Five Risk Factors for StrokeJul 1, 2014
Tom Miller: Stroke risk factors and do you have one? We're going to talk about that next on Scope Radio. This is Dr. Tom Miller.
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Tom Miller: I'm here today with Dr. Daniel Dewitt who is a professor in neurology, and a specialist in multiple sclerosis care. Dana, what are the major risk factors for stroke?
Dana Dewitt: High blood pressure, smoking, high cholesterol, diabetes, cardiac disease, particularly atrial fibrillation, and obesity.
Tom Miller: All of the main problems that I seem to be treating is an internist in many patients. Over time, that can lead to stroke. After years, right? Is that right
Dana Dewitt: Yes.
Tom Miller: It doesn't happen right away.
Dana Dewitt: You know we did talk a little bit about how there are a couple things you can't control that are risk factors. One, age. Stroke is obviously more prevalent as you get older. But, part of the problem there is that you may have had years of the stroke risk factors that have been occurring over time and have been untreated. The other is genetics. And there is a genetic risk, there's no question about that. But, sometimes that even is a risk of hyper-tension, or a risk of high cholesterol. All of which can be treated.
Tom Miller: What's the average age of stroke in men or women? When do they usually occur? 30's, 40's, 50's 60's?
Dana Dewitt: Over 60's would be, you know, most prevalent and above. Again, we can see stroke occasionally in young people, but the causes are very different. What we see is that patients over many years have had untreated hyper-tension, or have been smokers and haven't stopped, or may have high cholesterol and don't know it. And these are patients who really need to be aware of what these risk factors are and how they clearly put them at high risk for having a stroke.
Tom Miller: So, the issue for me is the stroke, or heart attack, is the culmination of many years of these problems on-going. They turn the arteries in the body into solid pipe like structures. That really lead to damage in the end.
Dana Dewitt: That's correct. Patients with high blood pressure, their little blood vessels become very fragile. And they can burst or they can clog.
Tom Miller: Due to high blood pressure, generally?
Dana Dewitt: Due to high blood pressure, just high blood pressure alone. We do know, also, that patient who have stroke, actually, most often die of myocardia infarction, which is a heart attack. And, so the arteries in the brain are being affected, but the arteries in the heart are being affected as well by the same risk factors.
Tom Miller: I mean, the image that I have is a person with high blood pressure, high cholesterol and perhaps diabetes, and what's happening is - and it's not a very flattering picture, but they have little pieces of material break off the inside of the arteries and float up into the brain and cause the irreversible damage, sometimes.
Dana Dewitt: They do. They can break off of the hardening of the arteries, arteries in the neck. They can occur in the brain as well with blood vessel blockages. Again, the heart becomes damaged by the same processes and can cause irregular heart beats that form clots, that break off and go to the brain.
Tom Miller: My main message to patients that may be listening or relatives that have patients that have had a stroke is, start now. Find out what your risk factors are. Know if you have hyper-tension and do something about it. And if you smoke, find a way to quit. And remember, quitting smoking sometimes takes as many as 7 tries in order to effectively quit. There are ways to get by this, but you have to start early and you got to-it's a life long effort to maintain healthy body and healthy life style. Yes, we have medications to treat many of these things, but at the base of it is, stay in shape, keep the right weight, monitor your health, and that will reduce your risk of stroke. Would you agree with that Dana?
Dana Dewitt: Totally.
Tom Miller: Dana, is there anything you would like to add to that. The main thing, as you mentioned, is to have a primary care physician who monitors your health and know what your blood pressure is, and know what your cholesterol is. And again, high on the list is, if you're a smoker, you've got to stop. And at the end of the day, this could make a difference in helping you to prevent having a stroke.
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