Help me decrease my stroke risk!
March 9, 2012 2:07 PM Subscribe
What can I do now to reduce my risk of stoke later in life?
I am in my mid-30's, female. I have never smoked, and socially drink. I am on the upper end of a healthy weight, with a BMI in the normal range. I try to eat well and exercise (though this is limited as I recover from my spinal cord issues.)
My father died last year at 63 of a stroke. My grandmother died in her early 60's of a stroke, and my grandfather in his early 70's.
My father and grandmother were overweight, and I know that my grandmother had diabetes. My father's eating habits (prior to our estrangement) were not healthy. He exercised, but not consistently and was a yo-yo dieter. I assume that he developed diabetes later in life, but I cannot confirm this.
I've asked my GP and he basically just told me to keep doing what I am doing. But I am wondering if there is something more out there that I am missing? I'd like to take action now while I am young, as I would like to beat the family odds and live past 70. Can I be tested for specific indicators that might increase my stroke risk? Should I bother seeing a specialist who can run tests to catch potential issues that are hidden?
FWIW, my mom is adopted and I have no idea what health indicators are for her side of the family. She is healthy as can be at 64 though.
I am in my mid-30's, female. I have never smoked, and socially drink. I am on the upper end of a healthy weight, with a BMI in the normal range. I try to eat well and exercise (though this is limited as I recover from my spinal cord issues.)
My father died last year at 63 of a stroke. My grandmother died in her early 60's of a stroke, and my grandfather in his early 70's.
My father and grandmother were overweight, and I know that my grandmother had diabetes. My father's eating habits (prior to our estrangement) were not healthy. He exercised, but not consistently and was a yo-yo dieter. I assume that he developed diabetes later in life, but I cannot confirm this.
I've asked my GP and he basically just told me to keep doing what I am doing. But I am wondering if there is something more out there that I am missing? I'd like to take action now while I am young, as I would like to beat the family odds and live past 70. Can I be tested for specific indicators that might increase my stroke risk? Should I bother seeing a specialist who can run tests to catch potential issues that are hidden?
FWIW, my mom is adopted and I have no idea what health indicators are for her side of the family. She is healthy as can be at 64 though.
Best answer: The National Stroke Association is the gold standard clearing house. Monitoring your blood pressure and making sure you don't have atrial fibrillation are probably the only things among their recommendations that are specific to stroke prevention, as opposed to general preventive health maintenance.
Your doctor can order fairly simple blood tests for C-reactive proteins, which are being studied extensively as a risk factor for stroke (and other cardiovascular events). If your insurance won't pay for it, it's not a hugely expensive test IIRC so you might want to go ahead and do it on your own dime just to have a baseline.
posted by Sidhedevil at 2:24 PM on March 9, 2012 [1 favorite]
Your doctor can order fairly simple blood tests for C-reactive proteins, which are being studied extensively as a risk factor for stroke (and other cardiovascular events). If your insurance won't pay for it, it's not a hugely expensive test IIRC so you might want to go ahead and do it on your own dime just to have a baseline.
posted by Sidhedevil at 2:24 PM on March 9, 2012 [1 favorite]
Here's a link to a more recent and more comprehensive study on the links between high levels of C-reactive protein and stroke risk.
posted by Sidhedevil at 2:26 PM on March 9, 2012
posted by Sidhedevil at 2:26 PM on March 9, 2012
Well, according to recent news stories, moderate alcohol consumption (1 per day) reduces the risk of stroke in women. Link.
posted by annie o at 2:33 PM on March 9, 2012
posted by annie o at 2:33 PM on March 9, 2012
Yes, monitor your blood pressure; I've had high blood pressure since I was in my 20s and I now keep it under control with medication (Lisinopril) and exercise. You could also ask your GP about sticky blood syndrome; people typically don't know they have it until something happens like a stroke. My boyfriend has a mild case of it and had a stroke at 40 (he had also smoked for about 20 years, which is another risk factor).
posted by WorkingMyWayHome at 3:07 PM on March 9, 2012
posted by WorkingMyWayHome at 3:07 PM on March 9, 2012
I think the most straightforward way to reduce risk for most potential health problems is clean up your diet, get regular exercise, and generally try to live a health lifestyle. It's hard to say what a certain person's risk for certain things is, and I think there is only so much we can really control.
