How to reduce your risk of life-threatening strokes


By Anthony Magnano MD, Ascension St. Vincent’s Riverside

A new study published in the American Heart Association journal Stroke showed that cases of a serious and more life-threatening type of stroke have been increasing in the United States. According to the research, there has been an 11% increase in intracerebral hemorrhage strokes (also known as ICH strokes). ICH strokes have grown at an even faster rate among younger to middle-aged adults under 65 years old as compared to individuals above 75.

These results are concerning, as they indicate not only a rise in hemorrhagic stroke, but occurrence at an earlier age. They also show the critical need for all adults, at all ages, to control stroke risk factors. May is American Stroke Month, so it is timely to gain a better understanding of this medical emergency and how it can be prevented.

Understanding Strokes

According to the World Health Organization, stroke is the second most common cause of death worldwide, and one in six of us will experience a stroke in our lifetime. The most common type is ischemic stroke, but ICH strokes are more life-threatening. ICH strokes are also more likely to cause long-term disability.

Strokes occur when blood flow to the brain is abruptly stopped due to a blood clot creating a blockage (ischemic) or a blood vessel leaking (hemorrhagic). This causes brain damage, and it can continue even after symptoms stop. In fact, ischemic strokes unfold over a period of 10 hours, aging the brain years. Depending on severity and how long blood flow was interrupted, a stroke can cause temporary or permanent disability. The sooner you recognize the signs of a stroke and seek medical attention, the better your chances of recovering and avoiding serious brain damage or disability. Even better, take steps to reduce the likelihood of stroke before it happens.

Risk Factors of Stroke

Two heart conditions that are tied closely to stroke are high blood pressure (also known as hypertension) and atrial fibrillation (AFib). The present study strongly suggests that we are doing a worse job identifying and controlling hypertension in young people. This trend was also worse in the South, Midwest and West as compared to the Northeast US Hypertension not only puts people at direct risk of stroke, but it also increases likelihood of AFib, the most common type of irregular heart rhythm.

In fact, 20 percent of all strokes are attributable to AFib. AFib increases stroke risk because the fibrillating atrium does not contract well, thus allowing blood to pool in a part of the heart called the left atrial appendage. This potentially creates clots that can travel (or “embolize”) to the brain. AFib-related strokes carry a higher risk of more severe brain damage than other ischemic strokes because the clots can be large in comparison to the small arteries of the brain. While AFib increases strongly with age, other contributors include hypertension, obesity, diabetes, sleep apnea and alcohol consumption.

Steps to Reduce Stroke Risk

The good news is that leading a heart-healthy lifestyle that includes regular physical activity and a low-fat diet can not only diminish stroke risk but also improve your overall health. Adults should aim for about 150 minutes of exercise per week, and focus on a diet high in fruits, vegetables and whole grains low in salt and fat.

Alcohol should be limited to one drink per day for women and two drinks per day for men. Breathing clean air is critical for good cardiovascular and pulmonary health – thus, smoking, second-hand smoke and air pollution should be avoided.

Another important part of a heart-healthy lifestyle is regularly seeing a doctor to monitor your heart and figure out the best plan for you. Knowing your numbers, such as blood pressure, cholesterol, blood glucose, body weight and body mass index are important for a good preventative strategy. Strive to improve each of these “numbers” to the best of your ability.

Know the Signs and Don’t Delay Treatment

Ideally, you can reduce your risk of stroke by managing your heart health. But recognizing the warning signs of stroke can still protect both yourself and your loved ones. The most important acronym to remember for identifying a stroke is BEFAST That stands for balance, eyes / vision loss, face drooping, arm weakness, speech difficulty, time to call 911. It’s common to mistake or minimize the signs of stroke, but don’t delay treatment. Call 911.

Dr. Anthony Magnano is a Ponte Vedra resident and Chief of Cardiology at Ascension St. Vincent’s Riverside. For more information on Dr. Magnano and his specialty treating atrial fibrillation, visit or call 904-388-1820.


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