More than 300 years ago, physicians noticed that some people-almost always the elderly-suddenly keeled over dead or paralyzed, often after complaining of headaches, dizziness, or weakness. These attacks seemed to come out of the blue, like a stroke of bad luck. So they named the condition stroke.
Stroke is the nation’s third leading cause of death, after heart disease and cancer. About 700,000 Americans suffer strokes each year, and almost 160,000 die from them, according to the American Heart Association.
With statistics like these, you’d think people would be able to recite the warning signs of stroke as easily as the lyrics of “Jingle Bells:” But unfortunately, few can. For a leading cause of death, stroke is a tragically well-kept secret. Many people don’t even know the six key warning signs: dizziness, numbness, weakness on one side, slurred speech, vision problems, and severe headache.
There are two main types of stroke: ischemic, caused by blocked blood flow through part of the brain, and hemorrhagic, caused by a burst blood vessel that bleeds into your brain. Ischemic stroke accounts for 75 percent of all strokes.
Ischemic strokes are virtually identical to heart attacks, except that they happen in your brain instead of your heart. These strokes begin with tiny injuries to brain arteries caused by high blood pressure, smoking, or a high-fat, high-cholesterol diet. Over time, these injured areas get covered with cholesterol-rich deposits called plaques that narrow the injured arteries.
Sometimes a plaque ruptures, causing a blood clot in the artery and cutting off the blood supply to part of your brain. That’s an ischemic stroke. In fact, heart attacks and ischemic strokes are so similar that the American Heart Association now calls them brain attacks.
Some time before you have a stroke, you experience one or more mini-strokes (transient ischemic attacks, or TIAs). During a TIA, there’s a temporary blockage of blood flow in your brain. But then the blockage dissolves on its own, and blood flow returns to normal. You seem to recover completely. The average TIA lasts about a minute.
Ischemic strokes have many of the same risk factors as heart attacks. Anything you can do to reduce these risk factors is likely to reduce your risk of stroke, too.
Make do without meat. If you eat meat every day, you may double your stroke risk, according to Yale neurologist John Lynch, M.D. For 10 years, Dr. Lynch tracked 6,500 stroke-free men between ages 57 and 67. In that time, 12 percent of the men who ate meat daily had strokes. But among those who ate meat only one to three times a month, just 5.4 percent experienced strokes.
Eat copious quantities of produce. A high-fat, high-cholesterol diet increases stroke risk by contributing to the formation of free radicals. These unstable oxygen molecules damage the arteries in your brain. Fortunately, a great deal of this damage can be prevented by special nutrients called antioxidants, found in abundance in fruits and vegetables. One British study found that those who eat the most fruit experience 32 percent fewer strokes.
A diet high in antioxidants helps prevent hemorrhagic as well as ischemic stroke, according to Alan Gaby, M.D. “Vitamin C and the flavonoids usually found with vitamin C in foods help maintain blood vessel integrity,” he explains. “This reduces the likelihood of bleeding in the brain.”
Boost your intake of Bs. In addition to being rich in antioxidants, fruits and vegetables contain generous supplies of vitamin B6 and folic acid. These B vitamins reduce levels of homocysteine, a recently identified risk factor for stroke.
For vitamin B6, clinical nutritionist Shari Lieberman, Ph.D., recommends spinach, carrots, peas, walnuts, sunflower seeds, wheat germ, fish (especially salmon and herring), chicken, and eggs. Foods rich in folic acid include spinach and other dark green leafy vegetables, broccoli, asparagus, and whole wheat.
Feast on fish. Dutch researchers who have tracked the health, diet, and lifestyles of people in Zutphen, the Netherlands, for many years have found that those who eat fish regularly have a lower rate of stroke than those who don’t. Cold-water fish such as salmon, mackerel, and herring are the richest sources of beneficial omega-3 fatty acids, but most other fish and seafood contain some as well.
