Stroke Risks Factors

Introduction

According to WHO, 15 million people are estimated to suffer from a stroke every year, and 5 million of these people will lose their life as a consequence of stroke. The American Stroke Association reports that up to 80% of these strokes could be prevented by simply leading a healthier lifestyle. Here, we will discuss the occurrence of  strokes in more detail and familiarise ourselves with the following:

• What is a stroke and the causes
• Major risk factors
• How we can reduce our risk of suffering from a stroke

All About Strokes

A cerebrovascular accident, more commonly known as a stroke, is a potentially life-threatening medical condition that most commonly occurs when oxygenated blood flow to the brain is restricted or completely cut off by a blockage. There are three main types of strokes: 

• Ischemic stroke: Ischemic strokes are the most common, accounting for 87% of total strokes. This occurs when blood flows through our arteries, the blood vessel responsible for the transportation of oxygenated blood, becomes restricted or completely cut off. This blockage is commonly caused by blood clotting or a build-up of fatty deposits (atherosclerosis).
• Hemorrhagic stroke: Considered the most life-threatening type of stroke, hemorrhagic strokes occur when the arteries surrounding our brains suddenly begin to bleed as a result of hypertension, physical trauma or suffering of a brain aneurysm. As blood leaks from our arteries, our brain begins to swell and brain cells are killed.
• Transient ischemic attack: Similar to an ischemic stroke, transient ischemic attacks (TIA) occur when blood flow to the brain is cut off. However, TIA blood flow is only cut off for 5 minutes or less. TIAs are a serious warning that a more severe stroke could be imminent, with research showing that those who suffer a TIA have upto 17% risk of suffering from an ischemic stroke within 90 days.

What are the signs of a stroke?

It is important to familiarise yourself with the signs of a stroke so you are able to quickly identify if someone may be suffering from one, so that immediate medical attention is provided. Major signs to look out for if someone may be suffering a stroke are:

• Face - one side of the individual's face may appear to have dropped
• Arms - the individual may be unable to lift both arms above their head
• Speech - words of the individual may sound slurred
• Confusion - they may appear confused or dazed and struggle to walk
• Pain - they may suffer a painful headache

Complications/Prognosis

Whilst only 10-20% of strokes are initially fatal, it is reported that 40% of stroke survivors will suffer ‘moderate to severe’ impairments as a result of the stroke.

Weakness/total paralysis: After a stroke, certain areas of an individual’s body can feel extremely weak or immovable. As the brain's ability to send messages to certain areas of the body is impaired, movement can become extremely difficult or even impossible.

Cognitive function: The NHS report 75% of stroke survivors suffer cognitive impairment, meaning their brain is unable to function as it once did. Cognitive impairments can affect an individual in a variety of ways including memory loss, lack of understanding and ability to make decisions.

Psychological changes: As a result of the brain damage, a stroke survivor’s emotions and the way they behave can change drastically. Stroke survivors may experience heightened feelings of anger, confusion, anxiousness or isolation.

Speech issues: Approximately 33% of stroke survivors suffer from speech issues. Speech issues can occur as a result of both the physical and cognitive damage a stroke can cause, for example being unable to utilise facial muscles or the brain being unable to use and understand language.

Risk Factors for Stroke

High Blood Pressure: The National Stroke Association reports that high blood pressure is the leading risk factor for stroke. High blood pressure causes a large amount of stress on our arteries, causing them to narrow, be less flexible and in some cases rupture. This significantly increases our risk of suffering all three forms of stroke.

Atherosclerosis: Atherosclerosis is the narrowing of our arteries due to plaque build-up within our arteries and is responsible for 20% of ischemic strokes. When this process occurs in the carotid artery, the blood vessel responsible for delivering oxygenated blood to the brain, blood flow to the brain can become restricted or completely cut off, increasing the risk of an ischemic stroke or a TIA occurring.

Atrial Fibrillation: Atrial fibrillation is a condition that causes our heart to beat irregularly and according to NICE can increase stroke risk by 20-30%. When our heart beats irregularly, it may be unable to fully empty its chambers of blood during each beat, meaning the remaining blood begins to clot. If the heart is eventually able to beat these clots out of its chambers, the clot may become lodged in our carotid artery, increasing the risk of an ischemic stroke or TIA.