A few years ago my dad dropped dead of cardiac arrest(also 63) while he was out jogging. No family history of that sort of thing, he had a pretty good diet and got regular exercise and this happened. Our family doctor was baffled and it freaked out all the other men he knew who were in worse shape. I was concerned about my risk, but it's hard to say why my dad died this way or if my risk is above average. Switch over to my mom's side and most everyone dies in their 90s of old age basically - and that side is full of smokers. I don't smoke at all, but I try to live a generally healthy life because I don't know what else I could do to avoid that type of sudden death.
posted by fromageball at 3:43 PM on March 9, 2012
A few years ago my dad dropped dead of cardiac arrest(also 63) while he was out jogging. No family history of that sort of thing, he had a pretty good diet and got regular exercise and this happened. Our family doctor was baffled and it freaked out all the other men he knew who were in worse shape. I was concerned about my risk, but it's hard to say why my dad died this way or if my risk is above average. Switch over to my mom's side and most everyone dies in their 90s of old age basically - and that side is full of smokers. I don't smoke at all, but I try to live a generally healthy life because I don't know what else I could do to avoid that type of sudden death.
posted by fromageball at 3:43 PM on March 9, 2012
I'm not a doctor, and people who are seem to believe that you should only do this under certain medical circumstances, but some people take an aspirin every day to thin their blood and prevent infarction.
posted by foursentences at 4:45 PM on March 9, 2012
posted by foursentences at 4:45 PM on March 9, 2012
Best answer: I definitely would not start taking daily Aspirin without consulting a medical practitioner. 20% of strokes are hemorrhagic, meaning they are caused by a blood vessel bleeding rather than an ischemic stroke that is caused by the flow of blood becoming blocked. You definitely do not want to be on Aspirin if you're at risk for a hemorrhagic stroke (or any other type of bleeding).
It sounds like you're doing everything right. The big things to keep under control are blood pressure, cholesterol, triglycerides, blood sugar and BMI. Ischemic strokes are often caused by an irregular heart beat known as atrial fibrillation. If you had an irregular heart beat all the time your primary care provider would probably notice, but some people go back and forth between a regular heart beat and an irregular one. If you notice yourself having irregular heart beat or palpitations for significant portions of time you should let your PCP know and have an ECG.
Hope this helps.
posted by brevator at 5:27 PM on March 9, 2012
It sounds like you're doing everything right. The big things to keep under control are blood pressure, cholesterol, triglycerides, blood sugar and BMI. Ischemic strokes are often caused by an irregular heart beat known as atrial fibrillation. If you had an irregular heart beat all the time your primary care provider would probably notice, but some people go back and forth between a regular heart beat and an irregular one. If you notice yourself having irregular heart beat or palpitations for significant portions of time you should let your PCP know and have an ECG.
Hope this helps.
posted by brevator at 5:27 PM on March 9, 2012
Yeah, and don't smoke.
Stress reduction can help as well (easier said than done, I know).
posted by brevator at 5:31 PM on March 9, 2012
Stress reduction can help as well (easier said than done, I know).
posted by brevator at 5:31 PM on March 9, 2012
I would also encourage you to learn about the typical stroke symptoms (FAST) and to assign a health care proxy who can make decisions for you in the unfortunate event that you are unable to make decisions for yourself. Obviously prevention comes first, but you want to have a plan in place for the worst case scenario.
posted by brevator at 5:48 PM on March 9, 2012
posted by brevator at 5:48 PM on March 9, 2012
There is still uncertainty about usefulness of CRP as a risk factor for cardiovascular disease.
Major risk factors for heart disease and strokes are hypertension, smoking, old age, alcoholism, diabetes, low HDL, and family history of premature coronary heart dsease. Your doctor should assess your risk factors and discuss whether cholesterol screening is needed.
posted by Pantalaimon at 6:07 PM on March 9, 2012
Major risk factors for heart disease and strokes are hypertension, smoking, old age, alcoholism, diabetes, low HDL, and family history of premature coronary heart dsease. Your doctor should assess your risk factors and discuss whether cholesterol screening is needed.
posted by Pantalaimon at 6:07 PM on March 9, 2012
Pantalaimon, the OP is asking about stroke, not coronary heart disease. The findings of correlations between CRP levels and ischemic stroke risk aren't controversial in my understanding--at least, none of the doctors currently treating me seem to think so.
posted by Sidhedevil at 6:17 PM on March 9, 2012
posted by Sidhedevil at 6:17 PM on March 9, 2012
Best answer: It's fairly simple.
