June is Stroke Awareness Month - June 2017

By The Heart and Stroke Foundation

healthy photoAccording to the Ontario Stroke Network, stroke is the leading cause of adult disability in Canada and the third leading cause of death. Every year in Canada, one person experiences a stroke every 10 minutes. About 426,000 Canadians are living with the effects of stroke. Would you be able to tell if you or someone else is having a stroke? Do you know if you are at risk for having a stroke? These are both important questions to ask yourself.

What is a stroke?
A stroke happens when blood stops flowing to any part of your brain, damaging brain cells. A blood vessel in the brain is blocked or bursts, so the blood that carries oxygen does not make it to the brain and parts of the brain start to die. The damage to the brain can begin within minutes, so the important thing is to know the symptoms of a stroke and act FAST. Many people don’t know they are having a stroke and may feel that they are simply having a bout of dizziness. Lack of action can result in physical or sensory disability. The effects of a stroke depend on the part of the brain that was damaged and the amount of damage done. For example, a stroke on the left side of the brain may result in vision loss and lasting muscle weakness or paralysis on the right side of your body, while a stroke on the right side of the brain may result in hearing impairment and lasting muscle weakness or paralysis on the left side of the body. An easy way to remember the signs of a stroke is by using the FAST mnemonic.

F - FACE drooping (Is there drooping or numbness on one side of your face? Is your smile uneven?)
A - ARM weakness (extend both arms out and hold to see if one drifts downward)
S - SPEECH difficulty (Is your speech slurred or otherwise difficult to understand?)
T - TIME to call 9-1-1

Stroke is a medical emergency. Do not drive yourself to the hospital – get an ambulance to take you to the hospital for stroke care.

Delaying medical treatment
Unfortunately, people may experience symptoms but because the symptoms go away they do not act on them. In this case, they may have had a Transient Ischemic Attack, or a mini-stroke. People will ignore the signs of a stroke because they question if they are real. The bottom line: listen to your body and trust your instincts. If you feel “off” seek medical attention right away. If a stroke is diagnosed quickly then medicines can be used to help you recover better. For ischemic stroke, a clot-busting drug called tPA (tissue plasminogen activator) can be effective for up to 4.5 hours after symptoms appear, but the earlier you receive it, the better the outcome. The Heart and Stroke Foundation provides an Emergency Checklist in the event of a stroke. Visit their website for more information about stroke, its treatment and prevention. You can also watch a video on the signs of a stroke.

Researchers at the University of Kentucky Stroke Center looked at 736 admissions for stroke and determined that at least 40 percent of these persons had balance and vision disturbances, and 14 percent of admissions did not show the FAST signs. This research is published in the January issue of the journal Stroke.  Including gait/leg and visual symptoms leads to a reduction in missed strokes. If adding B for 'balance' and E for 'eyes' is validated in a prospective study, it would suggest revising FAST to include BE FAST. The Icahn School of Medicine at Mount Sinai agrees.
B - BALANCE and gait problems (Is there a sudden loss of balance or coordination? You can ask the person to walk in a straight line or ask them to touch their finger to their nose)
E - EYES - sudden onset of visual problems (Is there a sudden vision change e.g., double vision, or loss of vision in one eye?)

What are the risk factors for having a stroke?
The National Institutes of Health explains that certain traits, conditions and habits can increase the risk of having a stroke. The more risk factors you have, the higher the risk of having a stroke. Some risk factors are controllable, and others are not.
The major risk factors:
  • High blood pressure - this is the main risk factor for stroke for both men and women, doubling or even quadrupling the risk of stroke if not controlled. Have your blood pressure checked and keep it in check to reduce your risk of stroke.
  • Chronic conditions such as diabetes, high blood pressure and heart disease (e.g., coronary heart disease, cardiomyopathy, heart failure, and atrial fibrillation can cause blood clots that can lead to a stroke).
  • Brain aneurysms or arteriovenous malformations (AVMs) – aneurysms are balloon-like bulges in an artery that can stretch and then burst.
  • Smoking - can damage blood vessels, raise blood pressure, and reduces the amount of oxygen that reaches tissues in the body.This includes avoiding second hand smoke.
  • Age and gender - your risk increases with age.  At younger ages, men are more likely to have a stroke but women are more likely to die from stroke. Women taking birth control pills are at slightly higher risk of stroke.
  • Race and ethnicity - First Nations/Aboriginal peoples and persons of Hispanic and South Asian descent have higher rates of high blood pressure and diabetes, and these conditions can lead to stroke.
  • Personal or family history of stroke or TIA - if you have had one stroke, you are at higher risk for having another stroke.
Other risk factors (both controllable and uncontrollable)
  • Alcohol and illegal drug use (Cocaine, amphetamines)
  • Medical conditions such as vasculitis (inflammation of the blood vessels) and bleeding disorders
  • Lack of physical activity. By not being active, you double the risk of stroke as well as increased risk of other conditions, such as diabetes, cancer and dementia.
  • Overweight and obesity
  • Stress and depression
  • Unhealthy cholesterol levels
  • Unhealthy diet
  • Medications, such as NSAIDS, but not aspirin, may increase the risk of heart attack or stroke, particularly in persons who have had a heart attack or cardiac bypass surgery.
While you cannot change some risk factors, knowing that you may be at increased risk makes you more aware of the symptoms. It is also a good idea to communicate your increased risk to family and friends, so that they are also aware of the symptoms and can support you to seek prompt medical attention.  

Prevention of strokes is key as eighty percent of strokes are preventable.
  • Do not smoke and keep away from second hand smoke.
  • Limit alcohol to daily limits of two drinks per day for men and one drink per day for women.
  • Manage your weight as being overweight increases chance of developing high blood pressure, heart problems, and diabetes.
  • Do 150 minutes of moderate- to vigorous-intensity activity each week (e.g., brisk walking 30 minutes a day). According to WebMD, women who walk 30 minutes a day may cut their risk of stroke by between 20 to 40 percent. A 'brisk' walk is where you increase you heart rate in order to strengthen your heart and reduce blood pressure.
  • Eat a heart healthy diet high in fruits, vegetables, high-fibre foods and foods low in sodium, saturated fat, trans fat, and cholesterol. Eat fish twice a week, especially fish high in Omega-3 fatty acids (e.g., salmon, mackerel, lake trout, herring and sardines).
  • Reduce the salt in your diet to no more than 1,500 milligrams a day (about a half teaspoon).
  • Assess your stress levels and take action to address stress such as using relaxation techniques, practicing mindfulness or and exercising.
Find out about your personal risk for a stroke by completing the Heart and Stroke Foundation’s Risk Assessment Tool, a 7 minute online questionnaire.

Resources for persons who have had a stroke include:
  • The Heart and Stroke Foundation website
  • The Stroke Recovery Association of BC website
  • University of Victoria's Chronic Conditions Self-Management Program is a no-cost six session workshop for people living with any type of chronic health condition. Participants gain knowledge, skills and confidence to manage the day to day challenges of living with stroke and other chronic health conditions. An online program is also available. For more information, visit the website www.selfmanagementbc.ca
Source: Ontario Stroke Network website, Heart and Stroke Foundation website, Mayo Clinic website, WebMD website, American Stroke Association website, National Institutes of Health website

The Heart and Stroke  FoundationThe Heart and Stroke 's Bio: The Heart and Stroke Foundation, a volunteer-based organization, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy. Okanagan Area Office: 4-1551 Sutherland Ave, Kelowna BC V1Y 9M9, Phone: 250-860-6275 - The Heart and Stroke Foundation Website - Email

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