Munch a few walnuts. Besides being delicious, walnuts contain an oil rich in alpha-linolenic acid, an essential fatty acid similar to the health-enhancing omega-3 fatty acids found in fish. Alpha-linolenic and omega-3 fatty acids help prevent the internal blood clots that trigger stroke. You can also obtain alpha-linolenic acid from canola and soybean oils.
Pounce on potassium. Dietary potassium helps prevent high blood pressure, and researchers have found that it might help prevent stroke. Good food sources of potassium include fruits, vegetables, beans, whole grains, poultry, and fish. “Basically, the higher your blood potassium level, the lower your risk of stroke;” Dr. Gaby says.
Buy your Bs in a bottle. If you’re concerned that your diet might not provide enough vitamin B6 and folic acid to prevent stroke, Dr. Lieberman suggests taking supplements of both nutrients. Aim for 300 milligrams of B6 and 800 micrograms of folic acid a day. Vitamin B6 doses this high, however, should only be taken under medical supervision.
Add E for extra protection. “Several large population studies have demonstrated that blood levels of vitamin E may be better predictors of future stroke than total cholesterollevels,” says Joseph Pizzorno Jr., N.D. Vitamin E speeds the breakdown of “bad” low-density lipoprotein (LDL) cholesterol while simultaneously increasing levels of “good” high-density lipoprotein (HDL) cholesterol.
Vitamin E is a potent antioxidant that appears to reduce the likelihood of the internal blood clots that trigger ischemic stroke. Unfortunately, the vitamin may increase your risk of hemorrhagic stroke. If you’re thinking about taking supplements, check with your doctor first.
To stop strokes, sweat. Chances are, you know that exercise helps prevent heart attack. But you may not realize the value of exercise for stroke prevention. Much research shows that physical activity helps prevent ischemic stroke. In one study, for instance, researchers found that people who engaged in moderate to high levels of exercise had less than half the stroke risk of people who engaged in low levels of exercise. Beneficial physical activities include walking, gardening, dancing, bowling-just about anything that gets your body moving.
Manage your anger. According to research by Susan A. Everson, Ph.D., of the University of Michigan School of Public Health in Ann Arbor, angry outbursts double your stroke risk. She recommends identifying your anger triggers and working to stay calm so that you don’t lose your temper and send your blood pressure soaring. She suggests deep breathing, counting to 10, and walking away from potentially anger-provoking situations.
Strike up the band. Many stroke survivors become depressed, which makes them less willing to work at rehabilitation. Music improves stroke rehabilitation because it has an antidepressant effect.
At Woodend Hospital in Aberdeen, Scotland, music therapist Heather Purdie divided 40 stroke survivors into two groups. One group received standard care, while the other received 40 minutes of music therapy a day. After 12 weeks, the people in the music-therapy group were less depressed, less anxious, and more motivated to participate in rehabilitation.
Recruit a team of cheerleaders. Duke University researchers studied 46 people who had been hospitalized for strokes. Eight had little emotional support, 24 had a moderate amount, and 14 had a great deal. The researchers correlated the stroke survivors’ social support with their recovery after 6 months. Those with the most support recovered much more quickly and fully.
Count on your spouse. Close relationships also help reduce risk of stroke. In a risk-factor-reduction program at the London School of Hygiene and Tropical Medicine in London, Stephen D. M. Pyke, M.D., worked with both individuals and couples. The people who participated as couples were significantly more successful at reducing their blood pressures and cholesterol levels and at quitting smoking.
Boost blood flow with ginkgo. European physicians often prescribe an extract of ginkgo leaves for stroke survivors because of studies showing that it improves blood flow through the brain. “I consider ginkgo preventive for stroke;’ says Alan P. Brauer, M.D. “In addition to its effectiveness, it’s nontoxic.” He recommends 100 to 200 milligrams a day. If you are regularly taking any type of bloodthinning medication, including aspirin, seek medical advice before taking ginkgo.
