May is Stroke Awareness Month

Stroke is a leading cause of disability and is the number five cause of death in the United States. It is dangerous and deadly; however, you can control and treat many of the risk factors. If you, or a loved one, is having a stroke, time is critical! Immediate medical attention and treatment may decrease the long-term effects of a stroke and may prevent death.  

Recognizing the warning signs can make the difference between recovery, disability or death. A simple way to remember the stroke warning signs is F.A.S.T.:

Other symptoms of stroke to watch for include: sudden onset of numbness, especially one side of the body; confusion; trouble understanding speech or trouble speaking; change in vision in one or both eyes; difficulty walking; loss of coordination or balance/dizziness; and severe sudden onset of headache with no known cause. 

Facts About Strokes

Did You Know:

• Every 40 seconds someone in the U.S. has a stroke
• 80 percent of brain disease is linked to cardiovascular disease
• 99 percent of adults in the U.S. have at least one of seven cardiovascular health risks
• Three out of five Americans will develop a brain disease in their lifetimes
• Women face a higher risk of stroke – one in five will have a stroke – for women it is the number four cause of death in the United States

Things You Can Do to Prevent a Stroke

Our lifestyle choices directly affect our brain health and having a healthy brain can help prevent a stroke. Here are some tips to help you prevent a stroke:

• Be sure you are getting enough sleep. Adults need seven to nine hours of sleep a night; children and teens need more.
• Schedule regular visits with your primary care provider. Discuss how to manage or control your risk factors.
• Move around more and sit less. Aim for 150 minutes of moderate aerobic exercise or 75 minutes of vigorous exercise (or a combination of both) every week.
• Increase the number of fruits and vegetables you eat and reduce the amount of sodium, added sugar and saturated trans fats from your diet.
• Don’t vape or smoke, and cut down or quit if your currently use tobacco.  

Stroke Risk Factors You Can Control:

• The leading cause of stroke is high blood pressure, it is the most controllable risk factor. Know your numbers – keep them low.
• Carbon monoxide and nicotine damage the cardiovascular system, which leads to stroke. Using birth control pills and smoking cigarettes greatly increases stroke risk. African Americans who smoke have a stroke risk more than double compared to non-smoking peers.
• Diabetes, type I or II, is an independent risk for stroke. Those with diabetes who also have high blood pressure, high cholesterol and are overweight, are at even higher risk.
• Diets which are high in trans- and saturated fat and cholesterol can increase blood cholesterol levels. Increased salt intake also increases blood pressure. Eating five or more servings of fruits and vegetables a day may reduce stroke risk.
• Physical inactivity increases stroke risk, as well as risk of heart disease, high blood pressure, diabetes, overweight/obesity and high cholesterol.
• The brain of middle-aged adults may age prematurely if they are obese. Approximately one-quarter of adults have what we call metabolic syndrome, which includes high blood pressure, high blood sugar, excess body fat around the waist and abnormal cholesterol levels – those factors combined increase the risk of diabetes, stroke, heart disease and other illnesses.
• High cholesterol can lead to cholesterol build up and blood clots, which leads to stroke. HDL is the good cholesterol, however in men, low HDL is a risk factor for stroke.
• The brain's blood supply is via the carotid arteries. When these are narrowed by fat deposits from atherosclerosis, they may become blocked by a clot and lead to a stroke.
• AFib, Atrial fibrillation is a heart rhythm disorder, and a clot can move to the brain leading to stroke. Sleep apnea has been linked to AFib, it too is associated with a higher risk of stroke.
• Sickle cell disease, a generic disorder mainly affecting Hispanic and African American children, has the highest rate of stroke during childhood. Children between the ages of two and 16 are encouraged to be screened annually with a transcranial doppler ultrasound.
• There is a significant link between stroke and heart disease. Those with angina, coronary heart disease, or who have experienced a heart attack due to atherosclerosis have two times the risk of stroke.
• Alcohol and drug abuse leads to complications including stroke.

Stroke Risk Factors That Are Not Within Your Control:

• Age – stroke risks increase with age for both females and males.
• Family history – having a blood relative (parent, brother, sister or grandparent) who has had a stroke, especially before 65, leads to a greater risk. Stroke may be due to genetic disorders.
• African Americans have an increased risk of stroke compared to Caucasians. This is due to also having higher risks of diabetes, blood pressure and obesity.
• Gender – women have more strokes than men. Women also tend to live longer than men and are older when stroke occurs.
  • Factors increasing this risk for women include: pregnancy, history of preeclampsia/eclampsia or gestational diabetes, oral contraceptives and post-menopausal hormone therapy.
• Those who have had a prior stroke have a higher risk of having another one, than a person who never had a stroke.
• Those who have had a Transient Ischemic Attack (TIA) or “mini stroke” are approximately 10 times more likely to have a stroke than someone of the same sex and age who has not.
• Those who have had a heart attack are at a higher risk of having a stroke.
• A COVID-19 complication of formation of blood clots can lead to stroke.
• Where you live can increase your risk. In the southeastern U.S., stroke is more common.
• Stroke appears to be more common with lower incomes.

Knowing and sharing the signs and symptoms of stroke may save someone’s life. Share F.A.S.T. and other sudden warning signs with your family and friends. Calling 911 is always the first choice when someone is experiencing these symptoms. If someone is having signs of a stroke, calling the Denver Health NurseLine or your provider will delay care and delay of care can lead to the long-lasting effects of stroke or even death.

For more information and resources, please visit the American Heart Association's website.

Marie Richardson, DNP, APN, FNP-C is a call center supervisor for Denver Health's NurseLine. She is a former Intensive Care nurse and has been with Denver Health since 2015.