Stroke

Menstuff® has compiled the following information on Strokes.

Top 10 Signs That You’re Headed for a Strokr

How Much Do You Know About Strokes? Take a quiz

Severe Strokes: Which Types of Strokes Are the Most Deadly?
How to Stop a Stroke from Starting
10 Common Symptoms of a Stroke
11 Signs and Symptoms of Stroke
7 Habits to Prevent a Stroke
Does Exercise Really Prevent Stroke?
Eating to Prevent Stroke
The Best News About Stroke Prevention...Chocolate

The Healthiest Chocolate

Blood Test For Stroke
What You Need to Know About a Mini Stroke
How Much You Sleep Affects Your Risk of Stroke
How Much Sleep Is Too Much Sleep?
Gender Differences in Stroke
Stroke - Know the symptoms, save a life!

What Does "Premature Death" Mean?
Faith May Help Stroke Patients Cope
Side Effects of Coumadin, Plavix and Other Blood Thinners
There's a Fourth Indicator of a Stroke - the Tongue
Heavy Drinking Boosts Stroke Risk

Top 10 Signs That You’re Headed for a Stroke


Nobody sees a stroke coming, but signs of danger are usually there. You could be at risk... Stroke is sometimes called a “brain attack” because what usually occurs is similar to what happens during a heart attack. In the most common form of stroke, an obstruction blocks flow in a blood vessel that supplies the brain. A fatty deposit on blood vessel walls often gets the obstruction started. Blood clots can then form at the site of the deposit and make the obstruction worse. Clots also can form elsewhere in the body, break free and migrate through the circulatory system toward the brain, where they can cause a stroke. Strokes from clots (ischemic strokes) account for 87% of strokes. They also occur when a blood vessel ruptures and bleeds into the brain (hemorrhagic strokes). Knowing the underlying cardiovascular factors that put you at risk for stroke can help you avoid its potential disabilities or death. Here are the top stroke risks and what you can do to improve your odds.

1. Being a man... or a woman The stroke risk: Men are more likely than women to have a stroke... until age 75, according to statistics from the American Heart Association. Then the chance evens out; after age 85, women are at greater risk. “There’s a misconception that stroke is a disease of old men,” says Larry B. Goldstein, M.D., chairman of the Department of Neurology and co-director of the Kentucky Neuroscience Institute at the University of Kentucky.

The good news? For both men and women, as many as 9 out of 10 strokes are preventable by minimizing risk factors, according to a July 2016 study of 26,000 people by McMaster University in Ontario, Canada. Reduce it: You’ve cut your risk just by reading this, because knowledge is power. Next, lower your chances of having a stroke by focusing on factors you can control, especially if you didn’t think you had anything to worry about.

2. Your family tree The stroke risk: If your father, mother, brother or sister already has had a stroke, your risk of stroke is one-third higher.

In some cases, the risk lies in a genetic disorder that can lead to stroke. Sickle cell disease is one example. A gene mutation called CADASIL (cerebral autosomal dominant arteriopathy with sub-cortical infarcts and leukoencephalopathy) is another.

Your ethnicity also plays a role. African Americans have a much higher risk of stroke than Caucasians, partly because they’re more likely to have a range of cardiovascular risks that contribute to stroke.

The odds of having a first stroke are twice as high for African Americans as they are for Caucasians; they also die of their strokes more often as well.

Reduce it: You can’t change your genes, so do everything you can to change bad lifestyle habits.

3. Smoking. The stroke risk: Smoking damages cells that line blood vessels, thickens and narrows arteries and encourages the formation of clots.

It also boosts blood pressure, lowers HDL (“good”) cholesterol and raises triglycerides — all of which can make strokes more likely.

Reduce it: Avoid all tobacco smoke — both your own and other people’s.

Exposure to second-hand smoke increases the risk of stroke by 30%, even among nonsmokers, according to a paper published in the July 2015 issue of the American Journal of Preventive Medicine.

“If you find it hard to quit smoking for your own sake, do it for the sake of the people around you, especially children,” Dr. Goldstein advises.

4. Multiple drinks. The stroke risk: Heavy drinking is associated with unhealthy changes in blood pressure and can make blood clots more likely.

In fact, alcohol may raise stroke risks even higher than other cardiovascular risk factors in middle-aged heavy drinkers. Their risks are 34% higher than those of light drinkers, according to research in the January 2015 American Heart Association journal Stroke.

Regardless of genetic and early-life risk factors, people in their 50s and 60s who drink too heavily are likely to have a stroke five years sooner than they would have otherwise, according to the National Stroke Association.

Reduce it: Men should have no more than one to two drinks per day; women should have no more than one. A single drink is at most 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor.

“Don’t think that avoiding alcohol all week means you can binge on Friday night,” Dr. Goldstein warns. “If you drink excessively, you’re at much higher risk of having a stroke in the next 12 hours.”

5. Excess weight. The stroke risk: Having a body mass index (BMI) of 25 or higher boosts cardiovascular risks, according to the National Stroke Association. These include:

  • High blood pressure
  • Insulin resistance
  • High triglycerides

(Find out your BMI, a number determined by your weight and height.)

Weight-related risks tend to occur together in metabolic syndrome — which is a cluster of these and other conditions — and stroke is one of the key dangers of having it.

Reduce it: Losing as little as 10 pounds can significantly reduce stroke risk factors, such as lowering blood pressure and improving cholesterol levels.

Eating more fruits and vegetables is key in any weight-loss plan. A Mediterranean diet that includes nuts, olive oil and whole grains may also help reduce your risk of stroke.

6. Lack of exercise. The stroke risk: A sedentary lifestyle increases your risk for stroke and a lot of the factors that contribute to it.

In fact, inactive people are 20% to 25% more likely to have a stroke than those who are moderately or highly active, according to a 2015 review of past studies published in the journal Stroke.

Reduce it: Get 30 minutes of moderate exercise, such as brisk walking or biking, at least five days a week.

If you can’t squeeze a half-hour workout into your schedule almost every day, aim for 150 minutes of exercise a week in any combination. Even bouts of activity lasting as little as 10 minutes count.

7. High blood pressure. The stroke risk: High blood pressure may be the single most important treatable risk for stroke.

That’s because too much pressure inside blood vessels can damage their inner lining. That in turn can make artery walls thick and stiff, which can contribute to blockages and clots that lead to ischemic stroke.

High blood pressure can also cause weak spots in artery walls that can lead to ruptures and bleeding that are typical of hemorrhagic stroke.

Reduce it: High blood pressure has no symptoms, so you won’t know you have it unless you get it checked.

Make sure a doctor, nurse — or even a blood pressure machine in your local pharmacy — measures your blood pressure at least once a year.

Lifestyle measures such as a diet with lots of fruits and vegetables and minimal amounts of salt can help bring pressure down. If more action is needed, medications can help.

