"Brain Attack:" How YOU Can Reduce Your Risk for Stroke

Max Rudansky, M.D., FACP

Attending a stroke conference at Harvard Medical Center a couple of years back, I heard a very striking metaphor by Dr. Martin Samuels: “As the winning strategy in baseball is to keep the runner off second base, the winning strategy in life is to get through it without having had a stroke!”
Stark but true!
In the United States an excess of 780,000 new and recurrent strokes occur each year, more often than not resulting in significant physical, cognitive, and emotional disabilities for the victim of stroke, as well as economic and psychological hardship for family and friends. That’s the discouraging news.
Now for the encouraging news: stroke is largely due to lifestyle choices well within one’s realm of mastery. Thoughtful collaboration with one’s internist and neurologist to address remedial medical risk factors can dramatically turn the tide to your favor!

First and foremost, stroke is about YOU and without YOUR healthy lifestyle choices the “genie is out of the bottle.” Specific recommendations include:
o Mediterranean Nutrition and “brain healthy” micronutrients: fruits and vegetables, cruciferous and green leafy vegetables as well as citrus fruits, B complex, omega 3 FA, and carotenoids
o Daily aerobic exercise
o Maintaining a BMI (body mass index) of less than 25
o Restorative sleep and evaluating for sleep apnea (even if you don’t snore)
o De-stressing and maintaining a positive emotional balance
o Good dental hygiene
o Throw out the cigarettes or get involved in a smoking cessation program...Today!
o Enjoy your one or two glasses of alcohol daily, not more

Secondly, work together with your internist and neurologist to proactively address stroke risk factors:
o Hypertension: getting serious about treating even “mild” hypertension. The goal is less than 130/85
o Hyperlipidemia: cholesterol and triglycerides, LDL—make sure you are in a healthy range
o Diabetes and the “metabolic“ syndrome—control for risk factors
o Cardiac conditions that predispose to stroke; i.e., atrial fibrillation

Taking a chapter from our medical and cardiology colleagues whose preventive efforts have dramatically reduced the risk of heart disease, neurologists are in the trenches working with patients to comprehensively assess, educate, and treat patients’ risk for stroke.
To date the results have been resoundingly positive when patient and physician team up to keep the runner off second base!
Though stroke, or the better suited term, “brain attack” oftentimes presents with sudden and dramatic change in neurological function such as difficulty expressing oneself, weakness, incoordination or numbness on one side of the body, loss of vision in one eye (as if a shade is being drawn), gait imbalance, double vision, vertigo, slurred speech, and so on, there are more subtle effects on memory and behavior due to the cumulative burden of small vessel disease or hardening of the arteries. These can be equally devastating and are often times misdiagnosed as dementia or depression. They require the same thoughtful and focused neurological assessment that is recommended for the more typical stroke presentations.
Work with your physicians to educate yourself on the interplay of individual health factors in your own personal risk “scorecard.” By taking small, easy steps and making healthy lifestyle choices, you can and will make a big impact on reducing your risk factors.