Stroke is a very serious problem that develops when there is an interruption in the flow of blood to the brain. Also known as cerebrovascular accidents or "brain attacks", there are two main types of strokes. If a blood vessel is blocked by clots or other particles, it is called an ischemic stroke. If a blood vessel breaks and bleeds, it is called a hemorrhagic stroke.
Blood carries oxygen and nutrients to the brain. When blood flow to part of the brain stops, that part of the brain starts to die within minutes. The dying cells then release chemicals that can damage other cells. The effects of a stroke depend on which part of the brain is starved of blood and for how long. Because of this, it is very important that anyone showing symptoms of a stroke (see below) get medical treatment as soon as possible.
Related to strokes are episodes called transient ischemic attacks (TIAs). A TIA (often called a "ministroke") is caused by a short interruption in blood flow to the brain. The effect, though, is only temporary, and symptoms last less than 24 hours. However, a TIA can be an important warning sign because about one third of people who have a TIA will have a stroke in the future. Anyone who experiences a TIA should see their doctor immediately to learn about special steps (including possible medications and surgery) that can decrease the risk of a future stroke.
Use of certain kinds of street drugs, like cocaine, amphetamines and heroin, also increases the risk of stroke.
How common are strokes?
Stroke is the third leading cause of death, after coronary heart disease and cancer. Each year there are about 600,000 strokes in the US, and strokes kill over 150,000 Americans each year. Over 15% of people who have had a stroke die within 30 days, and 15-30% of people who survive a stroke are permanently disabled.
Who is at risk for having a stroke?
Anyone can have a stroke but most people who have strokes are over the age of 55. Strokes affect both men and women. African Americans tend to be at highest risk, but people of all races and ethnicities suffer from strokes.
How can you prevent a stroke?
There are many things you can do to reduce your risk of stroke: don't smoke keep your blood pressure under control stay physically active if you have diabetes, treat it eat a healthy diet that focuses on fruits, vegetables, and whole grains maintain a healthy weight keep your blood cholesterol under control avoid illegal drug use
Who should be screened?For people without symptoms, there are no good screening tests for predicting stroke. Your doctor may do an exam to listen for partial blockage of the vessels in your neck that supply blood to your brain. If you have any symptoms of blocked blood vessels or special risk factors, your doctor may want to do other tests to study the vessels. Anyone who develops such symptoms (see below), should see a doctor immediately.
People of all ages should be periodically screened for risk factors of stroke: diabetes, high blood pressure, poor blood cholesterol levels and overweight/obesity.
What are the symptoms of a stroke?Sudden changes in your strength or sensation could indicate a transient ischemic attack or a stroke. If you experience any of the symptoms below, see a doctor immediately. Every minute is important when it comes to limiting damage and saving brain cells.
Symptoms of stroke:
Sudden weakness or numbness in your face, body, arms or legs, especially if only one side is affected Sudden loss of vision or problems seeing in one or both eyes Sudden confusion, inability to speak or understand what others are saying Sudden dizziness, instability or inability to stand, walk or coordinate movement Sudden severe, unexplained headache
Friday, December 7, 2007
Men With High Blood Pressure Who Drink Moderate Amounts of Alcohol May Have a Lower Risk of Heart Attack
Boston, MA -- Hypertension affects some 65 million people in the United States, making it a massive public health burden. It’s associated with a twofold increased risk of cardiovascular disease (CVD) and total mortality. Studies have shown that moderate consumption of alcohol, up to a limit of one to two drinks a day, may decrease the risk of CVD and total mortality. Drinking more than two drinks a day, however, may increase the risk of hypertension.