Discuss all your medications and symptoms with your doctor so that he or she can make sure you avoid adverse drug interactions and address any side effects.

8. A quivering heart. The stroke risk: With a condition called atrial fibrillation, or AFib, the top two chambers of the heart (the atria) quiver instead of contracting fully.

That can allow blood to pool and clump in the atria, increasing the risk of clots that could break loose, travel to the brain and cause a stroke.

Reduce it: Uncontrolled high blood pressure is a major cause of atrial fibrillation, so bringing blood pressure down can help lower stroke risk from AFib.

Blood-thinning medications, or anticoagulants, can also reduce risks specifically from AFib.

“All medications have pluses and minuses, but a general plus for newer anticoagulants is that they tend to be safer than older drugs in terms of bleeding complications,” Dr. Goldstein says.

9. Diabetes. The stroke risk: Having diabetes means having high blood sugar. And high blood sugar damages blood vessels throughout the body, causing numerous complications, including a higher risk for stroke.

In fact, people with diabetes have a 1.5 times higher risk of having a stroke than people without the disease.

Reduce it: Getting blood sugar under control includes many of the same steps that reduce risks for stroke — such as eating a healthy diet and staying physically active.

Whether taking diabetes medication lowers stroke risk has been less clear. But one of the most recent studies on that question found a stroke risk benefit in people who tightly regulated blood sugar through a combination of lifestyle and drugs.

Findings published in the June 2015 issue of the New England Journal of Medicine revealed that those who monitored their condition closely over a 10-year period didn’t necessarily live longer than those who managed their blood sugar less stringently, but they did have fewer cardiovascular problems — including stroke.

10. High cholesterol. The stroke risk: Excess cholesterol — a fatty, waxy substance that travels through the blood — can build up on artery walls to form deposits called plaque. Plaque can narrow blood vessels and create obstructions, but can also burst and send clots through the blood to the brain.

LDL (“bad”) cholesterol, which makes up most of the body’s cholesterol, is especially prone to build plaque.

HDL cholesterol gathers up bad cholesterol and ushers it to the liver, which excretes it from the body, so it’s good to have higher levels of HDL.

Reduce it: Get cholesterol checked at least every five years if you don’t have other cardiovascular risks — more often if you do.

As with high blood pressure, you can’t feel high cholesterol, so it’s important to have your cholesterol counts monitored.

Taking charge of other risk factors through healthy eating habits and physical activity will help bring cholesterol to healthier levels as well.

If you have an unhealthy balance of LDL and HDL, your doctor may also recommend taking medications such as statins to lower cholesterol — and bring down your risk of stroke.
Source: www.lifescript.com/health/centers/stroke/articles/top_10_signs_that_youre_headed_for_a_stroke.aspx?utm_source=aol&utm_medium=syn&utm_campaign=stroke

How Much Do You Know About Strokes?


Whether you call it a "stroke" or a "brain attack," it is a serious concern that strikes about 800,000 Americans each year. A stroke occurs when blood flow to a part of the brain is reduced or cut off completely. This can happen when a clot forms in an artery or a blood vessel ruptures. Take this quiz to see how much you know about preventing stroke and dealing with its outcomes.
Source: www.lifescript.com/quizzes/health/how_much_do_you_know_about_strokes.aspx

QUIZ

1. The most important stroke preventive measure against having a stroke is getting your blood sugar checked and treated. true/false

2. Atrial fibrillation – a heart condition – is related to strokes. true/false

3. By living a healthy lifestyle, you can eliminate your chances of having a stroke. true/false

4. Using street drugs such as cocaine or methamphetamine increases your chances of having a stroke. true/false

5. Strokes are becoming more common in people in their 30s and 40s. true/false

6. Hemorrhagic stroke is the most common type. true/false

7. A stroke on the left side of the brain will most likely cause speech and language difficulties. true/false

8. It’s important to get to the hospital immediately if someone appears to be having a stroke. true/false

9. A sudden, intense headache is one sign of possible stroke. true/false

10. It takes a minimum of five years to recover from a stroke. true/false

Answers

Severe Strokes: Which Types of Strokes Are the Most Deadly?


Brainstem Strokes, Bilateral Watershed Strokes, Hemorrhagic Strokes and More

All types of stroke are dangerous, but a few of them are notorious for causing severe disability and/or a rapid progression to death. Below we describe the most common strokes which are known for having the potential to cause severe disability and even death.

Brainstem Strokes:

All of the nerve impulses from the brain that go to the body must go through the brainstem, which is why brainstem strokes can be even more devastating than a spinal cord injury.

The brainstem also controls many of our most important functions, such as breathing, blood pressure, and heart rate, and contains the brain's awareness center, which allows us to stay conscious of the world around us. Therefore depending of the severity of a brainstem stroke, a person may become hemiplegic, paralyzed, or permanently unconscious.

Bilateral Watershed Strokes

Watershed strokes inherit their name from their effect on brain areas commonly referred to as the "watershed areas." These areas receive their blood supply from the farthest-end branches of two adjacent vascular territories and require adequate blood pressure to ensure that enough blood is pumped into them at all times. Because of this, watershed areas in both sides of the brain are at high risk of developing ischemia, or lack of blood flow, during times of extremely low blood pressure, which can be caused by extreme dehydration, heart attacks, and sepsis (widespread infections), among others.

Watershed strokes cause severe disability because they affect large muscle groups on both sides of the body (e.g., shoulders and hips).

People with advanced carotid stenosis (clogging of the neck arteries) on both sides of the neck are particularly vulnerable to suffering this type of stroke.

Hemorrhagic Strokes

Hemorrhagic strokes are caused by bleeding in the brain. There are multiple reasons why people develop bleeding inside the brain, but some of the most dangerous ones include:• Arteriovenous malformations

  • Ruptured aneurysms
  • Uncontrolled high blood pressure
  • Bleeding disorders
  • Traumatic injuries to the head
  • Dural sinus thrombosis
  • Brain Tumors

Hemorrhagic strokes are extremely dangerous because blood in the brain can sometimes lead to dangerous conditions such as hydrocephalus, increased intracranial pressure, and dangerous blood vessel spasms. If not treated aggressively, these conditions can lead to severe brain damage, brain herniation, and even death. This is why even minor episodes of bleeding inside the brain require emergency evaluation by a neurosurgeon.

Large Thrombotic Strokes

Thrombotic strokes are caused by large blood clots which either form inside of, or migrate into, one of the main blood vessels of the brain. These large blood clots are especially dangerous because they can completely stop blood from flowing through the largest, and thus most important, blood vessels in the brain.

The so-called “malignant middle cerebral artery (MCA) syndrome” is an example of such as stroke. Here, the MCA is blocked by a large blood clot causing the massive infarction (i.e., death) of almost one entire side of the brain. The potent swelling that ensues as a result of such a massive event causes a rapid increase in brain pressure throughout the entire brain. In turn, this high pressure leads to global brain dysfunction, impaired consciousness and very often, to brain herniation and death.

