New Guidelines for Stroke Survivors
Cardiovascular disease, which encompasses atherosclerosis, coronary heart disease and stroke, is still the leading cause of death in the United States. We've come a long way since the mid-20th century, when little was known about atherosclerosis; the underlying cause of most forms of deadly heart disease. Back then, little was known about the link between diet, lifestyle and the health of blood vessels.
Atherosclerosis is a disease that affects the delicate linings of blood vessels. Diets with too much fat and sugar, and too little dietary fiber and antioxidants from plant foods, take a toll on the health of this specialized tissue, called the endothelium. Most people know that cholesterol plays a role in the development of fatty plaques on blood vessel linings. Over time, these plaques can grow, harden, break apart, and release clots, which may eventually lodge in smaller blood vessels downstream. When these vessels feed areas of the heart muscle itself, crucial blood flow can be blocked, starving the muscle of nutrients and oxygen. A heart attack is the usual result.
When clots make their way to the small blood vessels that nourish the brain, a stroke can occur. Again, blood flow is blocked, and oxygen-starved brain tissue quickly suffers irreparable damage. Depending on where the blockage occurs, the stroke may be minor, or it could do more serious damage. Some small strokes are virtually undetectable. But others can rob a person of the ability to speak, or move freely. Or they can kill.
According to a newly issued statement by the American Heart Association/American Stroke Association, stroke survivors should take steps to reduce their risk of suffering another stroke. How? The specifics will sound familiar: Control blood pressure, body weight, and cholesterol levels. And engage in moderate, regular physical activity.
Many stroke patients have high blood pressure, so bringing those numbers down is believed to be one of the most important steps a stroke sufferer can take to reduce the risk of further brain damage. Exercise helps. So does weight loss. Among other recommendations targeted at guiding a patient's medical team, patients are advised to tackle stroke risk through diet and lifestyle changes. What kind of diet? The Mediterranean diet.
No one has done a controlled clinical trial with stroke patients to see if suddenly switching to the Mediterranean diet can prevent further strokes. But the existing evidence that it could help is so compelling, the AHA/ASA feels confident it's the right advice. Of course, I've been advocating a Mediterranean-style diet for years. Its key features include lots of fresh vegetables and fruits, whole grains, fish, olive oil, nuts, herbs, and low-fat dairy. Limited red meat, severely limited sugar, and some red wine.