“What can you do to prevent stroke? Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke.

You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control—provided that you’re aware of them. Knowledge is power. If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk.  To prevent a stroke in your control is the following:

1-Control you B/P in therapeutic range.  An ideal goal is maintaining a blood pressure of less than 120/80. But there may be good reasons why you and your doctor will not want your readings to be this low. For some, a less aggressive goal (such as no higher than 140/90) may be more appropriate.

2-Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.  While an ideal body mass index (BMI) is 25 or less, that may not be realistic for you. Work with your doctor to create a personal weight loss strategy.

3-Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

Your goal: Exercise at a moderate intensity at least five days a week.

How to achieve it:

• Take a walk around your neighborhood every morning after breakfast.
• Start a fitness club with friends.
• When you exercise, reach the level at which you’re breathing hard, but you can still talk.
• Take the stairs instead of an elevator when you can.
• If you don’t have 30 consecutive minutes to exercise, break it up into 10- to 15-minute sessions a few times each day.

Harvard Health Publishing / Harvard Medical School (7 things you can do to prevent a stroke – Harvard Health)

Statistics to know about strokes:

Stroke was the third leading cause of death in the United States. Presently the CDC says under its statistics that Stroke is the fifth leading cause of death for Americans, but the risk of having a stroke varies with many factors.  Remember strokes have declined since 2003 based on CDC risk factors now compared to risk factors CDC listed in 2014.

More than 140,000 people die each year from stroke in the United States, that’s 1 out of every 20 deaths now.

Stroke costs the United States an estimated $34 billion each year.  This total includes the cost of health care services, medicines to treat stroke, and missed days of work.

Stroke is the leading cause of serious, long-term disability in the United States. Each year, approximately 795,000 people suffer a stroke.

About 600,000 of these are first attacks, and 185,000 are recurrent attacks. Nearly three-quarters of all strokes occur in people over the age of 65.  Stroke reduces mobility in more than half of stroke survivors age 65 and over.

The risk of having a stroke more than doubles each decade after the age of 55.

Strokes can & do occur at ANY age. Nearly one fourth of strokes occur in people under the age of 65.  Stroke risk increases with age, but strokes can—and do—occur at any age.

In 2009, 34% of people hospitalized for stroke were less than 65 years old.

Stroke death rates are higher for African-Americans than for whites, even at younger ages.

On average, someone in the United States has a stroke every 40 seconds.

Stroke accounted for about one of every 17 deaths in the United States in 2006. Stroke mortality for 2005 was 137,000.

From 1995–2005, the stroke death rate fell ~30 percent and the actual number of stroke deaths declined ~14 percent.  It still has declined from 2005 by CDC statistics which is good.

While stroke death rates have declined for decades among all race/ethnicities, Hispanics have seen an increase in death rates since 2013.

What is a Stroke?

A Stroke is a disease that affects the arteries leading to and within the brain. It is the No. 5 cause of death and a leading cause of disability in the United States.  A stroke occurs when a blood vessel which carry oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so this in the end causes brain cells to die.

There is a stroke noted as a mini stroke which is a transient (temporary) ischemic attack= TIA, which we went over last Friday.  If you want to review it go right ahead, its listed under 5/08/2020 article.  A TIA is different than  strokes.  First some call it a mini stroke but remember the symptoms of a TIA are similar to stroke symptoms listed below for actual strokes; the difference for the patient is that they are completely reversible.  Take angina for example, in this case the pt has the heart affected but the symptoms are completely reversible, just a different organ.  The organs (the heart for angina and the brain for TIA) are simply having the symptoms of an infarction of the organ that is involved but both are due to lack of 0xygen, called ischemia.

Getting back to actual strokes lets review types of strokes.

There are 2 types of strokes:

Ischemic Stroke which are strokes that occur through an obstruction of blood flow by a clot called a thrombus.

Hemorrhagic stroke by a blood vessel rupturing and preventing blood flow to the brain.

In the case of a stroke its a infarction to the brain due to lack of oxygen to the organ we call the brain, only the symptoms are not reversible but they can decrease in the intensity of the damage the caused in time with treatment (PT and OT) in time.  For some the symptoms are almost completely gone, again it depends on the intensity of the stroke to the brain, how bad was it with the symptoms it caused.

What are the risk factors for a stroke?

Non modiafiable risks meaning you can’t change them are:

–Age:  Stroke occurs in all age groups.  Studies show the risk of stroke doubles for each decade between the ages of 55 and 85.  But strokes also can occur in childhood or adolescence.  Although stroke is often considered a disease of aging, the risk of stroke in childhood is actually highest during the perinatal period, which encompasses the last few months of fetal life and the first few weeks after birth.

-Gender:  Men have a higher risk for stroke, but more women die from stroke.  Men generally do not live as long as women, so men are usually younger when they have their strokes and therefore have a higher rate of survival.

-Race:  People from certain ethnic groups have a higher risk of stroke.  For African Americans, stroke is more common and more deadly—even in young and middle-aged adults—than for any ethnic or other racial group in the United States.  Studies show that the age-adjusted incidence of stroke is about twice as high in African Americans and Hispanic Americans as in Caucasians.  An important risk factor for African-Americans is sickle cell disease, which can cause a narrowing of arteries and disrupt blood flow. The incidence of the various stroke subtypes also varies considerably in different ethnic groups.