Large thrombotic strokes are commonly the result of medical conditions in which people have a tendency to form blood clots inside the blood vessels of the brain, inside the heart, or inside blood vessels that that bring blood into the brain. Such conditions include carotid, vertebral, or basilar artery dissection, and atrial fibrillation.

Symptoms

Unfortunately the symptoms of large strokes can be deceiving, and can originally seem like a simple episode of dizziness or headache. However certain strokes have a tendency to cause very specific symptoms. For instance, a classic symptom of hemorrhagic strokes (bleeding inside the brain) is the sudden onset of a headache which is typically described by people as the "worst headache of my life."

Large brainstem strokes typically cause double or blurry vision, vertigo, unsteadiness of gait, and/or severe nausea and vomiting. Depending on the part of the brain they affect, large thrombotic strokes can cause a sudden onset of weakness and or numbness on one entire side of the body. Large strokes can also cause sudden loss of consciousness. Needless to say, should you, or someone you know, ever be affected by these symptoms act quickly and call 911 without delay.
Source: stroke.about.com/od/causesofstroke/a/deadly_strokes.htm?utm_source=cn_nl&utm_medium=email&utm_term=Health%20Channel%20Newsletter&utm_campaign=healthsl&utm_content=20150519

11 Signs and Symptoms of Stroke


Stroke signs and symptoms can affect different parts of the body. You probably aren't sure whether or not you would be able to recognize the signs and symptoms of a stroke if you or someone else had any. Most signs and symptoms of stroke are unsettling enough that they would be hard to ignore. Whether you are at work, at a family or social gathering or even in a public setting, you could save someone's life if you recognize the 11 signs and symptoms of stroke.

You should not attempt to medically aid a stroke victim- but you should call 911 right away.

If you experience any of these 11 signs or symptoms do not wait - call 911 or get attention from someone nearby to call 911 for you.

1. Slurred Speech

Sudden onset of slurred speech may be the result of a stroke. Drugs and alcohol in high quantities may also produce slurred speech due to toxic effects on the speech centers of the brain. Additionally, some illegal drugs can also cause stroke. Slurred speech is a serious warning sign to get medical attention right away.

2. Falling

Weakness of one or both legs can cause falling. A stroke that affects the balance center of the brain can cause a stroke victim to fall. Serious strokes can also induce sudden loss of consciousness, which may manifest as falling. If you or someone nearby falls, this is an urgent situation that requires emergency medical care.

3. Uneven Appearing Face

The brainstem controls the muscles of the face and eyelids. If your face or someone else’s face appears lopsided or if the eyelids are uneven, this is caused by a weakness of the muscles that move the face.

A brainstem stroke can start subtly with a painless droopy mouth, but can progress very quickly to stop breathing. Anyone who has a sudden appearance of asymmetry of the face needs an expert evaluation ASAP.

4. Changes in Vision or Double Vision

Normal vision requires a complex serious of interactions between the eyes, the nerves and several regions of the brain to produce a 'picture' of vision. When any of the connections are disrupted by a stroke, double vision or loss of a section of vision results. This is painless, but disturbing. Sudden visual changes including double vision require emergency evaluation and treatment to help preserve as much vision as possible for the long-term.

5. Can't Say the Right Words

When you notice that someone is using the wrong words or obviously misunderstanding speech, this is a typical sign of stroke. Language is controlled by several large areas of the brain that are particularly vulnerable to stroke due to the arrangement of blood vessels in the brain. Some stroke victims are aware of the language deficit, while others are completely unaware of the problem and need help from a stroke care team immediately.

6. Dropping Objects

Weakness most often manifests with dropping items or inability to lift items. When this happens, particularly on one side of the body involving the hand or the whole arm, the cause often turns out to be a stroke or a TIA.

7. Confusion

A variety of medical emergencies cause confusion, and stroke is one of the most commonly associated with confusion. It is impossible to diagnose the cause without a thorough medical evaluation- and postponing care for sudden confusion is undoubtedly the worst possible thing to do.

8. Inappropriate Behavior

Inappropriate behavior can be annoying or offensive- it may make you actually want to avoid a stroke victim. However, because the brain is responsible for integrating high-level decision-making, any stroke can interfere with judgment. People who appear to demonstrate sudden changes in behavior need medical attention. Not only is the stroke an urgent emergency- prevention of dangerous consequences that can result from faulty decision-making is crucial as well.

9. Numbness

This is the most often brushed off symptom of stroke. Often, only the patient is aware of this problem and may not tell companions. However, numbness is one of the signs of stroke and TIA and assessing it right away can help prevent other more disabling effects from occurring.

10. Clumsiness

This can result from a stroke affecting the cerebellum, the brainstem or the cerebral cortex. Clumsiness results from lack of balance, weakness, sensation problems or a combination of any of these.

11. Loss of Consciousness

Large strokes or even small strokes located in the brainstem can cause loss of consciousness or passing out. It is absolutely crucial to get emergency help right away – as a stroke that results in loss of consciousness can be fatal.

You can recognize stroke symptoms. The good news is that with emergency medical attention and treatment, most stroke victims can survive and experience significant neurological recovery.
Source: stroke.about.com/od/Symptoms-and-Warnings/fl/11-Signs-and-Symptoms-of-Stroke.htm

The Best News About Stroke Prevention...Chocolate


One of your favorite and most decadent snacks has been strongly associated with a reduced risk of stroke. A recent research study from the UK and the Netherlands titled the European Prospective Investigation into Cancer, the EPIC- Norfolk analysis, examined 20,951 men and women. Careful analysis of a food diary distributed to men and women who participated in the study determined that those who reported the highest levels of consistent chocolate consumption experienced lower rates of stroke, while enrolled participants who reported no chocolate consumption or very low chocolate consumption had the highest rates of stroke throughout an almost 20 year follow up period.

This study was consistent with several other research studies at different institutions, which also looked at the association between chocolate and stroke risk.

A large analysis from Sweden followed 37,103 Swedish men for ten years. The Swedish results similarly showed that those who reported the highest chocolate consumption, averaging 62.9 grams per week, were the group who had the lowest stroke risk. An even larger investigation examined a bigger group, a total of 157, 809 participants from nine different studies, and confirmed the same trend.

How much chocolate should you eat to protect yourself from stroke?

The research investigations were pretty consistent in reporting that the highest group’s chocolate consumption was measured between 16-99 grams of chocolate per day, which is about half an ounce to 3.5 ounces per day. That is the equivalent of eating about of 10 chocolate chips per day up to one regular size chocolate bar, or a few snack size chocolate bars per day.

What kind of chocolate helps protect against stroke?

The benefits of chocolate are found in both milk chocolate and dark chocolate.

