Historically, most strokes occurred in people over the age of 65, but according to the U.S. Centers for Disease Control and Prevention (CDC), nearly one fourth of strokes now occur in younger people. The National Stroke Association reports that during the past decade the number of young Americans hospitalized due to stroke has risen by 44 percent and that 15 percent of ischemic strokes (the most common type in which blood supply is cut off to part of the brain) have occurred among young adults and adolescents. It’s believed that this increase is due largely to obesity-related lifestyle risks, including high blood pressure, diabetes and high-cholesterol. (CDC data indicate that 35.7 percent of younger adults are obese.) The risk of stroke is also higher among patients who suffer from migraine with aura. In the U.S. the risk of stroke and stroke deaths is highest in the southeastern states and Mississippi Valley.
Ischemic strokes occur when a blood vessel supplying the brain is occluded, often preceded by the buildup of plaque in the carotid arteries, the main arteries in the neck that supply blood to the brain. This is a consequence of atherosclerosis, often related to high serum cholesterol, which can also impair blood flow through the coronary arteries. A blood clot forming in, traveling through, or blocking a carotid artery (or even the dislodging of carotid plaque that travels toward the brain and blocks its blood supply) can cause a stroke.
The risk factors for stroke include high blood pressure, diabetes, smoking and high cholesterol, all of which impact circulation and vascular health and contribute to plaque and clot formation. A history of atrial fibrillation (a potentially serious abnormal heart rhythm); clotting disorders, and the use of estrogen replacement therapy and birth control pills can also increase risk.
Here are the most important things you can do to help lower your risk of stroke:
- Control your blood pressure, either through lifestyle changes or medication.
- Exercise regularly (people who do so consistently have a lower risk of stroke).
- If you smoke, quit.
- Limit alcohol intake to no more than one drink per day for women and two drinks per day for men.
- If you are a diabetic, keep tight control of blood sugar and cholesterol levels.
The warning signs of stroke include drooping or numbness on one side of the face (such as an uneven smile), weakness or numbness in one arm (if one arm drifts down when both are raised), and slurred speech. (See if the affected individual can correctly repeat a simple sentence like “the sky is blue,”) If any of these are noted, call 9-1-1 and have the individual transported to a hospital immediately. Other signs of stroke are sudden numbness or weakness of the leg, arm or face, sudden confusion or trouble understanding speech, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination and sudden severe headache with no known cause. Here, too, call 9-1-1 and get the individual to a hospital.
Andrew Weil, M.D.
Majid Ezzati et al “Global and regional burden of stroke during 1990—2010: findings from the Global Burden of Disease Study 2010,” The Lancet, doi:10.1016/S0140-6736(13)61953-4