|Carolyn D. Brockington, MD|
It’s well established that the African-American community has a higher incidence of stroke—as well as death related to stroke. In addition, strokes are more severe in women, and the mortality rate one month after a stroke is higher among women than men. While race and gender are non-modifiable risk factors, there are many steps you can take to greatly reduce your chance of having a stroke.
Remember that prevention is key. For this reason, we’ve held a number of outreach events in New York City—at churches involving the African-American community and in Times Square—where people can learn about their own risk factors, have their blood pressure taken and gather information to share with family and friends.
Undoubtedly, the word “stroke” is scary. Nobody wants to think they could suffer a stroke and end up with a disability. We want to get the word out that many people who suffer strokes are able to return to being functional, happy people.
Nonetheless, we must emphasize the importance of prevention and quick response to stroke. Thus we talk about two key issues when it comes to stroke: First, what to do immediately if a stroke occurs; and second, what are the best ways to minimize your chances of having a stroke to begin with.
An important phrase to remember is “time is brain.” In other words, with every moment that goes by after a stroke, the brain can become irreversibly injured. So if a loved one develops signs or symptoms of a stroke, it’s an emergency. You should call 911 right away so the patient can be taken to the closest hospital.
There has been tremendous growth in treatment of stroke in recent years, and today there are advances in acute therapy—namely, intravenous t-PA and the ability to go into the blood vessels of the brain with catheters to give blood thinning medication and remove blood clots—that can drastically change a patient’s outcome. But only a short window of time exists to provide treatment: only three hours from the first sign of stroke symptoms.
When you think a stroke may have occurred, think of the acronym “FAST”: Face (does one side droop?), Arms (does one drift downward when raised?), Speech (does it sound slurred or does the person have difficulty expressing themselves or understanding you?), Time (if you see any of these symptoms, call 911 immediately to go to the closest hospital with a stroke center). So that is how to react when a stroke occurs.
The other critical knowledge is how to minimize your chances of having a stroke. We say that up to 80 percent of strokes can be prevented if people identify and modify their own risk factors. This goes for all races, men and women, young and old.
Genetics play a large role, and if someone has a strong family history of stroke, that’s a non-modifiable risk factor. And like the African-American community, the Hispanic community has a high incidence of stroke and mortality related to stroke.
With that knowledge, we must focus on the factors that we can modify:
1. Blood pressure: High blood pressure should be identified and controlled.
2. Diabetes: High blood sugar that’s not controlled well may cause corrosion of the arteries, reducing the amount of
blood flow over time.
3. Heart disease: A history of heart disease can increase the risk of stroke.
4. Smoking: Cigarette use is a huge risk factor for stroke and heart disease.
5. Cholesterol: Build up in the arteries can lead to stroke.
Addressing these risk factors may greatly diminish your chance of stroke. The bottom line is, do what you can to prevent stroke, and act quickly if you suspect one has occurred.
In recent years, the public has learned a great deal about the warning signs of heart attack. It’s now widely known, for example, that if you begin to experience chest pain that radiates through the arm, you should to straight to the ER.
We’re trying to promote the same kind of education with the brain.
With every minute that goes by without enough blood flow, the brain can become irreversibly damaged. Remember, time is brain and strokes are now preventable, treatable and beatable.
Dr. Carolyn D. Brockington is the director of the Stroke Center at Mount Sinai St. Luke’s and Mount Sinai Roosevelt Hospitals in New York City.