But this is where it gets a little tricky. The healthy effects specifically come from chocolate produced by the cocoa plant, not from imitation chocolate flavoring, food coloring, artificial chocolate smells or sugars. Read labels because many chocolate flavored snacks and candies do not contain actual chocolate made with cocoa. Instead, some processed chocolate flavored products are made with small amounts of chocolate and are passed off as chocolate because they contain food coloring and other additives that can make them resemble chocolate.

Dark chocolate and milk chocolate are both made from cocoa, while white chocolate is not made with the same cocoa ingredients that protect against stroke.

Why does chocolate protect you from a stroke?

Chocolate is a tasty treat, but when you eat it, the cocoa in chocolate also has several biological and chemical effects on your body. These biochemical actions include protecting the inside lining of your blood vessels, which works to prevent stickiness that contributes to the formation of harmful blood clots. Blood clots in the brain cause ischemic strokes. Healthy blood vessels are also more resistant to the risk of tearing and leaking that results in sudden bleeding. Thus, cocoa serves to protect you from another type of stroke, which is a hemorrhagic stroke.

Additionally, cocoa beans have been scientifically proven to provide anti-oxidant effects, which is important in counteracting the toxic brain damage induced by a stroke.

Chocolate has been established as a means to reduce feelings of stress and the perception of stress. Severe stress increases your risk of stroke, and the long-term buildup of chronic stress also raises the likelihood that you will have a stroke.

The best news about stroke prevention

The best news about stroke prevention is that is isn't expensive, unusual or hard to do. A variety of easy and enjoyable life style modifications can go a long way in reducing your risk of stroke. Eating and sharing moderate amounts of chocolate just might be the most pleasant way to protect yourself and your loved ones from having a stroke.

If you want to learn more about how you can be a part of scientific studies like the chocolate studies, find out more here.

Sources:

Chocolate consumption and risk of stroke: a prospective cohort of men and meta-analysis, Larsson SC, Virtamo J, Wolk A, Neurology, September 2012

Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women, Kwok CS, Boekholdt SM, Lentjes MA, Loke YK, Luben RN, Yeong JK, Wareham NJ, Myint PK, Khaw KT, Heart, June 2015

Flavanols, proanthocyanidins and antioxidant activity changes during cocoa (Theobroma cacao L.) roasting as affected by temperature and time of processing, Ioannone F, Di Mattia CD, De Gregorio M, Sergi M, Serafini M, Sacchetti G, Food Chemistry, May 2015

Source: stroke.about.com/od/Your-Lifestyle-Can-Lower-Your-Risk-of-Stroke/fl/The-Best-News-About-Stroke-PreventionhellipChocolate.htm?utm_content=20150815&utm_medium=email&utm_source=cn_nl&utm_campaign=healthsl&utm_term=Health%20Channel%20Newsletter

The Healthiest Chocolate


Less Processing, Greater Benefit

One of the best pieces of news to emerge over the last several years is that chocolate may help you live longer, probably by reducing cardiovascular events like heart attacks and stroke. After all –- how often is a remedy this easy to take? But which type of chocolate is really the healthiest?

Cocoa and the Kuna Indians: Chocolate has been used for medicinal effect for thousands of years, but its recent recognition as a possible heart-healthy food came to light in the early 1990s.

Harvard Medical School researchers, led by Norman Hollenberg, investigated why Kuna Indians, living in the San Blas Islands off the Caribbean coast of Panama, had low blood pressure, even with increasing age. This was true despite a high level of salt consumption, which exceeded that of most Western populations.

If the Kunas had their genetic makeup to thank for healthy blood pressure, moving to an urban environment on the mainland shouldn’t make any difference. But it did –- migration to cities corresponded with a rise in blood pressure, with increasing age. Further investigation showed island-dwelling Kunas also lived longer than their mainland cousins, with low rates of cardiovascular disease and cancer. After allowing for factors like stress and lack of pollution, Hollenberg and his team concluded the most striking difference in the Kuna Indians’ island environment was dietary, including a dramatic average daily consumption of more than 5 cups of cocoa, per person.

There’s a big difference between the cocoa the Kunas drink, and the cocoa and chocolate people usually purchase in a grocery or specialty store -- mostly due to how it’s processed and its formulation.

Processing: Cocoa beans grow as the seed of the berry-like fruit of the cacao tree. After shelling and roasting, the beans are ground into a suspension called cocoa liquor, made up of cocoa butter (fat) and solids. Pressing removes most of the cocoa butter, resulting in a hard, dry cake, which is ground into what we use as cocoa powder.

This powder contains most of the flavanols, a family of flavonoids, or antioxidants, that have since been credited with most of chocolate’s health benefits. Flavanols affect the way nitric oxide is produced in the body, helping blood vessels to relax, and thereby improving blood flow to the heart, the brain, and extremities. They also may reduce inflammation, and the proliferation of dangerous free radicals produced in regular cell metabolism.

At this stage, cocoa powder remains quite bitter. As a result, it’s often processed by treatment with alkali -- most commonly sodium bicarbonate, or baking soda -- to make it darker, less acidic, and easier to mix into beverages. Unfortunately, this 200-year-old method, also known as "Dutch-processing," has been shown to destroy the active flavanol content by as much as 80%. Thus, the percentage of cocoa contained in a piece of chocolate, whether it’s 60%, 70% or higher, is no indication of its flavanol content, argues Hollenberg in a 2007 editorial in the journal Circulation. He and other nutrition researchers have argued for labeling chocolate products with flavanol values instead.

The Kuna Indians drink largely homegrown, unprocessed cocoa powder, containing very high flavanol levels.

Formulation: Cocoa butter’s unique property of having a melting point that matches human body temperature –- allowing it to literally “melt in your mouth” –- makes it delicious. Its fat content, however, puts chocolate-lovers at risk of weight gain if they don’t compensate for those calories elsewhere. A 3.5 oz (100g) bar of chocolate contains more than 500 calories (compared with just 12 calories in a tablespoon of unsweetened cocoa). Obesity increases the risk of cardiovascular disease, diabetes, and cancer, so don’t try to extend your life by eating chocolate if it results in gaining weight. Indeed, a very small amount of chocolate may be sufficient for improved longevity.

Bottom line: Research on the indigenous Kuna Indian population of Panama suggests that unprocessed cocoa may be the healthiest form, due to its high flavanol content. Since flavanols are destroyed through chemical Dutch-processing, or alkalization, look for cocoas labeled "natural," as they have not been treated with alkali.

Sources:

Andres-Lacueva C., et al. “Flavanol and flavonol contents of cocoa powder products: influence of the manufacturing process.” J Agric Food Chem. 2008. May 14;56(9):3111-7. Epub 2008 Apr 16.