–Family history of stroke:  Stroke seems to run in some families.  Several factors may contribute to familial stroke.  Members of a family might have a genetic tendency for stroke risk factors, such as an inherited predisposition for high blood pressure (hypertension) or diabetes.  The influence of a common lifestyle among family members also could contribute to familial stroke.

Modiafiable Risk Factors meaning you CAN change them:

–High Blood Pressure (hypertension)

RX: DIET & EXERCISE & MEDS that a MD would decide.

–High Cholesterol

RX: DIET and if necessary MEDS that a MD would decide.

–Diabetes Mellitus

RX: DIET & EXERCISE & MEDS that a MD would decide.

–Cigarette Smoking

RX: QUIT

–Carotid Artery Disease

RX: DIET & EXERCISE & MEDS  even possible SURGERY that a MD would decide.

–Atrial Fibrillation

RX: DIET & EXERCISE & MEDS even possible SURGERY that a MD would decide.

–Unhealthy Diet   RX: DIET

–Physical Inactivity and Obesity

RX: DIET & EXERCISE & possibly even MEDS that a MD would decide.

Go to your DOCTOR before doing any program and let your MD tell you what type of a program would be best for you especially if you are diagnosed with disease (EX. Diabetes, Cardiac, etc…).

“Urothelial carcinoma accounts for the vast majority of bladder cancer cases in the United States, about 90%. It is sometimes called transitional cell carcinoma (TCC) because the urothelial cells from which it develops are also known as transitional cells. This is because they may expand when the bladder is full and contract when it is empty.

These urothelial (transitional) cells line the bladder and, as more cancer cells grow, they may form a cancerous tumor.

The exact cause of bladder cancer is not known, but researchers have identified some factors that may increase a person’s lifetime risk for developing this cancer.

These risk factors may be linked to DNA changes in the body, causing mutations in the parts of cells that control growth. These mutations change how bladder cells behave, allowing them to grow abnormally, which may cause cancer cells to form.

Gene changes that occur during a person’s life sometimes happen randomly, without a known cause. Other times, exposure to chemicals that cause cancer, such as tobacco smoke, may be what prompts cells in the bladder to mutate. About 50% of people diagnosed with bladder cancer have a history of smoking.”

City of Hope (What is Bladder Cancer & Its Causes | City of Hope)

“Finding cancer early, when it’s small and hasn’t spread, often allows for more treatment options. Some early cancers may have signs and symptoms that can be noticed, but that’s not always the case.

After a cancer diagnosis, staging provides important information about the extent (amount) of cancer in the body and the likely response to treatment.

Bladder cancer signs and symptoms may include:

• Blood in urine (hematuria), which may cause urine to appear bright red or cola colored, though sometimes the urine appears normal and blood is detected on a lab test
• Frequent urination
• Painful urination
• Back pain
• Feeling tired or weak (advanced)
• Swelling in the feet (advanced)
• Bone pain (advanced)”

American Cancer Society  (Bladder Cancer Signs and Symptoms | American Cancer Society)

“Bladder cancer is a common type of cancer that begins in the cells of the bladder. The bladder is a hollow muscular organ in your lower abdomen that stores urine.

Bladder cancer most often begins in the cells (urothelial cells) that line the inside of your bladder. Urothelial cells are also found in your kidneys and the tubes (ureters) that connect the kidneys to the bladder. Urothelial cancer can happen in the kidneys and ureters, too, but it’s much more common in the bladder.

Most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. But even early-stage bladder cancers can come back after successful treatment. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs.”

MAYO Clinic (Bladder cancer – Symptoms and causes – Mayo Clinic)

“According to a 2023 report, the prevalence of ALS in the United States is about 9.1 cases per 100,000 people.

“Amyotrophic lateral sclerosis (ALS) is a progressive neurological disorder that affects motor neurons in the brain and spinal cord, leading to the degeneration and death of these crucial nerve cells [1]. This fatal condition, often referred to as Lou Gehrig’s disease, causes a gradual loss of voluntary muscle control, impacting essential functions such as walking, talking, chewing, and breathing [2]. ALS typically manifests between the ages of 40 and 70,

Notably, ALS does not typically affect cognitive function, sensory perception, or bladder control [2]. While the exact cause remains unknown for most cases, approximately 10% are attributed to genetic factors, classified as familial ALS. The remaining 90% are considered sporadic, occurring randomly without a clear hereditary link [3]. Despite ongoing research, there is currently no cure for ALS, and the average life expectancy after diagnosis ranges from 3 to 5 years, although some individuals may survive for a decade or more [1].”

ALS United Ohio (ttps://alsohio.org/als-vs-ms-amyotrophic-lateral-sclerosis-vs-multiple-sclerosis/)

“ALS is a progressive disease in which a person’s brain loses connection with the muscles, slowly taking away their ability to walk, talk, eat, and eventually breathe. There is no cure for ALS, but there is hope.”

ALS Association (May is ALS Awareness Month | The ALS Association)