, it can impact your odds of having a blood clot leading to stroke. And also, have you ever had a deep vein thrombosis (DVT) in your leg? If you have, you should not be taking birth control pills. Even for my friends who don't have any of these risk factors, my advice for everyone is to talk to your primary care doctor about your individual situation. It's important that you know your personal risk factors and work together to find the contraception that makes the most sense for you." -Bushnell

Watch your neck at the hair salon--and everywhere else
"Something a lot of women don't know about in terms of their stroke risk has to do with twisting or stretching their neck. Although it's rare, it's possible to experience a stroke through dissection--the tearing of an artery in your neck. That's why we neurologists generally advise against neck adjustments at the chiropractor. You also want to be careful when you're, say, on a roller-coaster ride at the amusement park or getting your hair washed at the salon; extending your neck back without proper support for longer than a few minutes can be dangerous. I even know that stroke has happened to people watching air shows, for instance, because of the craning of their neck. While I certainly don't want my friends to think they have to walk around with their chins down all the time, it's a good idea not to overextend or twist when it's not necessary." -Brorson

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Chill out--your health depends on it!

"I don't worry about stroke risk for friends who seem to have a hair-trigger temper. Short-term increases in blood pressure, the kind you can experience during the occasional freak-out moment, generally won't hurt you. The danger really lies in long-term elevation of your BP, which chronic stress can lead to. If you find yourself in a constant state of emotional distress--you're yelling at your family every day, you feel very tense and unhappy all the time--it's not healthy. That kind of stress can activate inflammatory mechanisms in your body and release the stress hormone cortisol, which can cause cell damage. Those factors do contribute, ultimately, to your stroke risk. I tell people I know that if they often feel angry or depressed, they really need to make being calmer and happier their goal. Taking care of your mind can powerfully protect your physical health." -Irene Katzan, M.D., neurologist and director of the Center for Outcomes Research at the Cleveland Clinic

Memorize this acronym--FAST!

"I remind my friends about the symptoms of stroke all the time and how to spot any red flags. For example, if you wake up with weakness in your arm, how can you tell whether it was just the way you slept last night or if it might be a warning sign? Well, you have to think FAST--and by this I mean: Face (does one side of your face droop when you smile?), Arm (does either arm drift downward when you raise it?), Speech (are you slurring your words?), and Time (if you're experiencing one or more of these symptoms, you need to call 911 immediately). You also need to be on the lookout for vision changes, such as not being able to see out of one eye, feeling numb on one side of your body, or having trouble walking normally. Even if you're not totally sure that what you're experiencing matches these symptoms, it's better to be safe than sorry. I know a teen who had learned 'FAST' and noticed that his grandfather had slurred speech and a face droop. He called 911 and told the operator that he suspected it was a stroke. Thanks to that call, his grandfather got immediate care and has made a great recovery." -Ralph L. Sacco, M.D., professor and chairman of neurology at the Miller School of Medicine at the University of Miami and former president of the American Heart Association


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