Claims About Cocoa. US National Institutes of Health Information Sheet. Accessed January 27,2011.http://newsinhealth.nih.gov/issue/aug2011/feature1

Kenneth B. Miller et al. Impact of Alkalization on the Antioxidant and Flavanol Content of Commercial Cocoa Powders. J. Agric. Food Chem., 2008, 56 (18), pp 8527–8533. DOI: 10.1021/jf801670p.

Norman K. Hollenberg, MD, PhD and Naomi D.L. Fisher, MD. “Is It the Dark in Dark Chocolate?” Circulation. 2007; 116: 2360-2362.http://circ.ahajournals.org/content/116/21/2360.full

K. Hollenberg N. Vascular action of cocoa flavanols in humans: the roots of the story. J Cardiovasc Pharmacol. 2006;47 Suppl 2:S99-102; discussion S119-21.

Source: longevity.about.com/od/lifelongnutrition/a/The-Healthiest-Chocolate.htm

7 Habits to Prevent a Stroke


A stroke can be a devastating event with serious long-term consequences. Advances in stroke treatment have made the long term outcome for stroke patients better. However, there is often a short window of time for effective treatment. One important approach to stroke care includes prevention, especially for people who are at risk. Not every stroke is preventable but there are some known preventable risk factors that can be modified with lifestyle habits.

It is helpful to know some of the controllable causes of stroke and to learn how to control them.

1. Lower high blood pressure

Hypertension is chronic high blood pressure. It raises the risk of stroke and it also contributes to the development of heart disease and cerebrovascular disease- 2 well-known stroke risk factors. The first step in effective management of hypertension requires diagnosis through regular blood pressure screenings. Treatment of hypertension can include a diet low in salt, weight management, regular exercise or stress control. Sometimes medication to lower blood pressure is required. Your doctor can advise you on the best approaches for you when it comes to maintaining a normal blood pressure.

2. Control heart disease

Heart disease can be present at birth. It may occur later in life due to hereditary. Heart disease can develop a result of hypertension, obesity, diabetes or high cholesterol. Heart disease can include coronary artery disease (disease of the blood vessels that supply the heart), heart valve problems, heart muscle problems, an enlarged heart or an irregular heartbeat.

There are many effective ways to diagnose and treat heart disease, depending on the cause. As with hypertension, the best approach is to have regular check ups with your doctor to detect problems early before they progress.

3. Lower high cholesterol

High cholesterol contributes to heart disease and cerebrovascular disease. It is usually the result of a diet high in unhealthy kinds of fat. Lowering cholesterol requires a diet with moderate fat intake, moderate exercise and sometimes medication.

4. Control diabetes

Diabetes can contribute to cardiovascular disease and cerebrovascular disease. Diabetes is a disorder of blood sugar metabolism. Diabetes may be inborn or acquired. People with type 1 diabetes require close management of blood sugar levels, usually with insulin treatment. People with type 2 diabetes require management of food intake, weight management and sometimes medication to maintain desirable levels of blood sugar.

5. Manage obesity

Obesity is also a risk factor for stroke. It can contribute to hypertension and high cholesterol. Obesity is often managed by diet and exercise. Sometimes, weight loss supplements or surgical procedures for weight loss can help when it is difficult to lose weight with diet and exercise alone. Genetics play a role in obesity as some people are more predisposed to being overweight than others, making weight loss a bigger challenge.

6. Stop smoking

Smoking contributes to heart disease, cerebrovascular disease and hypertension. Smoking can be a difficult habit to break. Different approaches, including behavioral control, counseling, support groups, nicotine patches and smoking cessation programs can be used to help quit smoking. Research shows that many of the harmful effects of smoking can be reversed over time when smoking is discontinued. Often, smoking cessation is more successful when guided by a trained health care professional.

7. Manage stress

Stress can contribute to stroke risk by contributing to hypertension, heart disease, diabetes and cerebrovascular disease. Management of stress and anxiety often involves a comprehensive approach to behavior and emotional responses. Stress is not objectively measurable and requires a long term approach for optimal control

Other less common causes of stroke may be more complex such as autoimmune disease and blood clotting disorders. These medical problems require long-term close medical management by a physician.
Source: stroke.about.com/od/strokeprevention/fl/7-Habits-to-Prevent-a-Stroke.htm

Does Exercise Really Prevent Stroke?


Physical fitness is often recommended as one of the practical ways to prevent a stroke. Exercise provides easy to observe, obvious benefits when it comes to weight loss and maintaining an attractive appearance. But it is quite a bit more difficult to picture the more undetectable long-term benefits of exercise and physical activity when it comes to a disease like stroke.

For some people, working out is fun, exhilarating and energizing.

For others, exercise is truly a source of dread. Most of us are somewhere in between- exercise sounds like fun but it sure is a lot of trouble. And how do I know if it is really worth it? Many people would exercise for a long-term benefit only if they knew for sure that exercise could actually produce a long-term advantage.

Does Exercise Really Work in Stroke Prevention?

To help find the answer to that question, scientists have done numerous research experiments to measure the benefits of exercise. When it comes to stroke, scientific studies time and time again have verified that working out, even in moderate doses, can help prevent a stroke.

What Kind of Exercise?

One study published in the January 2014 issue of Stroke evaluated over 4000 patients and demonstrated a decreased risk of stroke associated with time spent walking. Another research article published in the journal Cerebrovascular Disease reported that patients who had already had a stroke and later participated in aerobic exercise had a better overall improvement.

Aerobic exercise is the type of exercise that requires fast paced energy, as opposed to weight lifting or stretching exercises. Water therapy is another very interesting type of exercise that is generally gentler on the muscles and has been shown to help increase blood flow to the brain, which can be immensely helpful in preventing stroke and in stroke recovery.

Because so many different types of exercise have been shown to prevent stroke, exercise does not have to be painful and does not have to be one size fits all. Tailoring your exercise to your personality, preferences and abilities is definitely the best way to go. There are so many different ways to stay physically fit that it doesn't have to be a bitter pill- it can be a fun, no matter who you are.

How Does it Work?

One of the well-understood ways that exercise helps in preventing stroke is through heart fitness. Another very interesting way that exercise can help prevent stroke is through actual neuroplasticity caused by growth of neurons in the brain.

Staying Safe

The possibility that exercise could be risky for stroke patients has been a long-standing concern for patients, their loved ones and health care professionals. A recent article out of Spain published in ‘The European Journal of Internal Medicine’ has provided reassurance that exercise is safe for stroke patients. Check with your doctor to make sure that you do not have a physical reason to avoid a particular type of exercise and then- get started!

