What is stroke?
A stroke occurs when the blood supply to a part of the brain is suddenly interrupted or reduced, depriving the brain of oxygen and nutrients. This usually leads to damage or death of brain cells within minutes.
This can either be due to:
- A blood clot forming within the blood vessels and obstruct the flow of blood to the brain – Ischemic stroke or
- A blood vessel rapturing and preventing blood flow to the brain – Hemorrhagic stroke
A Transient Ischemic Attack (TIA) or ‘mini-stroke’ is usually caused by a temporary clot.
Signs of a stroke
The letters in “F.A.S.T” can help you spot signs of stroke and take action immediately before it is too late.
Image courtesy of the American Stroke Association
Other signs of stroke to watch out for include:
- Sudden NUMBNESS or weakness of face, arm, or leg, especially on one side of the body.
- Sudden CONFUSION, trouble speaking or understanding speech
- Sudden SEVERE HEADACHE with no known cause
- Sudden TROUBLE WALKING, dizziness, loss of balance or coordination
- Sudden TROUBLE SEEING in one or both eyes
Effects of stroke
If a stroke occurs and blood flow can’t reach the region of the brain that controls a particular body function, that part of the body won’t work as it should. Because of this, stroke survivors may suffer from disabilities (depending on severity of the stroke) that leave some of them requiring institutional care. Some of the patients struggle with:
- Paralysis of half of the body
- Inability to walk without assistance
- Poor speech
- Depression
Besides, the condition leaves some patients unable to perform daily activities thereby requiring placement in a nursing home because they require attention around the clock. Stroke patients who are disabled cannot perform simple tasks such as bathing and dressing thereby exerting a toll on those around them, such as family members, both emotionally and financially.
Stroke, cholesterol, and high blood pressure
The risk of stroke increases when there is fluctuation in several health measures including:
- Cholesterol
- Blood pressure
- Body Mass Index
- Blood sugar
Therefore, it is important to maintain these measures within normal ranges to prevent the onset of stroke. Older people are more likely to experience fluctuations in these health measures. For example, those above 65 years are more prone to stroke while women tend to suffer from severe forms of the disease. Apart from gender and age other modifiable risk factors include cigarette smoking, sedentary lifestyles, and other cardiovascular diseases.
Lipid Disorders and Stroke
Lipid disorders (dyslipidemia) occurs when the concentration of lipids or lipoproteins fluctuate in the blood. The fluctuations can present as:
- Increased total cholesterol (TC)
- Raised low density lipoprotein cholesterol (LDL-C)
- Elevated triglycerides
- Reduced high density lipoprotein cholesterol
These lipid disorders, especially elevated levels of LDL-C, promote atherosclerosis which can subsequently lead to stroke. Therefore, interventions aiming to normalize the level of LDL-C can effectively prevent stroke. Low HDL-C level is also associated with ischemic stroke. The contribution of lipid disorders towards stroke depends on genetics, culture, lifestyle, and dietary patterns. The association between lipid disorders and stroke suggests that during primary prevention of stroke the interventions should aim to control lipid disorders. It is equally important to control factors that can cause lipid disorders such as obesity.
High Blood Pressure and Stroke
High blood pressure can exert pressure on the walls of the arteries and lead to stroke or heart attacks. High blood pressure exerts an increased workload on the heart and eventually damages the arteries and organs. The damage that high BP causes on the walls of the arteries can combine with other factors such as lipid deposition and block the blood vessels thereby causing ischemic stroke. Besides, when chronic, the blood pressure can cause the blood vessels to rupture and cause hemorrhagic stroke.
Diabetes and Stroke
Diabetes is a significant risk factor in the development of atherosclerosis, which ultimately promotes the development of stroke. Type 2 Diabetes is usually attributed to poor eating patterns, obesity, and sedentary lifestyles. Besides, diabetes patients may be at risk of other conditions such as hypertension, dyslipidemia, and obesity, which increase the risk of blood vessel damage. When poorly managed diabetes can contribute to the progression and recurrence of stroke.
Available options for managing and preventing stroke
It is evident that dyslipidemia, diabetes, and hypertension are major predisposing factors for stroke. Dyslipidemia is a common feature in all three conditions and is usually targeted during the prevention and management of stroke. Lifestyle interventions can be used with or without medication for managing dyslipidemia. Besides, lifestyle interventions can target the prevention or management of stroke, hypertension, and diabetes concurrently.
Which lifestyle interventions should be given priority?
- Eating enough fruits and vegetables
- Engaging in physical activity
- Weight management (BMI kept between 18.5 and 29.9 kg/m2)
- Moderate alcohol intake
- Smoking cessation
Diet
Apart from fruits and vegetables, a healthy diet should contain low-fat dairy products, fish, legumes, nuts, and whole grains. On the contrary, it is advisable to avoid, sweets, sugar-sweetened beverages, red meat, and sodium intake. It is also important to reduce caloric intake if weight loss is to be considered. Such a diet will guarantee:
- Lower blood pressure and LDL-C
- Better glycemic control and improved insulin sensitivity
- Weight loss and reduced incidences of obesity
Physical Activity
Sedentary lifestyles and disability because of stroke contribute to the reduction in physical activity levels. During the primary prevention of stroke, it is important to engage in moderate to intense physical activity for management of blood pressure, LDL-C, weight. Besides, exercise improves insulin sensitivity and glucose uptake. Patients who have already experienced stroke should engage in light activities such as walking and standing. In addition, they should only increase the intensity of their exercises after examination and clearance from a physician.
