Thursday, May 9, 2019

Reduce Risk for for “Silent Strokes”

Reduce Risk for for “Silent Strokes”

Reduce Risk for for “Silent Strokes”
by Stephanie Trelogan, Caring.com senior editor

In a report published in Stroke: Journal of the American Heart Association, researchers found that almost 11 percent of seemingly healthy, middle-aged study participants had some brain damage from one or more “silent” strokes. The researchers also found a correlation between silent stroke and cardiovascular risk factors, such as high blood pressure, atrial fibrillation, and thickening or partial blockage of the carotid arteries.

Also known as silent cerebral infarction, a silent stroke is a true stroke that causes actual brain injury without any noticeable symptoms. People who’ve had a silent stroke have a higher risk of having more strokes, and are more likely to suffer from vascular dementia later in life.

This finding may sound ominous, but the study’s authors point out the good news: Early detection and treatment of cardiovascular risk factors can decrease the risk of stroke. Besides those mentioned above, risk factors that can be controlled include smoking, diabetes, and heart disease.

For more on strokes, see 10 Ways to Help Prevent a Stroke.


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1. Control Blood Pressure
High blood pressure means a high risk of stroke. If one of your parents has been diagnosed with prehypertension (120/80 to 139/89) or hypertension (140/90 mm Hg or higher), his blood pressure should be treated. The doctor will prescribe the appropriate medications, but your parent’s blood pressure needs regular monitoring. Although it can be a bit tricky to use, an inexpensive manual cuff (starting at about $12 at your local drugstore) is a great way to monitor blood pressure at home. But if you can’t get the hang of using it, you may want to consider investing in a blood pressure machine, which is a bit more expensive (between $70 and $150); it’s also available at your local drugstore.

Next: Stroke prevention tip #2

2. Manage Stress and Depression
A parent’s emotional and psychological state can have a very real effect on his physical health. Minimizing stress, anger, and depression is an important aspect of maintaining good cardiovascular health and avoiding a stroke. If your parent lives by himself, he may feel disconnected and alone. Even if your parents still have each other, sitting around the house can lead to boredom and unhappiness. Help your parents get out, make new friends, or simply engage in stimulating activities. Their local church or community center is an excellent place to connect with other seniors.

Perhaps your parent is already a social butterfly but still seems to be having difficulty with his mood. Encourage him to try these stress-busting strategies:

Cut back on caffeinated beverages and alcohol.
Try meditation or yoga.
Play relaxing music.
Go for a walk outdoors.
If you’ve tried everything and still feel concerned about your parent’s mood, talk to his doctor. Depression is a serious but treatable illness.

Next: Stroke prevention tip #3

3. Reduce the Risk of Blood Clots
Ask your parents’ doctor about medications that can reduce their risk of developing blood clots. The most commonly recommended medication is aspirin, which is inexpensive and can be taken at a low dose (81 milligrams is the usual recommended dose). If your parents have other medical issues, the doctor may prescribe a more potent drug.

Next: Stroke prevention tip #4

4. Control Other Medical Conditions
If your parents have atrial fibrillation (an abnormal rhythm involving the upper two chambers of the heart), diabetes, heart valve disease, or vascular disease, they have a much greater risk of stroke. These medical conditions require careful management. Make sure their doctor knows about any such conditions and is treating them appropriately.

Next: Stroke prevention tip #5

5. Review Medications
Talk to the doctor about medications that might increase your parents’ risk. Hormone replacement therapy (HRT), rosiglitazone (for diabetes), and COX-2 inhibitors (for controlling arthritis pain) are all examples of medications that may increase your parents’ risk of stroke. Review their medications with their doctor and ask if there are less risky alternatives.

Next: Stroke prevention tip #6

6. Know the Early Warning Signs
According to the National Institute of Neurological Disorders and Stroke, one out of three people who have a transient ischemic attack (TIA) will suffer an acute stroke. Signs of a TIA, or ministroke, include:

Sudden numbness or weakness of the face, arm, or leg–especially on one side of the body
Sudden confusion, trouble speaking or understanding
Sudden trouble seeing out of one or both eyes
Sudden difficulty walking, loss of balance or coordination, dizziness

If you think your parent has suffered a TIA, notify his doctor right away so that he can be treated.

Next: Stroke prevention tip #7

7. Keep “Bad” Cholesterol Levels Low
One of the major risk factors for stroke is a high bloodstream level of LDL, or “bad” cholesterol. Ideally, your parent’s total cholesterol should be no more than 200 mg/dL (milligrams per deciliter) and no more than five times the level of HDL or “good” cholesterol; his LDL levels should be below 70 mg/dL. Make sure his cholesterol levels are checked regularly and treated if necessary. Following a low-fat diet and exercising regularly may help, but it might not be enough. If his cholesterol levels don’t respond to lifestyle changes, his doctor may prescribe medication.

Next: Stroke prevention tip #8

8. Follow a Heart-Healthy Diet
The best diet for preventing stroke is the one recommended by the American Heart Association. Choose a diet rich in whole grains, vegetables, fruits, fish, poultry, lean meats, and low-fat or fat-free dairy products.Your parent should limit intake of fat (total fat between 25 and 35 percent of daily calories, saturated fat less than 7 percent, and trans fat less than 1 percent), cholesterol (less than 200 milligrams per day if LDL levels are high, less than 300 milligrams per day if they aren’t), and sodium (less than 1,500 milligrams per day for high blood pressure, less than 2,300 milligrams per day otherwise). Your mother should consume no more than one alcoholic beverage per day, your father no more than two. And they should each eat 25 to 30 grams of dietary fiber every day.

Next: Stroke prevention tip #9

9. Encourage Regular Exercise
Exercise is essential for general cardiovascular health and is key to preventing a stroke. But how much exercise is enough? The Centers for Disease Control and the American Heart Association recommend accumulating at least 30 minutes of moderate-intensity physical activity at least five days a week on most days. This doesn’t mean your parents need to do half an hour of aerobics five days a week; instead, you can encourage short bursts of activity throughout the day. Just parking farther away from the store and walking the extra distance, or taking the stairs instead of the elevator, can quickly add up. But before your parents begin any exercise program, they should talk to their doctor about any restrictions they might have.

Next: Stroke prevention tip #10

10. Help them Stop Smoking
Smoking is one of the biggest risk factors for stroke. If your parents or anyone who lives in their home smokes, quitting is essential to good health. Just living with a smoker increases the risk of stroke by almost 30 percent. But recognize that stopping smoking isn’t easy. Here are a few ways you can help:

Ask your parents what they think would make it easier for them. They may have suggestions you haven’t thought of.
Encourage them to talk about their feelings and what they’re going through. Smoking may be a comforting lifelong habit; let them mourn a little.

You may be tempted to nag or yell if they slip up, but it’s more effective to remind them that you love them no matter what. Be positive and encouraging — and vent your frustration to a friend instead.

Help them avoid situations that trigger the desire for a smoke. If they’re used to enjoying a cigarette after meals, try going for a short walk outside instead.

Be understanding as they go through withdrawal symptoms. Try not to take it personally if they’re especially irritable, short-tempered, and tired.

Quit smoking yourself. If you must smoke, don’t smoke around your parents. Not only will it make quitting more difficult for them, but the secondhand smoke will increase their risk of heart attack.

If your parents find it too difficult to quit on their own, talk to their doctor. Nicotine replacement therapy, support groups, and counseling may all be helpful


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