Sources

Pang MY, Charlesworth SA, Lau RW, Chung RC, Using aerobic exercise to improve health outcomes and quality of life in stroke: evidence-based exercise prescription recommendations, Cerebrovascular Disease, February 2014

Jefferis BJ, Whincup PH, Papacosta O, Wannamethee SG, Protective effect of time spent walking on risk of stroke in older men, Stroke, January 2014

Ploughman M, Austin MW, Glynn L, Corbett D, The Effects of Poststroke Aerobic Exercise on Neuroplasticity: A Systematic Review of Animal and Clinical Studies, Translational Stroke Research, July 2014

Pugh CJ, Sprung VS, Ono K, Spence AL, Thijssen DH, Carter HH, Green DJ, The Impact of Water Immersion during Exercise on Cerebral Blood Flow, Medicine and Science in Sports and Exercise, June 2014

Bouzas-Mosquera Mdel C, Bouzas-Mosquera A, Peteiro J, Broullón FJ, Alvarez-García N, Castro-Beiras A, Exaggerated exercise blood pressure response and risk of stroke in patients referred for stress testing, European Journal of Internal Medicine, July 2014
Source: stroke.about.com/od/Screening-and-Prevention/fl/Does-exercise-Really-Prevent-Stroke.htm

How Much Do You Know About Strokes? - Answers


The test questions are here. The good news is we have the information for you. First and foremost, get your blood pressure checked and under control to prevent stroke. A healthy diet, exercise and treatment for atrial fibrillation, a heart condition, go a long way to ward off strokes. Read on for the answers and more on this serious condition:

1. False. The most important thing you can do is have your blood pressure – not sugar – checked and treated. “Also quit smoking and make sure diabetes is treated – but controlling high blood pressure is absolutely the biggest,” says Rhode Island neurologist Brian Silver, M.D., spokesperson for the American Stroke Association. One study estimated that if all cases of high blood pressure were treated, the rate of stroke would decrease by 40%. That means 320,000 fewer strokes a year.

2. True. About 15% of women who suffer a stroke have an undetected or untreated condition called atrial fibrillation (a-fib). This condition causes an irregular heartbeat and allows blood to pool in the heart, increasing the risk of clotting and stroke, says David Meyerson, M.D., director of cardiology at Johns Hopkins University Medical School in Baltimore and a spokesman for the American Heart Association (AHA).

3. False. Yes, you can reduce your risk by getting high blood pressure treated, exercising and eating healthfully. “Roughly 80%, of stroke risk can be controlled by adopting healthy lifestyle habits,” Meyerson says. But some risks are uncontrollable, such as being female, age 55 or older, having a family history of stroke or heart disease, and being of African-American descent, he says.

4. True. Taking street drugs like cocaine and methamphetamines raises your risk of stroke, Meyerson says. Besides avoiding illicit drugs, get high blood pressure and cholesterol treated, maintain a healthy weight, avoid smoking, exercise regularly and drink alcohol only in moderation, he says.

5. True. “We’re seeing more people in their 30s and 40s having strokes,” says Brian Silver, M.D., a Rhode Island Hospital neurologist and spokesperson for the American Stroke Association. According to Silver, the rising rates of obesity, high blood pressure and diabetes in younger people likely contribute to the growing rate of stroke.

6. False. Ischemic stroke is actually the most common type. “About 87% of strokes are ischemic,” Silver says. Ischemic stroke happens when a blood vessel gets blocked by a piece of a clot. The other type of stroke – hemorrhagic – is when blood vessels burst. About 13% of strokes are hemorrhagic.

7. True. The left side of your brain controls speech and language abilities for most people, says John Whapham, M.D., a neurologist and head of the stroke center at Loyola University Health Systems outside Chicago. “The right side of your brain controls spatial and perceptual abilities, short-term memory, behavior and judgment,” he says.

8. True. A clot-busting medication called tPA can be administered if someone having a stroke gets to a hospital within 4. 5 hours, Silver says. “Getting stroke victims to the hospital quickly can do wonders,” he says. “A tPA can limit dramatically limit the damage of an ischemic stroke.” About one-third to one-half of people with ischemic stroke can benefit from tPA. “For hemorrhagic stroke, unfortunately, we don’t currently have anything like this treatment,” he says.

9. True. A sudden severe headache is definitely a warning sign. So is sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; trouble walking, dizziness or loss of coordination. If you or someone you know may be having a stroke, get to the hospital as quickly as possible.

10. False. “Most people get the maximum recovery they’re going to get within six months,” Whapham says. If you’ve had a severe stroke, though, some things may never come back. “Other things may take several months or a year,” he says.
Source: www.lifescript.com/quizzes/health/how_much_do_you_know_about_strokes.aspx

Eating to Prevent Stroke


11 Ways to Incorporate a Healthy Diet into Your Routine

A stroke is often related to cerebrovascular disease and cardiovascular disease. This means disease in the blood vessels of the heart and the blood vessels of the brain. Narrowing, stiffening and cholesterol buildup inside the blood vessels can lead to blot clots, which cause stroke. These conditions have a hereditary component but can be exacerbated by certain lifestyle habits.

A healthy diet low in junk food, cholesterol and saturated fats has been associated with lower stroke risk. Exercise, smoking cessation and lowering stress and anxiety are also healthy habits that can help decrease the risk of stroke. When it comes to maintaining a healthy diet, changing habits is key. One of the difficulties with changing lifestyle habits is that habits are just that- habitual. It is always easier to follow the path of least resistance and to continue doing what you are doing than to switch gears and adopt new habits, even when you know the new habits will be beneficial. One of the reasons the bad habits started in the first place is because they are easier.

A great strategy to adopting healthy eating habits is to work on making healthy habits convenient so that healthy eating can become an easier part of your daily routine.

How to Incorporate a Healthy Diet into Your Routine

One of the roadblocks to maintaining a healthy diet is convenience. Healthy foods such as fruit and vegetables have a shorter shelf life than junk food, which is made to last.

Additionally, junk food is often pre-cooked or very easy to prepare. Staying stocked up on fresh fruits an vegetables requires frequent shopping and meal planning in order to eat or prepare the fresh food before it spoils.

So what is the solution for healthy eating?

11 Solutions

1. Create a healthy menu of meals and snacks so you won't have to think about healthy recipes to prepare or eat when you are rushed or hungry. You could create a menu for the whole week prior to your grocery shopping.

2. Put healthy items on your shopping list to avoid impulse purchases. Make sure you think ahead about ingredients for your menu and include enough healthy snacking options.

3. Eat before you go grocery shopping. When you are hungry while shopping, you may be tempted to stock up on ready-made food and junk food.

4. Pay attention to the cost when you shop. One of the deterrents to eating healthy is that some fresh produce can be expensive. But they do not have to be. In-season fruits and vegetables tend to be less costly. When produce is in season- it tends to taste better too.

5. Stock up on frozen or canned produce, especially items that you plan to bake or boil because most vitamins and minerals are maintained in canned or frozen fruits and vegetables. Opt for choices with little or no preservatives, artificial sauces or juice.