Age: Unfortunately, like many other medical conditions, our risk of suffering from a stroke increases as we grow older. A study published in the journal ‘Journal of the American Geriatrics Society’ reported that our risk of stroke doubles each decade after the age of 45. As we age, our arteries naturally become less flexible and narrower, making them more prone to blood clots and blockages, therefore increasing our risk of suffering an ischemic stroke or TIA.

Gender: Whilst more people assigned female at birth (AFAB) suffer strokes per year, people asigned male at birth (AMAB) are at a higher risk of suffering from a stroke when reviewing age specific statistics. More people AFAB suffer strokes each year due to their longer life expectancy, making them more prone to strokes compared to people AMAB. The reason for people AMAB being more prone to strokes can be attributed to a multitude of reasons; for example, they are more likely to over-consume alcohol and smoke, have high blood pressure and consume a less healthy diet than people AFAB, all of which increase the risk of suffering from a stroke. 

Preventing Stroke

Thanks to the comprehensive research completed by the leading scientists around the world, we are now able to understand what causes a stroke, and more importantly, how we can reduce our risk of suffering. To help ensure your risk of stroke is as minimal as possible, here are a few lifestyle changes you could potentially incorporate.

Healthy Diet: Consuming a balanced and healthy diet can significantly reduce your risk of suffering from a stroke. Try to incorporate the following while planning your meals.

• Five a Day: Consume five portions of fruit and veg per day to reduce your risk of stroke by as much as 30%, as per the Stroke Association.
• The complex not Simple Carbohydrates: Choose slow-burning carbohydrates such as wholemeal pasta, rice, and bread over fast burning sugary carbohydrates such as sweets, chocolate, and fizzy drinks.
• Healthy Fats: Try to make sure at least 90% of your fat intake comes from foods high in unsaturated fats such as salmon, avocados, and nuts to help increase high-density lipoprotein levels (good cholesterol). Try to completely avoid foods high in saturated and trans-fats (take-aways, ready meals and confectionery).
• Reduce Salt Intake: Try to reduce the amount of fast foods, ready meals, and confectionery you consume to help reduce salt intake and help maintain healthy blood pressure levels.

Regular Physical Activity: Regularly achieving at least 150 minutes of aerobic exercises per week (such as walking, swimming, cycling and jogging) is a great way to improve your overall health as well as reduce your risk of stroke. Research has found those who partake in at least 150 minutes per week are 30% less likely to suffer a stroke.

Stop Smoking: When smoking a cigarette, both carbon monoxide and nicotine enter our bloodstream, reducing the amount of oxygen in our blood and increasing our heart rate. This, therefore, reduces oxygen delivery to the brain and increases blood pressure significantly, thus increasing the risk of an ischemic or hemorrhagic stroke.

Reduce alcohol consumption and cease drug misuse: Whilst most of us enjoy an alcoholic drink at some point, try to restrict yourself to one or two glasses a week. 

Consuming an excess of alcohol can cause a wide variety of health issues including increased blood pressure, risk of atrial fibrillation, type 2 diabetes and liver damage, all of which increase our stroke risk. Unlike alcohol, drugs should be completely avoided. As well as being illegal, the use of drugs can cause a sharp and sudden rise in blood pressure, as well as damage our brain cells, again both of which increase our risk of stroke.

Limit stress: Taking time to relax each day is vital in the prevention of many medical conditions. So make sure to include activities you find relaxing throughout your day, whatever they may be. Over time, stress can increase our blood pressure, heart rate and the pressure placed on our arteries, increasing our risk of stroke by as much as 59%.

Birth control options: Whilst only marginally, research has found that people AFAB who use birth control are at an increased risk of suffering from a stroke. Whilst mostly seen in people AFAB who smoke or have existing conditions such as high blood pressure and clinical obesity, taking birth control medication can cause blood clots and therefore increase stroke risk. If you are concerned about your current birth control method, contact your local GP to discuss your concerns and potentially safer alternatives.

Summary

After exploring various ways you can help protect yourself from a stroke, try and implement some of these ideas into your lifestyle. Even if you are not currently at risk of stroke, increasing the amount of exercise and intake of healthy foods can only make you healthier! If you believe you may be at risk of suffering from a stroke, book an appointment with your local GP immediately, even if it is just to put your mind at rest.