New Guidelines for Stroke Victims
Now that people are living longer, the risk of stroke is a growing concern. In 2008, stroke was the fourth leading cause of death in the United States. It was also the leading cause of severe long-term disability. But when you look at the statistics a little more carefully, it turns out that stroke was the third leading cause of death among women. Clearly, stroke prevention is an important women's health issue.
A small proportion of stroke cases arise during pregnancy, but in most instances, stroke reflects underlying long-term cardiovascular disease. For most of us the risk of stroke increases with age. A clot forms within the blood vessels, breaks free, and travels to one of the smaller vessels that supply blood to the brain. There, it can become lodged in a tiny vessel, blocking blood flow to that portion of the brain. Brain cells die very quickly when deprived of oxygen and glucose.
Earlier this year the American Heart Association/American Stroke Association released new recommendations for the prevention of stroke. They feature some familiar advice. Monitor and control your cholesterol levels, blood pressure and weight, and get adequate exercise. Some new advice concerns additional risk factors, such as prediabetes (a condition of marginally elevated blood sugar levels that can precede a diagnosis of type 2 diabetes), and screening for sleep apnea.
Patients who have had a stroke of unknown cause are advised to be monitored for a trial fibrillation. A trial fibrillation is an arrhythmia; a disorder of the electrical system of the heart that causes the heart to beat irregularly. To pump blood efficiently, the muscles of the heart must contract in a specific rhythm and sequence. This is facilitated by an electrical signal that naturally synchronizes contractions. When something goes wrong with this rhythmic signal, a trial fibrillation can occur. It is experienced as an irregular and often rapid heartbeat. Because blood is not fully circulated when the heart is beating this way, clots can form within the heart itself. This increases the risk of stroke, because these clots can break free and travel to the brain.