Prevent clots with garlic. Garlic helps prevent ischemic stroke in three ways: It reduces blood pressure, it lowers cholesterol levels, and it’s an anticoagulant. “If I were at risk for ischemic stroke, I’d increase my use of garlic in cooking;” says James A. Duke, Ph.D. “I’d also take garlic capsules.” Onions, scallions, leeks, chives, and shallots have similar benefits.
Know your numbers. Because high blood pressure and high cholesterol greatly increase stroke risk, the National Stroke Association recommends having both checked at least once a year. Lowering your blood pressure to normal reduces your stroke risk about 40 percent, according to Roger E. Kelley, M.D., chairperson of neurology at Louisiana State University School of Medicine in Shreveport.
In addition, cutting your cholesterol by 25 percent lowers your stroke risk by 29 percent, according to an analysis of 16 studies by researchers at Brigham and Women’s Hospital in Boston. “If you bring your blood pressure and cholesterol to recommended levels, you greatly reduce your risk of stroke and heart disease;” Dr. Pizzorno says.
Get tested for atrial fibrlllation. This condition-which can be detected during a check-up-is treatable with medication. Atrial fibrillation increases your risk of the internal blood clots involved in stroke.
Join the nonsmokers. Researchers at the University of Birmingham in England compared 125 men and women who had just experienced first strokes with 198 similar people who hadn’t. The stroke victims were much more likely to smoke (and to be overweight and not exercise).
In the United States, every surgeon general since 1964 has urged Americans to quit smoking. Stroke is one of the many reasons.
Other Good Choices
Let your Blood flow. Practitioners of Chinese medicine attribute stroke to a chronic weakness of qi that eventually blocks the flow of Blood through the brain. “Chinese medicine has equated stroke and heart attack for centuries;” says Efrem Korngold, O.M.D., L.Ac. “Western medicine has come to this view only recently.”
To treat stroke, Dr. Korngold prescribes herbs that open the blood vessels and promote the flow of Blood. These include hawthorn, frankincense, myrrh, santalum wood, aristolochia root, and borneol crystals.
Make an appointment with an acupuncturist. Both the United Nations World Health Organization and the National Institutes of Health endorse acupuncture as a treatment for stroke-related disabilities. Successful acupunture studies with stroke patients have been conducted in Norway and Sweden, with promising results. If you’re interested in trying acupuncture, consult a professional acupuncturist.
If your doctor recommends taking an anticoagulant to prevent stroke, ask whether you can try aspirin. Constance Johnson, M.D., professor of neurology at Johns Hopkins University School of Medicine, calls aspirin the best-choice anticoagulant. She prefers it over prescription drugs because it’s almost as effective, yet it is much cheaper and causes fewer side effects. Many studies have shown that taking regular lowdose aspirin helps prevent stroke.
Instead of aspirin, your doctor might prescribe other anticoagulants such as dipyridamole (persantine), ticlopidine (Ticlid), or warfarin (Coumadin).
If a doctor administers a clot-dissolving drug within 3 hours of an ischemic stroke, normal blood flow can often be restored, and the risk of death or permanent disability drops by about 30 percent. There are also brain-saving drugs that reduce the number of brain cells killed by the stroke and help minimize disability.
To benefit from clot-dissolving and brainsaving drugs, you have to be treated quickly-within a few hours. That’s why it’s so important to recognize the warning signs of stroke. Here’s what the American Heart Association says to watch out for.
- Sudden weakness or numbness in the face or in an arm or leg on one side of the body
- Sudden dimness or loss of vision, particularly in one eye
- Sudden loss of the ability to speak, or slurring of words, or an inability to understand speech
- Sudden severe headaches for no apparent reason
- Unexplained dizziness, balance problems, or sudden falls
The more of these symptoms a person has, the greater the likelihood of a stroke orif the symptoms appear only briefly-a TIA.
If you or someone you know exhibits any of these signs, don’t delay. Call your local emergency number or get the person to an emergency room as quickly as possible.