In the UK, there are over 150,000 strokes every year. Stroke is the third biggest killer and the largest cause of complex disability. Globally, the burden of stroke is expected to double by 2030.
Stroke costs the NHS around £4 billion a year and the wider economy £9 billion. Therefore, improving support for stroke survivors will benefit the economy as well as individuals.
Knowledge of stroke, its complexities and how it affects people’s lives is improving all the time and thanks to medical and technological advances, the number of people dying from stroke has almost halved over the past 20 years.
However, an increasing older population, rising obesity, plus sedentary and unhealthy lifestyles, threaten to reverse progress previously made.
VITAL STROKE WARNING
Most strokes are caused by a blockage cutting off the blood supply to part of the brain. A mini-stroke (also known as atransient ischaemic attack, or TIA) is exactly the same except that the blockage either dissolves on its own or moves, so that the blood supply returns to normal and symptoms disappear within 24 hours.
Each year, 46,000 people in the UK have a mini-stroke for the first time, with one in 12 going on to have a full-blown stroke within a week. However, if mini-stroke symptoms were recognised, diagnosed and promptly treated, a person’s risk of stroke could be reduced by as much as 80%. This could prevent around 10,000 strokes a year in the UK.
MANY STROKES ARE AVOIDABLE
Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke. Whilst you can't reverse the years, or change your family history, there are many other stroke risk factors that you can control – provided that you're aware of them. More people could avoid stroke if we tackled problems such as mini-stroke, high blood pressure, obesity and atrial fibrillation.
Here are seven ways to start reducing your risks today to avoid stroke:
1. Lower blood pressure
High blood pressure is the leading cause of stroke and affects 15 million people in the UK. Helping people manage their blood pressure through lifestyle is essential. It is important that people with high blood pressure are diagnosed and understand what they can do to help control their condition. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.
- Ideally maintaining a blood pressure of less than 135/85. But for some, a less aggressive goal (such as 140/90) may be more appropriate.
- Reduce the salt in your diet to no more than 1,500 milligrams a day (about half a teaspoon).
- Avoid high-cholesterol foods, such as burgers, cheese, and ice cream.
- Eat 4 to 5 portions of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.
- Get more exercise — at least 30 minutes of activity a day, and more, if possible.
- Quit smoking, if you smoke.
- If needed, take blood pressure medicines.
2. Lose weight
Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you're overweight, losing as little as 10 pounds can have a real impact on your stroke risk.
- While an ideal body mass index (BMI) is 25 or less, that may not be realistic for you. Work with your doctor to create a personal weight loss strategy.
- Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI).
- Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day.
3. Exercise more
Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.
- Exercise at a moderate intensity at least five days a week. When you exercise, reach the level at which you're breathing hard, but you can still talk.
- If you don't have 30 consecutive minutes to exercise, break it up into 10 to 15 minute sessions a few times each day.
4. If you drink – do it in moderation
- Have no more than one glass of alcohol a day.
- Make red wine your first choice, because it contains resveratrol, which is thought to protect the heart and brain.
- Watch your portion sizes. A standard-sized drink is a 5-ounce glass of wine, 12-ounce beer, or 1.5-ounce glass of spirits.
5. Treat atrial fibrillation
More than one million people in the UK have a five-fold increased risk of stroke due to atrial fibrillation, a form of irregular heartbeat that raises the risk of blood clots. Treatment with anti-coagulation therapy can reduce risk of clots, yet this is under prescribed.
- If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.
- You may need to take an anticoagulant drug (blood thinner) such as warfarin (Coumadin) or one of the newer direct-acting anticoagulant drugs to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.
6. Treat diabetes
Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.
- Monitor your blood sugar as directed by your doctor.
- Use diet, exercise, and medicines to keep your blood sugar within the recommended range.
7. Quit smoking
Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly.
- Ask your doctor for advice on the most appropriate way for you to quit smoking.
- Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.
- Don't give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.
Identify a stroke >>> F-A-S-T <<<
Too many people ignore the signs of stroke because they question whether their symptoms are real. The National Stroke Association has created an easy acronym to help you remember, and act on, the signs of a stroke. The FAST test can help you to spot the signs of a stroke or mini-stroke. Look for:
Can the person smile? Has their mouth or eye drooped?
Can the person raise both arms?
Can the person speak clearly and understand what you say?
Time to call 999
If you see any one of these signs, seek immediate medical attention.
REACHING THOSE MOST AT RISK
People in socially deprived areas are twice as likely to have a stroke and three times as likely to die as those in the least deprived areas. Black and South Asian people are more likely to have a stroke at a younger age than white people. Deaths from stroke are also higher in people in routine jobs than those in managerial or professional roles. Where you live, your ethnicity, social status and wealth make a big difference to your risk of stroke and survival in the UK.
GOOD HOSPITAL CARE SAVES LIVES
Timely access to high-quality stroke services can make a huge difference to people’s survival chances and recovery, but this is not happening everywhere. A stroke is a medical emergency. People must get immediate access to brain scanning and clot-busting drugs (thrombolysis) when appropriate, and be treated in specialist stroke units rather than on other wards. We know this leads to better outcomes, reducing the need for, and costs of, rehabilitation and long-term care.
WHERE WE ARE NOW
There has been a dramatic improvement in acute care, thanks to national strategies, advances in treatment and the way services are organised. More than nine in 10 stroke patients in England now receive a brain scan within 24 hours of admission.
WHAT NEEDS TO HAPPEN
We must build on the progress made in stroke care. The quality of acute stroke services varies greatly between regions. All areas must consider how to organise their services to provide the highest standard of care. All who work in health and care need to be aware of stroke, its effects and how to support people appropriately.
WHEN PEOPLE LEAVE HOSPITAL
Hospital treatment for stroke has dramatically improved over the past few years, but follow-up assessment and support are equally important. With the right support people can recover after stroke.
Physiotherapy can help to rebuild strength and improve mobility to get the recovering person more active, thus reducing the risk of a further stroke. Lessons in the Alexander Technique can also help to develop strategies to improve balance and function.
See www.stroke.org.uk for more information.