The following is in partnership with Dr. Steven Goins and Stroke Awareness Oregon
1. High blood pressure greatly increases the risk of stroke and heart attack but is treatable.
Your blood pressure should be below 130/80. If you need to be on blood pressure medicine, is very important that you take your medicine correctly and closely work with your doctor. Being on blood pressure medicine will result in:
- 50% relative risk reduction in the incidence of heart failure
- 30-40% relative risk reduction for stroke
- 20-25% relative risk reduction for myocardial infarction
2. The bad effect of cholesterol in arteries begins during our teens but it is affected by lifestyle choices.
Some common attributes of increased cholesterol levels include:
- Even slightly elevated blood pressure.
- Even mildly elevated cholesterol levels.
- Tobacco use.
- Elevated, prediabetic glucose levels.
Any of these will lead to more rapid cholesterol related damage to your arteries.
3. Doctors often recommend treatment with a statin.
These drugs lower cholesterol damage by two ways:
- Lowered production of new cholesterol by our liver is the main source of cholesterol rather than diet.
- Actual regression of the cholesterol related atherosclerotic plaques and reduction of the plaque inflammation which leads to clots.
For patients with a previous stroke, treatment with statins can reduce the risk of second stroke by 24%. For patients with previous heart attack or coronary artery disease, treatment with statins can lead to 42% reduction of future fatal heart attack.
4. If you are 65 years or older, you should know about each of fibrillation, which causes up to one third of all strokes.
There are 700,000 people in the United States with undiagnosed atrial fibrillation. Most of them have no symptoms. Each of them has a 2-5% chance of having a major stroke each year unless they are treated with special anticoagulant medications.
If you’ve ever had atrial fibrillation and are not taking anticoagulant medication, you should know your CHA2DS2-VASc score. By using simple web tools, it only takes a minute to determine your stroke risk. It is recommended that you discuss this with your doctor. Be aware that there are now ways to self-monitor for a fibrillation with inexpensive devices such as Kardia or wearable devices such as the Apple Watch.
5. Remember F.A.S.T.
Face. Is the person’s face crooked or asymmetric? Ask them to smile or frown. Look for flattening of the nasolabial fold. The forehead is usually not affected.
Arm. Is one arm weaker? Ask them to raise both arms quickly. The weak arm will react slower. The person may be unable to keep the arm elevated at shoulder level or even raise it at all. The person’s hand may be affected so they may have a weak grip or show slower finger motion.
Speech. Can they understand you are saying? Ask them to close their eyes or make a fist. They may not be able say names of common objects or even names of their family or their speech is slurred. They may understand you but they may not reply in a comprehensible manner. Ask the person to repeat an easy phrase such as “I live in Oregon” or “it is a sunny day”. They should be able to say every word perfectly. No slurring. No dropped words.
Time. Call 911 immediately. This will activate the EMS as well as the receiving emergency department stroke team. Driving the person yourself to the hospital or calling the doctor or nurse will waste valuable time.
In the event of a stroke, remember these important reminders:
- Do not give aspirin. This may worsen a brain hemorrhage.
- Be able to tell the paramedics when the person was last seen normal. This means when the victim was awake and talking and functioning normally. It is not mean when they were discovered. This information may be crucial for the patient to qualify for treatments.
- Be able to tell the paramedics if the patient is taking any blood thinners such as warfarin (Coumadin), apixaban (Eliquis), rivaroxaban (Xarelto) or dabigatran (Pradaxa). If possible, collect the person’s medication bottles or provide a medication list for the EMS responders.