What Is a Stroke?
What Causes a Stroke?
Who Is at Risk for a Stroke?
Signs & Symptoms of Stroke How Is a Stroke Diagnosed? How Is a Stroke Treated?
Types of Stroke Stroke Prevention Life After a Stroke Clinical Trials
Lower Stroke Risk & Mini Stroke Treatment Health Guide
a good time to start preventing a stroke... A stroke is a medical emergency. Strokes and Mini-Strokes happen when blood flow to your brain stops. Within minutes, brain cells begin to die. There are two kinds of stroke. The more common kind, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain. "Mini-strokes" or transient ischemic attacks (TIAs), occur when the blood supply to the brain is briefly interrupted.
Symptoms of stroke are
- Sudden numbness or weakness of the face, arm or leg (especially on one side of the body)
- Sudden confusion, trouble speaking or understanding speech
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
If you have any of these symptoms, you must get to a hospital quickly to start treatment. Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot or by stopping the bleeding. Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage. Drug therapy with blood thinners is the most common treatment for stroke.
Cholesterol Lowering in Elderly Reduces Heart Disease and Strokes
Older Americans have the Nation's highest rate of coronary heart disease (CHD) and can benefit greatly from lowering elevated cholesterol, according to a new report from the National Cholesterol Education Program (NCEP). The report notes that cholesterol lowering also has been shown to reduce the risk of strokes.
NCEP is coordinated by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.
The report, which appears in an issue of the Archives of Internal Medicine, makes it clear the NCEP's stand on the controversial issue of cholesterol lowering in those age 65 and older.
"Some investigators have questioned the value of testing cholesterol and treating high levels in the elderly," said NHLBI Director Dr. Claude Lenfant. "But an overview of the research shows that cholesterol lowering can improve both the quality and length of life for many older Americans."
"Because most older Americans have cholesterol buildup in their arteries, an elevated cholesterol causes more cases of CHD in the elderly than in any other age group," said Dr. Scott Grundy, Director of the Center for Human Nutrition at The University of Texas Southwestern Medical Center at Dallas and lead author of the NCEP report. "It is clear that cholesterol counts in the elderly."
Dr. James Cleeman, NCEP Coordinator and a coauthor of the report said, "The new report reviews the evidence from epidemiological studies and clinical trials, and concludes that controlling cholesterol produces significant benefits in the elderly. For those with CHD, it can prolong life and dramatically reduce their risk of having a heart attack. For healthy seniors, it will reduce their high risk of developing CHD."
NCEP recommends that older Americans keep their cholesterol in check by following an eating pattern lower in saturated fat, total fat, and cholesterol, being physically active, and maintaining a healthy weight.
High cholesterol is a major risk factor for CHD. It leads to hardening of the arteries, or atherosclerosis, in which cholesterol deposits build up in vessel walls, including the coronary arteries that feed the heart. According to the report, more than two-thirds of over age-65 have either obvious CHD or "silent" atherosclerosis. With atherosclerosis, there may be no obvious disease symptoms but plaque likely formed in the veins and in arteries.
Older Americans have more CHD than any other age group and suffer more coronary events, such as heart attacks and angina. Most first CHD events strike after age 65, according to the report. The report indicates in the past decade, treatment for elevated cholesterol has expanded and includes a wider-range of cholesterol-lowering meds, especially statins, which produce the largest reduction in cholesterol levels. The report adds that cholesterol-lowering treatment works for both women and men. Recommendations include the following:
- Older Americans should have their total cholesterol tested once every 5 years and, if an accurate measurement is available, their high density lipoprotein (HDL, the "good" cholesterol)--the same recommendation as for all American adults. The test should be done in a medical setting, so the presence of other CHD risk factors can be checked.
- Those with high cholesterol should take steps to lower it, especially if they also have other CHD risk factors. These include cigarette smoking, high blood pressure, physical inactivity, overweight, and diabetes.
- For seniors without CHD who need to lower a high cholesterol, the first line of treatment should be the adoption of the healthy life habits noted above--eating a diet lower in saturated fat, total fat, and cholesterol, being physically active, and maintaining a healthy weight.
- When life habit changes do not sufficiently lower cholesterol and seniors are at high risk for CHD, drug therapy may be advisable. However, physicians should evaluate a patient's overall health status in making that decision.
- For most seniors with CHD, life habit changes and medication should be used together from the start of stroke treatment.
- Postmenopausal women who are judged to need drug treatment to reduce their risk for CHD should consider cholesterol-lowering drugs instead of hormone replacement therapy. A study of women with CHD found that a combination of estrogen and progesterone did not reduce the risk of CHD events. By contrast, studies have shown that postmenopausal women at high risk for CHD benefit greatly from treatment with statin drugs.
- "It's very important for older folks to pay close attention to their cholesterol," said NCEP's Cleeman. "Even if you're 70 and feeling fine, you can develop CHD, so you should take action."
- "Whether you are old or young, cholesterol counts, you can improve your quality of life by caring about your cholesterol," he added.
Other Names for a Stroke
- Brain attack
- Cerebrovascular accident (CVA)
- Hemorrhagic stroke (includes intracerebral hemorrhage and subarachnoid hemorrhage)
- Ischemic stroke (includes thrombotic stroke and embolic stroke)
A transient ischemic attack sometimes is called a TIA or mini-stroke. A TIA has the same symptoms as a stroke, and it increases your risk of having a stroke.
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