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Talk to the Doctor About Stroke Prevention

August 21, 2012

Make Exercise a Regular Part of Your Routine and Reduce Stroke Risk

Having a stroke, also known as a "brain attack," is not inevitable or something that "just happens" to people when they get older. In fact, stroke has been shown to be up to 80 percent preventable.

That just leaves the question of how to prevent stroke from happening. And a good way to find out is by attending the free Stroke Education Series seminar, Stroke Prevention and Other Disease Processes/Healthy Lifestyle - Be Smart and Avoid Stroke, on Tuesday, Sept. 4.

Get the upper hand in stroke prevention

"Stroke is a disease process that I would like to see community members take an active role in learning about," says Ash Jain, M.D., medical director of the Stroke Program at Washington Hospital. "Stroke is a highly preventable disease, but it is absolutely devastating when it happens and often comes as a surprise to people. It's true that most strokes occur in people over the age of 65, but strokes can happen at any age."

More than 140,000 people die each year from stroke in the United States, according to The Internet Stroke Center, and stroke has also long been the leading cause of serious, long-term disability in the United States.

"During this segment of the stroke series, I will be discussing other diseases processes - such as diabetes and hypertension - that contribute to increased risk of stroke, as well as how to manage these conditions."

Some risk factors that increase the likelihood of having a stroke, like obesity and smoking, often can be improved through lifestyle modification. Others - such as irregular heartbeat and full-blown diabetes - require supervision by a physician and other members of the health care team.

"Very often people may not realize just how much these factors increase their risk of stroke," Dr. Jain says. "The reality is that high blood pressure and diabetes contribute to atherosclerosis, which can cause plaque on the arterial walls. As plaque progresses and causes arterial blockage and decreased blood flow, it leads to cell death; or a clot can break off and block a smaller artery, which also can lead to cell death."

Dr. Jain says the surest path toward stroke prevention is identifying risk factors, including diabetes and hypertension, and talking to the doctor about how to best get them under control.

"Stroke is commonly known as a silent killer, because most of these risk factors build up over time without symptoms before a stroke finally occurs," he points out. "I never want to see a patient in the ER for a stroke that didn't have to happen."

"The important thing is to talk to your physician about assessment of risk factors including diabetes, high blood pressure, cholesterol issues, smoking habits, and also to make sure that these are addressed aggressively by the physician. Also, if you have problems with circulation in the body - like blockages in the heart, legs, or other areas - then you have to be very aggressive in management as the chance of having a stroke is much higher."

Take it from Dr. Jain: It's best to address these issues early with your doctor to make sure stroke doesn't catch you by surprise.

Making good habits

During his portion of the seminar, Doug Van Houten, R.N., clinical coordinator of Washington Hospital's Stroke Program, will take an in-depth look at what steps people can take to reduce their stroke risk simply through lifestyle changes.

"This time I really want to focus in on why exercise is so important," he says. "First, it strengthens your heart and reduces blood pressure. Second, it reduces stress, which helps reduce blood pressure and decrease anxiety. It also is associated with weight loss, which can reduce blood pressure. The other thing is that it's also a mood elevator, which generally has a positive health effect."

Exercise, he says, also helps to raise high-density lipoprotein (HDL), the "good" cholesterol, which helps to remove low-density lipoprotein (LDL), the "bad" cholesterol, from the blood.

"One of the best ways to increase HDL is to exercise," Van Houten says. "Also, exercise has sort of a natural insulin effect. Insulin's job is to move glucose from the blood vessels into the cells by helping glucose cross the cell membrane. If you don't have enough insulin, glucose collects, which causes damage to the blood vessels."

"Take, for example, someone with diabetes who is sedentary after a meal. They might need five units of insulin. In contrast, if they exercise after a meal, they might need only two units. Anything that helps reduce glucose levels in the blood helps to reduce damage to the blood vessels."

Van Houten says one key to success when incorporating regular exercise into your routine is to find something that will fit in with your lifestyle.

"My wife doesn't like the treadmill or the elliptical," he says as an example. "Instead, she likes to get up early and go to Lake Elizabeth where she walks around the lake really fast twice. It's a good time for her to get her head clear."

"I find that I can't do exercise when I get home. It's too late with dinner and then getting to bed, but I actually live close enough to cycle to work. I do 20 minutes in the morning and 20 in the afternoon. Everybody has some little thing they can do."

If you think you don't have the time to exercise, Van Houten says this is a good opportunity to take a closer look at your habits.

"You have to make exercise a habit," he says. "We all have habits that we do already that aren't so good, like after dinner we go and sit down in front of the TV. That's a habit, but you can form a better habit. Your new habit can be to get up and take a walk around the block with your spouse in the evening. Once you do it regularly, it will feel odd not to do it."

Prevent stroke

To learn more about what you can do to decrease your risk of stroke, make sure to attend the upcoming free stroke seminar focusing on prevention. The class will be held from 6 to 8 p.m. on Tuesday, Sept. 4, in the Conrad E. Anderson, M.D. Auditorium located at 2500 Mowry Avenue (Washington West) in Fremont.

To register, call Health Connection at (800) 963-7070 or visit www.whhs.com.