6 ways to lower stroke risk

Stroke – one of the most fatal types of cardiovascular diseases, and the third leading cause of deaths in Norway. Every year around 15 000 Norwegians are affected by stroke, and the number is expected to increase by 50 % over the next 20 years due to an ageing population.

hjerne2A stroke is caused by interruption of the blood supply to the brain, usually because a blood vessel bursts or is blocked. This causes damage to the brain tissue, since the supply of oxygen and nutrients is affected. The consequences of a stroke depends on which part of the brain is injured and how severly the injury is. Time between symptom onset and treatment is also a crucial factor for the outcome.

The most common symptom of a stroke is sudden weakness or numbness of the face, arm or leg, most often on one side of the body. Other symptoms may be confusion, aphasia, visual disturbances, difficulties with walking, dizziness, severe headache with no known cause, fainting or unconsciousness.

Is there any way to prevent this disease? Some factors, like age and family history of stroke, is unchangeable. However, there are a few things you can do to protect yourself. This months Harvard Health Letter gives 6 tips to lower the stroke risk:

  • Smoking is the worst risk factor of smoking – quitting will be a great step to prevent stroke (and several other diseases at the same time, of course).
  • Weight loss – a healthy weight is associated with lower prevalence of cardiovascular disease
  • Moderate alcohol consumption – according to Harvard this means no more than two drinks a day for a man and one a day for a woman. Bingeing on weekends is not either recommended, even though you don’t drink during the week.
  • Lower salt consumption –  limit sodium to no more than 2,300 mg per day—and to no more than 1,500 mg per day if you’re over age 50, or have diabetes, kidney disease, or certain other chronic conditions.
  • Healthy diet – you already knew, right? Reduce the intake of saturated fat, sugar and red meat, but gorge on vegetables, fruits, fat-free or low-fat dairy, whole grains, fish, poultry, beans, seeds and nuts.
  • Exercise – last, but not least; your comfortable couch may represent one of the greatest risk factors of stroke. Get up and move!

Maria Henningsen, CERG

Healthy lifestyles here, there and everywhere

The association between healthy lifestyle and risk of disease is well-known. No one has a guarantee of staying healthy, but numerous studies have shown that healthy habits, like regularly exercise, healthy weight, dietary habits and quit smoking, are strong protective factors of developing, for instance, coronary heart disease (CHD). Every year, millions of people are affected by such problems worldwide. Caused by bad luck, bad genes or bad lifestyle – who knows? The main advice from health professionals would in any case be to life a healthy life afterwards, and, eventually, quit habits that are known to increase the risk of disease. How well are these healthy advices adapted? And – interestingly – are there differences across countries regarding this?

Global studies are extremely difficult due to large cultural and socioeconomic differences. However, this was the main topic of a recently published study in JAMA by Teo and colleagues (2013). The authors examined the prevalence of avoidance or cessation of smoking, healthy diet and regular physical activity performance among individuals with a CHD or stroke event. These individuals were part of The Prospective Urban Rural Epidemiology (PURE) Study, involving 153 996 adults all over the world. The socioeconomic distribution was as follows: 3 high-income-countries, 7 upper-middle-income countries, 3 lower-middle-income countries and 4 lower-income countries.

iStock_000000731034XSmallOf this larger sample, 7519 individuals had CHD or stroke (self-reported). Among these, the analysis showed, maybe not surprisingly, that the lifestyle habits not really were in accordance with the official recommendations. Not even after getting sick they were especially willing to change; for instance, 18.5 % continued to smoke, and 39 % had healthy diets. Further, only 35.1 % started exercising – dissapointing, as we know all of the benefits of physical activity both for healthy and unhealthy hearts. Alltogether, only a few had all these 3 healthy behaviours (4.3 %).

What then about differences between low- and high income countries? The impression of smoking becoming less attractive in our part of the world was here testified confirmed. As much as 75 % of the participants in the high-income countries quit smoking after they got sick, while 38.1 % their counterparts in lower-income countries did the same. Levels of physical activity increased with increasing country income, but this trend was not statistically significant. As for diets, the lowest prevalence of eating healthy diets was in lower-income countries, compared to the others. Still, it seems like adaption to healthy lifestyle after CHD or stroke is poor all over, but even worse in the poorest countries. The situation is complex and the governments definately have a job to do to improve knowledge of healthy behaviours, as well as paving the way to perform them.

Maria Henningsen, CERG.