Stroke association issues new advice

More than 600,000 Americans are expected to experience their first stroke this year — but up to 80% of these incidents may be preventable.

The American Stroke Association (ASA) issued updated advice on Monday urging health care workers to screen for stroke risk factors such as high blood pressure, elevated cholesterol, high blood sugar and obesity.

“The most effective way to reduce the occurrence of a stroke and stroke-related death is to prevent the first stroke — referred to as primary prevention,” said Dr. Cheryl D. Bushnell, chair of the ASA guideline writing group.

“Some populations have an elevated risk of stroke,” Bushnell continued, “whether it be due to genetics, lifestyle, biological factors and/or social determinants of health, and in some cases, people do not receive appropriate screening to identify their risk.”

A stroke occurs when blood flow to the brain is blocked or when a blood vessel bursts and leaks blood into the brain.

Stroke was the fourth leading cause of death in the US last year, accounting for 162,600 deaths, according to preliminary data.

The updated ASA recommendations — which replace 2014 guidelines — encourage adults to follow the Mediterranean diet no matter their stroke risk. The plant-based eating plan emphasizes fruits, vegetables, whole grains and healthy fats and not red meat and sugar.

The ASA, a division of the American Heart Association, also suggests cutting stroke risk by exercising regularly, getting sufficient sleep, maintaining a healthy weight, controlling cholesterol, managing blood pressure and blood sugar and avoiding smoking.

Health care professionals should screen patients for sedentary behavior — adults should get at least 150 minutes a week of moderate-intensity aerobic activity or 75 minutes a week of vigorous exercise, or a mixture of both throughout the week.

Adults should also be screened for and educated on the importance of non-medical factors such as education, financial stability, access to care and healthy food, as well as neighborhood walkability, the ASA said.

For their part, women may need to be screened more frequently than men for stroke risks.

Their risk factors include birth control pill use and pregnancy complications such as high blood pressure and premature birth. Women also tend to live longer. About 55,000 more women than men have a stroke each year in the US, according to the ASA.

To help inform preventive treatment, the American Heart Association last year introduced its updated (PREVENT) risk calculator that can estimate 10-year and 30-year stroke and heart disease risk in people over 30.

“Understanding which people are at increased risk of a first stroke and providing support to preserve heart and brain health can help prevent a first stroke,” Bushnell said.

Stroke warning signs

Experts use the acronym BE FAST to quickly recognize stroke warning signs and know when to call 911.

• B is for balance — difficulty with walking. 
• E is for eyesight — seeing double vision, blurred vision, loss of vision. 
• F is for a facial droop or crooked smile.
• A stands for arm weakness or numbness. This also applies for leg weakness or numbness.  
• S is for changes with speech.
• T represents time — time to call 911.