The American Heart Association and American Stroke Association recently published their 2024 Guideline for the Primary Prevention of Stroke and how to apply those guidelines in clinical practice. Based on extensive and comprehensive review of recent literature surrounding stroke data and stroke care, the new guidelines replace those put in place in 2014.
Key callouts of the 2024 update include gender-specific recommendations for screening and prevention of stroke, nutrition and the impact of cardiovascular disease on strokes. The new guideline also includes commentary on different age groups and associations of stroke with pre-existing comorbidity diseases.
What is a stroke?
There are two categories of stroke — hemorrhagic and Ischemic. Hemorrhagic is when a blood vessel in the brain is leaking or bursts, causing internal bleeding within the enclosed area of the skull where the brain is housed. An Ischemic stroke is an interruption of blood flow to the cerebral arteries. Blood carries oxygen and oxygen is delivered through the circulatory system. The cerebral arteries are the vessels that deliver oxygen to our brain cells. When blood supply to the brain cells is blocked or reduced the cells begin to die in minutes.
Stroke symptoms include slurred words or difficulty speaking, numbness, weakness or paralysis often on just one side of the body (depending on the location of the stroke), mouth or facial droop, sudden blurred vision in one or both eyes, severe headache accompanied by severe vomiting and dizziness, sudden difficulty walking, or sudden difficulty with balance or coordination.
By the numbers
Closing the prevention gap is of enormous consequence to Americans. Every year, more than 795,000 people in the U.S. have a stroke.
• 600,000 residents have a first stroke and 200,000 have a recurrent event.3
• Nearly 160,000 will die because of stroke, making it the fifth leading cause of death.3,4
• Someone in the U.S. has a stroke every 40 seconds.
• Every 4 minutes, someone dies of stroke.
The probability of having a stroke over the age of 60 increases as a person ages.
What is your risk?
General risk factors include age, race/ethnicity, sex (men have a higher risk than women), hormones, underlying diseases such as diabetes, high blood pressure, obesity and high cholesterol, but vary based on the specific type of stroke.
Risk factors for Hemorrhagic stroke include high blood pressure (often called the silent killer), blood thinners, head trauma, protein deposits over time in the brain vessels leading to blood vessel weakness.
Risk factors for Ischemic stroke include overweight/obesity, heavy drinking, use of illegal drugs, physical inactivity, cigarette smoking, high cholesterol, diabetes, sleep apnea, family history of stroke, heart attack, COVID 19 infection.
For women in particular, hormonal shifts and drop in hormones during the phases of menopause (pre/peri/post), can affect other hormones that control metabolism and water/sodium regulation in the body.
The changes in the hormone levels can affect the body in a variety of ways. For example, a drop in women hormone levels can affect the body including weight gain, increase in blood cholesterol levels, decrease in insulin sensitivity, interrupted sleep, anxiety and depression and restlessness, all of which can play a role in women’s risk for strokes.
What can you do to help prevent stroke?
Lifestyle modification such as increasing physical activity, eating fewer fried foods to lower cholesterol, eating fewer processed foods containing high sodium that can impact blood pressure, increasing water consumption to ensure the blood is not thick and viscous, quitting smoking and decreasing alcohol consumption are all recommended to help improve health and reduce stroke risks.
Those concerned should talk with their health care provider to determine their risk factors and to make a plan for addressing those risks and improving health. Individual patients’ pre-existing disease conditions, lifestyle behaviors, mental health challenges and daily nutritional habits are important to share during conversations with health care providers.
Editor’s note: Dr. Raelene Brooks is dean of the College of Nursing at the University of Phoenix. Reader reactions, pro or con, are welcomed at AzOpinions@iniusa.org.