Previous studies that looked at the relationship between hypertension and CVD mortality showed a link between moderate consumption and lower CVD mortality in individuals with hypertension. But no prior studies had examined whether moderate consumption was associated with non-fatal myocardial infarction (MI), such as a heart attack or stroke, and none had repeatedly collected information on individual drinking habits. In a new, long-term study, researchers at the Harvard School of Public Health (HSPH), Beth Israel Deaconess Medical Center and Dutch research institute TNO Quality of Life and Wageningen University, the Netherlands, found that, among hypertensive men, moderate alcohol consumption was associated with a decreased risk of fatal and non-fatal heart attack. The researchers also found that rates of stroke and death from heart disease and all causes did not differ for hypertensive men who drank moderate amounts of alcohol and those who drank no alcohol.
“This was the first study to our knowledge that examined the risk of heart attacks among men with high blood pressure who drank moderately. Because excess alcohol intake clearly increases blood pressure, many men with hypertension are counseled not to drink, but our results suggest that may not be necessary if men drink safely and responsibly,” said lead author Joline Beulens, a PhD-fellow at TNO Quality of Life and Wageningen University and a visiting scholar at HSPH when the study began.
The study appears in the January 2, 2007, issue of the Annals of Internal Medicine.
The researchers analyzed data from 11,711 hypertensive men from the Health Professionals Follow-Up Study, which was launched in 1986. Every four years, participants filled out a survey and noted the frequency with which they drank beer, red wine, white wine and liquor. Cases of non-fatal MI, fatal heart disease and stroke were documented from 1986 to 2002.
The results showed that, during that time span, 653 cases of total MI were documented, 279 fatal and 374 non-fatal. The authors found that consuming one to two drinks a day was associated with a decreased risk of fatal and non-fatal MI. No association was observed between alcohol consumption and risks of cardiovascular and total mortality. The study also investigated whether men changed their alcohol consumption after hypertension was diagnosed and whether specific alcoholic beverages or number of drinking days per week influenced the risk of heart attack.
Prior research has shown that one way alcohol consumption decreases the risk of heart disease is by increasing the levels of HDL cholesterol and possibly thinning the blood. Although those mechanisms were not the focus of this study, the relationship between alcohol drinking and lower heart attack risk remained after accounting for many differences between drinkers and non-drinkers, including their diet, physical activity and weight. Very light drinkers who consumed less than one drink every two to three days did not have lower risk than non-drinkers. However, because drinking three or more drinks a day increases blood pressure, it is important to adhere to the USDA guideline of one to two drinks a day or less.
The study’s limitations include that only male health care professionals participated, so it is not known whether the findings apply to women or men in different occupations.
“It is important for all individuals with high blood pressure to discuss their alcohol intake with their physicians, as heavy consumption, even occasionally, can raise blood pressure. However, our results suggest that men with high blood pressure seem to have the same lower risk associated with moderate drinking that other men do,” said Kenneth Mukamal, internist at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard Medical School.
The study was supported by grants from the National Institutes of Health, a travel grant from the Dutch Heart Association and a research exchange award from European Research Advisory Board.
Previous studies that looked at the relationship between hypertension and CVD mortality showed a link between moderate consumption and lower CVD mortality in individuals with hypertension. But no prior studies had examined whether moderate consumption was associated with non-fatal myocardial infarction (MI), such as a heart attack or stroke, and none had repeatedly collected information on individual drinking habits. In a new, long-term study, researchers at the Harvard School of Public Health (HSPH), Beth Israel Deaconess Medical Center and Dutch research institute TNO Quality of Life and Wageningen University, the Netherlands, found that, among hypertensive men, moderate alcohol consumption was associated with a decreased risk of fatal and non-fatal heart attack. The researchers also found that rates of stroke and death from heart disease and all causes did not differ for hypertensive men who drank moderate amounts of alcohol and those who drank no alcohol.
“This was the first study to our knowledge that examined the risk of heart attacks among men with high blood pressure who drank moderately. Because excess alcohol intake clearly increases blood pressure, many men with hypertension are counseled not to drink, but our results suggest that may not be necessary if men drink safely and responsibly,” said lead author Joline Beulens, a PhD-fellow at TNO Quality of Life and Wageningen University and a visiting scholar at HSPH when the study began.
