Stay Aware of Your Risk for Stroke Year Round

Author: David Palestrant, MD, Medical Director, Spine & Brain Institute

May is Stroke Awareness Month which is why you are probably seeing more than the usual number of articles and public service announcements about this potentially life-threatening medical event. Stroke awareness, however, must be more than just a disease-of-the month topic. Continued awareness of how we can prevent strokes and recognize its symptoms is our best chance to guard ourselves and our loved ones against the destructive impact stroke could have on our lives.

Almost 800,000 people in the United States suffer a stroke every year. Every 40 seconds, someone has a stroke in this country; it is the leading cause of long term disability in the U.S.

The most common type is an ischemic stroke in which an obstruction in a blood vessel reduces or stops blood flow to the brain. A hemorrhagic stroke is when a weakened blood vessel in the brain ruptures. A third type of stroke — TIA (transient ischemic attack) is typically caused by a temporary clot. Typically considered warning strokes, they should be taken very seriously.

Although 80% of all strokes are preventable, some risk factors you cannot modify. For example, your risk for stroke increases as you age, although stroke can occur in young adults and children as well. The risk of stroke is 2X higher if you are African-American and 3X higher if one parent had an ischemic stroke before age 65.

The most important modifiable risk factor for stroke and intracerebral hemorrhage is hypertension. The risk of stroke increases progressively with increasing blood pressure. Three of four people who suffered a first stroke had high blood pressure.

Studies have shown that the risk of stroke is lower when your systolic blood pressure is below 140 mm Hg and diastolic blood pressure is below 90 mm Hg. Lower numbers than these may be even better and should be discussed with your physician. Here is where awareness of this risk factor is key. You can significantly reduce your risk of stroke by having regular blood pressure screenings, and with your physician’s help, adopting a combination of behavioral lifestyle modification and drug therapy measures. 

Talk to your physician about other modifiable stroke prevention measures, including smoking cessation, management of diabetes and high cholesterol, weight loss, treatment for depression, healthy lifestyle changes such as improved diet and nutrition and increased exercise.

Atrial fibrillation, a condition in which the heart beats unevenly or skips beats, carries a 4 to 5 times risk for ischemic stroke. Since atrial fibrillation often goes undiagnosed, be sure to ask your physician to screen you for this disease. Treatment for atrial fibrillation usually includes medication, and sometimes surgical procedures.

Several measures are also available to prevent second strokes or a major stroke in patients having one or more TIAs. These include antiplatelet therapy, use of antihypertensives, statins, and risk factor modification. Additionally, when arteries show plaque buildup or blockage, medical procedures such as carotid artery surgery or angioplasty/stents may be needed.

In addition to prevention, stroke awareness means being able to quickly and accurately recognize signs of a stroke and to get medical treatment as quickly as possible.

This year, the American Stroke Association has adopted an easy to learn and remember the acronym for stroke recognition and response.


F. Face drooping?

A. Arm weakness?

S. Slurred speech?

T. Time to call 911

If you’re having a stroke, it’s critical that you get medical attention right away. Time is brain and every minute counts when trying to save brain cells – and immediate treatment may minimize the long-term effects of a stroke and prevent death.

The “clot-busting” drug used to treat most ischemic strokes, tPA, must be administered within 41/2hours from onset of symptoms to improve your chances of recovery. The sooner the treatment starts the higher the chances of improving outcome

Doctors can also thread a catheter through an artery in the groin to the blocked artery in the brain and using a special device can “grab’ the clot and remove it. This procedure needs to be done within six hours of when stroke symptoms occur and may be used after tPA has been used.

Treatment for hemorrhagic stroke is similar to ischemic strokes, and while the window of time to start treatment is not as precise, stopping bleeding in the brain as soon as possible can decrease the damage the stroke may cause.

Two takeaways for stroke awareness month.

  • If you know your risk factors and can make modifications, you have a good chance of preventing a first stroke.
  • Memorize the F.A.S.T. acronym. Quick stroke treatment is vital to saving lives.