Eat healthily, maintain a healthy weight in particular. Exercise.
The major modifiable risk factors (i.e. excluding age and family history, which you can't help) for ischaemic stroke, i.e. blood clots which are 85-90% of strokes are smoking, diabetes, high cholesterol levels, high blood pressure. It is worth getting checked for diabetes, and having your BP and cholesterol checked. Atrial fibrillation (a kind of irregular heartbeat) is the other are the other major factor, but if you have this it will usually be obvious to you (palpitations, shortness of breath, and you can easily take your own pulse). There is no point checking your CRP, there's nothing you can do to modify it and the number of things that can cause an elevated CRP is huge.
Re: foursentences advice - do NOT take an aspirin every day. It prevents recurrent ischaemic stroke, but increases risk of haemorrhagic stroke, (potentially fatal) gastric bleeding and other complications and is not advisable as a prophylactic unless you have actually already had an ischaemic stroke - in other circumstances the risk-benefit will not be in your favour.
(FWIW I am a neurologist)
posted by inbetweener at 2:27 AM on March 10, 2012 [2 favorites]
Eat healthily, maintain a healthy weight in particular. Exercise.
The major modifiable risk factors (i.e. excluding age and family history, which you can't help) for ischaemic stroke, i.e. blood clots which are 85-90% of strokes are smoking, diabetes, high cholesterol levels, high blood pressure. It is worth getting checked for diabetes, and having your BP and cholesterol checked. Atrial fibrillation (a kind of irregular heartbeat) is the other are the other major factor, but if you have this it will usually be obvious to you (palpitations, shortness of breath, and you can easily take your own pulse). There is no point checking your CRP, there's nothing you can do to modify it and the number of things that can cause an elevated CRP is huge.
Re: foursentences advice - do NOT take an aspirin every day. It prevents recurrent ischaemic stroke, but increases risk of haemorrhagic stroke, (potentially fatal) gastric bleeding and other complications and is not advisable as a prophylactic unless you have actually already had an ischaemic stroke - in other circumstances the risk-benefit will not be in your favour.
(FWIW I am a neurologist)
posted by inbetweener at 2:27 AM on March 10, 2012 [2 favorites]
Response by poster: Thanks everyone for your input. I am vigilant about my yearly checkups and luckily have great BP (110/65 almost always). I get a cholesterol screening every year as part of my physical. All my numbers are in an optimal range.
Many years ago (about 10) I was MUCH heavier than I am now (I've lost 115 pounds and kept it off) and my doctor told me that I was in the pre-diabetes range in terms of fasting glucose. That alone was the final straw in losing all the weight and being serious about keeping it off. Since then, my blood sugar remains normal, but I ask to be tested every year to continue to have a baseline.
Because of multiple surgeries (unrelated to this - I have spinal cord issues), I've had 2 EKG's in the last two years, as part of my pre-surgery clearance and they've always been normal.
I will bookmark the National Stroke Association, because I think it's important that I do understand the symptoms of a stroke, and share it with my loved ones so they know as well.
posted by carmenghia at 9:57 AM on March 10, 2012
Many years ago (about 10) I was MUCH heavier than I am now (I've lost 115 pounds and kept it off) and my doctor told me that I was in the pre-diabetes range in terms of fasting glucose. That alone was the final straw in losing all the weight and being serious about keeping it off. Since then, my blood sugar remains normal, but I ask to be tested every year to continue to have a baseline.
Because of multiple surgeries (unrelated to this - I have spinal cord issues), I've had 2 EKG's in the last two years, as part of my pre-surgery clearance and they've always been normal.
I will bookmark the National Stroke Association, because I think it's important that I do understand the symptoms of a stroke, and share it with my loved ones so they know as well.
posted by carmenghia at 9:57 AM on March 10, 2012
This thread is closed to new comments.
posted by Ery at 2:14 PM on March 9, 2012