The study appears in the January 2, 2007, issue of the Annals of Internal Medicine.
The researchers analyzed data from 11,711 hypertensive men from the Health Professionals Follow-Up Study, which was launched in 1986. Every four years, participants filled out a survey and noted the frequency with which they drank beer, red wine, white wine and liquor. Cases of non-fatal MI, fatal heart disease and stroke were documented from 1986 to 2002.
The results showed that, during that time span, 653 cases of total MI were documented, 279 fatal and 374 non-fatal. The authors found that consuming one to two drinks a day was associated with a decreased risk of fatal and non-fatal MI. No association was observed between alcohol consumption and risks of cardiovascular and total mortality. The study also investigated whether men changed their alcohol consumption after hypertension was diagnosed and whether specific alcoholic beverages or number of drinking days per week influenced the risk of heart attack.
Prior research has shown that one way alcohol consumption decreases the risk of heart disease is by increasing the levels of HDL cholesterol and possibly thinning the blood. Although those mechanisms were not the focus of this study, the relationship between alcohol drinking and lower heart attack risk remained after accounting for many differences between drinkers and non-drinkers, including their diet, physical activity and weight. Very light drinkers who consumed less than one drink every two to three days did not have lower risk than non-drinkers. However, because drinking three or more drinks a day increases blood pressure, it is important to adhere to the USDA guideline of one to two drinks a day or less.
The study’s limitations include that only male health care professionals participated, so it is not known whether the findings apply to women or men in different occupations.
“It is important for all individuals with high blood pressure to discuss their alcohol intake with their physicians, as heavy consumption, even occasionally, can raise blood pressure. However, our results suggest that men with high blood pressure seem to have the same lower risk associated with moderate drinking that other men do,” said Kenneth Mukamal, internist at Beth Israel Deaconess Medical Center and associate professor of medicine at Harvard Medical School.
The study was supported by grants from the National Institutes of Health, a travel grant from the Dutch Heart Association and a research exchange award from European Research Advisory Board.
Fruits and Vegetables, Blood Pressure, and Cholesterol
High blood pressure is a primary risk factor for heart disease and stroke. As such, it's a condition that is very important to control. Diet can be a very effective tool for lowering blood pressure. One of the most convincing associations between diet and blood pressure was found in the Dietary Approaches to Stop Hypertension (DASH) study. (3) This trial examined the effect on blood pressure of a diet that was rich in fruits, vegetables, and low-fat dairy products and that restricted the amount of saturated and total fat. The researchers found that people with high blood pressure who followed this diet reduced their systolic blood pressure (the upper number of a blood pressure reading) by about 11 mm Hg and their diastolic blood pressure (the lower number) by almost 6 mm Hg - as much as medications can achieve.
Eating more fruits and vegetables can also help lower cholesterol. In the National Heart, Lung, and Blood Institute's Family Heart Study, the 4466 subjects consumed on average a shade over 3 servings of fruits and vegetables a day. Men and women with the highest daily consumption (more than 4 servings a day) had significantly lower levels of LDL (bad) cholesterol than those with lower consumption.(4) How fruits and vegetables lower cholesterol is still something of a mystery. It is possible that eating more fruits and vegetables means eating less meat and dairy products, and thus less cholesterol-boosting saturated fat. Soluble fiber in fruits and vegetables may also block the absorption of cholesterol from food.
Eating more fruits and vegetables can also help lower cholesterol. In the National Heart, Lung, and Blood Institute's Family Heart Study, the 4466 subjects consumed on average a shade over 3 servings of fruits and vegetables a day. Men and women with the highest daily consumption (more than 4 servings a day) had significantly lower levels of LDL (bad) cholesterol than those with lower consumption.(4) How fruits and vegetables lower cholesterol is still something of a mystery. It is possible that eating more fruits and vegetables means eating less meat and dairy products, and thus less cholesterol-boosting saturated fat. Soluble fiber in fruits and vegetables may also block the absorption of cholesterol from food.
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