6. Don't buy too much junk food when you shop. Calculate the cost that you are saving with each purchase that you pass up and consider saving on an account for a luxury purchase, an enjoyable outing or a contribution to a good cause. However, some favorites are ok. When you don’t have any on hand, you might crave some items so much that you could end up buying fast food or raiding the vending machines while you are out. This can be unnecessarily costly, when in reality, just some ice cream at home would have satisfied your sweet tooth.

7. Avoid buying foods just because they are healthy- stick to the healthy choices you like. You could end up paying for a few types of vegetables that you don’t enjoy simply because you know they are healthy. Remember, you do not have to eat every type of healthy item, just a reasonable variety.

8. Cut up fruit and veggies for yourself in the morning to last all day. This will put healthy food on par with junk good for convenience.

9. Decide ahead of time how much of each type of item you should have for the day. For example, if donuts are your weakness, you could decide how many are suitable for you ahead of time, and make sure you have enough healthy satisfying food available and on hand so that donuts aren’t the only item to turn to when you are hungry.

10. Consider using a fitness app on your phone or electronic device. Many of them track your calories as well as your intake of vitamins, minerals, protein and types of cholesterol. You can watch your progress throughout the day. After a few days or weeks, you can decide to adapt some habits to achieve healthier results. This way you can see for yourself how many donuts you can have and still maintain adequate calories and vitamins and minerals. You can see if you are having too much fat or too little protein and swap some of your regular go-to items.

11. If you need to have some less healthy ingredients on hand for special recipes, keep them in less convenient storage in the kitchen and keep healthier items in more accessible spots.

Overcoming the inconvenience of eating healthy is a great first step to stroke prevention and recovery.
Source: stroke.about.com/od/strokeprevention/fl/Eating-to-Prevent-Stroke.htm

What You Need to Know About a Mini Stroke


In order to understand what a mini stroke, or transient ischemic attack (TIA) is, you must first understand the meaning of the word ischemia.

What is brain ischemia?

The healthy brain requires a constant delivery of oxygen- and nutrient-rich blood to each one of its approximately 100 billion neurons. To accomplish this, and thus to ensure normal brain function, blood travels across multiple blood vessels to every part of the brain.

In some people, however, blood vessels become blocked by blood clots, or cholesterol plaques, leaving discrete brain areas transiently disconnected from their blood supply. The resulting lack of oxygen and nutrients in these areas is known as ischemia. Neurons in ischemic areas starve and rapidly stop functioning.

What is a Mini Stroke or TIA?

A mini stroke then, which as stated previously is also known as a TIA, is a brief period of lack of blood flow to an area of the brain. Because ischemia impairs the function of brain cells, a person suffering a TIA develops symptoms of brain function impairment, such as difficulty speaking or moving the arm and leg on one side of their body. The symptoms of a TIA can last from a few minutes to a few hours, but by definition they go away in less than 24 hours.

Up to 20% of people who experience TIA symptoms go on to have a major stroke in the next three months. Unfortunately, many people fail to seek medical attention and suffer a stroke before they are seen by a doctor.

The symptoms of a mini stroke begin suddenly and vary depending on the part of the brain that is affected. Mini strokes that affect areas of the brain used minimally in day to day function cause symptoms that are mild or almost unnoticeable. By contrast mini strokes affecting areas of the brain used heavily in normal day to day function cause symptoms which can be extremely debilitating.

For instance a person who suffers a mini stroke in the hand area of the brain may develop difficulty writing for a few minutes or hours. A different person who experiences a mini stroke of a similar size in the brainstem, an area of the brain which harbors the centers for gait balance, voice control, and eye movements, might feel temporarily unable to carry on with his or her day because of vertigo, difficulty speaking, or double vision.

Mini strokes most commonly affect parts of the brain which control movement and feeling in the face, arm, and leg. They can also affect our ability to understand and produce speech. Here is a list of the most common symptoms of a mini stroke:

  • Weakness of the face, and/or arm, and/or leg muscles on one side of body
  • Numbness of face and/or arm and/or leg one side of the body
  • Inability to understand spoken language
  • Inability to speak
  • Unexplained dizziness or vertigo
  • Loss of vision through one eye
  • Double vision or blurry vision

What is the difference between a mini stroke and a stroke?

By the current definition, the symptoms of mini stroke/TIA disappear completely within 24 hours. Strokes on the other hand leave long-lasting physical impairments. But when one compares the brain of a person who suffered a stroke, with the brain of a person who suffered a mini stroke using MRI, very often one cannot tell which is which. Why is this? This is currently a subject of intense study and definitive answers have yet to be produced, but this suggests that even though mini strokes only cause temporary symptoms, they can still cause permanent damage to the brain.

I think I had a mini stroke. What should I do?

The more we learn about mini strokes, the more convinced we become that they are a sign that a debilitating stroke is on the way. This is why no matter how mild or short-lived the symptoms of a mini stroke might be, it is extremely important that you go to the nearest emergency room immediately after you start feeling stroke-like symptoms.

Even if you had a mini stroke a few days ago you should still seek medical attention as soon as possible. The urgency of this matter cannot be overemphasized as up to 20% of people who suffer a TIA will go on to suffer a stroke within 90 days.

The high risk of stroke after a mini stroke has motivated many medical institutions to keep all mini stroke patients in the hospital for observations and thorough testing even in cases when symptoms have resolved completely by the time the patient arrives in the Emergency Room. In many cases an early search for the cause of a mini stroke allows for early intervention and successful stroke prevention.
Source: stroke.about.com/od/whatisatia/a/TIAs.htm

How Much You Sleep Affects Your Risk of Stroke


A new study of 200,000 Americans has found that if somebody has high blood pressure – a condition that affects one third of the country – their risk of stroke is significantly affected by how much they sleep.

Specifically, people who sleep less than 5 hours per night and more than 8 hours per night were found to have an 83 percent and 74 percent higher risk of stroke, respectively.

Most strokes are triggered by a blood clot in the brain, and they’re relatively common: about 800,000 people each year have a stroke in the U.S., and it’s a leading cause of disability. So what can you do to minimize your risk?

How Much Sleep Is Too Much Sleep?


Sleep Needs Vary for Everyone

Although most people should be concerned about not sleeping enough, you may wonder: How much sleep is too much sleep?

First, it is important to determine how much you sleep you need, which can be accomplished with a simple experiment. Individual sleep needs are largely determined by genetics, but other factors may include your general health and even your age. Most adults need 7.5 to 8.5 hours of sleep per night.

When you get less than the sleep you need, you begin to experience sleep deprivation. With chronic loss of sleep you may gradually accumulate a sleep debt. You may experience excessive daytime sleepiness and you may find yourself taking frequent, prolonged naps or sleeping more on the weekends.

But, ultimately, how much sleep is too much? If you are a long-sleeper based on your genetics, you may sleep 8 to 10 or more hours a day to feel rested. Just as there are exceptional people who can get by on 4 hours of sleep per night, other people may require 12 hours, though both scenarios are rare.

