Last time, in Part 1 of our series on strokes, we talked specifically about the 3 presentations of brain damage: TIA-transient ischemic attack, damage that resolves in 24 hours; RIND-reversible ischemic neurologic deficit, damage that reverses itself, but takes more than 24 hours; and stroke-permanent brain damage. We also learned that the most common cause of these brain insults is the build up of atherosclerosis (plaque) in the carotid arteries, the main supply of blood to our brains.
The Effects of Atherosclerosis and Plaque Build Up in the Arteries
Atherosclerosis, or hardening of the arteries, is the most common medical problem in our society. It leads to blockage not only of arteries to the brain, but also heart arteries, leg arteries, kidney arteries and intestinal arteries. In fact, all arteries in the body can be affected. So it makes sense that the first step in prevention of stroke, is to cut down on the build up of plaque in our arteries-this of course will also help prevent heart disease, kidney disease, and peripheral artery disease [PAD] of all types.
Many of the factors that cause atherosclerosis are often factors that we can influence. Sometimes this involves a life-style change, but these factors can be influenced and the rate of plaque build-up in your arteries can be decreased. The most common factors include nicotine use, high cholesterol and fats, high blood pressure, excessive weight, lack of exercise, and diabetes.
People should work with their family physician and zero in on these factors and address them. I can tell you from personal experience that after 30 years of operating on hearts and peripheral blood vessels, over 95% of these patients had one or more of the above factors. Many of those patients had been seeing their family physician for routine check-ups.
Take Responsibility for Your Health to Reduce Your Risk of Stroke
So what to do? The most important thing to do is to do what is most important in most things in life. TAKE PERSONAL RESPONSIBILITY FOR YOUR HEALTH. Do not depend on anyone, including your doctor, to prevent hardening of the arteries. It must be a team effort. It is up to you to find a doctor who is competent and who can convince you that he or she is just as interested in preventing vascular disease in your body as you are.
Address the common factors listed above. Consider taking a baby aspirin every day. Consider taking fish oil daily. Know what your cholesterol and blood pressure are. Keep your diastolic pressure [the second of the 2 blood pressure readings] at 80 or lower-take medicines if necessary to reach this goal. Do not stop your medicine once you reach this goal. If you are diabetic, keep your hemoglobin A1C around 6. Keep your weight under control and eliminate nicotine.
Warning Signs of a Stroke
What if is too late? That is, if you or someone you know has already had a neurologic event. DON’T think it is too late and don’t ignore it. The most common TIA’s are sudden loss in the ability to speak, sudden paralysis or severe weakness in an arm or leg, or sudden blindness.
Remember, TIA’s and RIND’s are reversible and the biggest mistake people make is that they ignore these events. These events are warning signs and those warning signs read: STROKE is coming! See a physician do not ignore these signs. At the very least, a Doppler evaluation of the carotid arteries is needed. A visit to a vascular surgeon may be in order. If the event is a stroke, a carotid Doppler is still needed as well as a CT scan.
Taking responsibility for your vascular health may prevent or minimize neurologic damage and is the take-home message of this article.
Dr. Robert W. Ruess, MD, of Five Star Vein Institute, is a Board Certified Cardiovascular, Thoracic Surgeon and is also certified by the American Board of Phlebology. Call today to schedule a free vein screening at Five Star Vein Institute.