If your personal sleep needs have changed dramatically, or if you suffer from symptoms of sleep disorders such as feeling too sleepy, you may wish to speak with your doctor or a sleep specialist. Certain medical conditions such as hypothyroidism or depression may leave you sleeping too much and these may require treatment.

For those who have always required a little extra sleep than average, there is no reason for feeling guilty about sleeping too much.

It’s not too much; it’s just what you need.
Source: sleepdisorders.about.com/od/sleepdisorderevaluation/a/How-Much-Sleep-Is-Too-Much-Sleep.htm?utm_source=cn_nl&utm_medium=email&utm_term=Health%20Channel%20Newsletter&utm_campaign=healthsl&utm_content=20150519

Heavy Drinking Boosts Stroke Risk


Men who down seven or more drinks a day have a significantly increased risk of atrial fibrillation, the irregular heartbeat that can lead to stroke, a study finds.
Source: The New York Times News Service, 9/12/05

There's a Fourth Indicator of a Stroke - the Tongue


During a BBQ, a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) .....she said she had just tripped over a brick because of her new shoes.

They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening

Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 pm Ingrid passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don't die.... they end up in a helpless, hopeless condition instead.

It only takes a minute to read this...

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke... totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

Recognizing a Stroke

Thank God for the sense to remember the '4' steps, STRT. Read and Learn!

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke. Now doctors say a bystander can recognize a stroke by asking three simple questions:

S * Ask the person to SMILE.

T * Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently) ( i.e. It is sunny out today)

R * Ask the person to RAISE BOTH ARMS.

T * Ask the person to stick out their TONGUE. If the tongue is 'crooked', if it goes to one side or the other, that is also an indication of a stroke.

If they have trouble with ANY ONE of these tasks, call 999/911 immediately and describe the symptoms to the dispatcher.

Two requests:

1. Copy this section, put it in an email and send it to 10 friends. That simple effort will probably save a life.

2. Print out Stroke Signals on thick paper, cut it up, put on in your wallet where it shows if someone opens your wallet to see if you have a medical card and give the rest out to family and friends. That may save your life.

Gender Differences in Stroke


Spanish researchers publishing in this month's Stroke find an abundance of differences between male and female victims of stroke.

Most significantly, women are more likely to suffer a more severe stroke than men, and women are more likely to have a stroke at an older age.

Stroke is the third-leading cause of death in women. While stroke is more common in men, in the year 2000 about 61 percent of all deaths from stroke occurred in females, and statistics indicate about one in six women will eventually die of stroke. This compares to one in 25 dying of breast cancer. Many studies on stroke have involved women, but few have looked at factors that may be putting women at higher risk for stroke or how women fare after the event.

Researchers from Spain decided to clarify the data with a study of around 1,500 stroke patients, 772 of them women. Results showed the average age of female stroke patients was 75, compared to 69 for men. For men, the predominate risk factors were peripheral artery disease and overuse of alcohol. For women, stroke was most often predicated on a higher frequency of atrial fibrillation, an irregular heartbeat.

Stroke outcomes also differed between the genders. Nearly 30 percent of the women were left with the inability to use or understand words, compared to 22 percent of the men. Visual impairments were seen in about 17 percent of the women vs. 14 percent of the men. About 20 percent of the women experienced chewing or swallowing difficulties, compared to 14 percent of the men.

Noting treatment with anticoagulants can help people with atrial fibrillation reduce their risk for stroke, the authors write, "Stroke prevention with anticoagulation in atrial fibrillation is a priority in both men and women; however, women obtain the most benefit from it."
Source: www.healthcentral.com/news/NewsFullText.cfm?id=8006405  

How to Stop a Stroke from Starting


It’s practically guaranteed that at some point in your life, you or a loved one will have a brush with stroke. In fact, every 45 seconds someone suffers a stroke in the United States, and it’s the third most common cause of death.

But despite all of this, could you say exactly what a stroke is if you were asked? Would you know how to recognize a stroke? Would you know if you were having one right now? This may sound clichéd, but don’t wait until it’s too late: Strokes can be prevented, and you’re the one to help.

What Is Stroke?

You have heard the term over and over again but you still wonder: What is stroke anyway? Stroke is a sudden impairment in brain function. One may suffer an inability to speak or speak clearly, walk, or move a limb because blood has stopped flowing to an area of the brain. Usually, this is caused by the blockage, or the rupture, of a blood vessel.

Unlike ministrokes, which are also known as transient ischemic attacks (TIA), whose symptoms resolve on their own in less than 24 hours, strokes leave behind long-lasting neurological impairments. The severity of these impairments depends on how large the damage is to the brain, and on the part of the brain that is affected.

What Are The Different Types of Stroke?

There are two major categories of stroke: ischemic and hemorrhagic.

Ischemic Stroke

This type of stroke is caused by the physical blockage of blood flow to an area of the brain. The most common forms of ischemic stroke are:

1) Embolic Stroke

This type of stroke occurs when a blood clot or a cholesterol plaque wanders into the brain until it reaches a narrow point where it becomes trapped. This causes a blockage of the artery and prevents blood from reaching a section of the brain. There are other, less frequent causes of embolic strokes which include:

Septic Emboli

Atmospheric Air

Embolic Myxoma

Deep Venous Thromboses

2) Thrombotic Stroke

In this type of stroke a blood clot forms along the inside of a blood vessel causing the interruption of blood flow to an area of the brain. Such a blood clot, also known as a thrombus, usually affects very small blood vessels in the brain, especially in people who have high cholesterol.

Because small blood vessels in the brain bring blood to proportionally small brain areas, thrombotic strokes tend to be small, and are sometimes referred to as lacunar strokes . In some rare instances, however, a large blood clot can form inside of one the large blood vessels in the neck, and later break off causing a large embolic stroke .

Hemorrhagic Stroke

This type of stroke occurs when a blood vessel inside of the brain ruptures, allowing blood to pool inside or around healthy brain tissue. In many cases this is the result of uncontrolled high blood pressure.

High Blood Pressure Basics

Depending on the location of bleeding, a hemorrhagic stroke is further subdivided into

Intracerebral Hemorrhage: Bleeding takes place inside the brain tissue.

Subarachnoid Hemorrhage: Bleeding takes place along a space between two of the membranes that cover the brain.

Intraventricular Hemorrhage: Bleeding takes place inside the ventricles of the brain, which do not contain brain tissue, but instead are filled with a fluid known as cerebro-spinal fluid. Blood inside the ventricles rarely causes a stroke by itself, but it has the potential to cause hydrocephalus a condition in which elevated intracraneal pressure can cause stroke and even death.

Subdural Hemorrhage: Bleeding takes place outside of the brain tissue near the skull.

Hemorrhagic strokes are most often caused by a ruptured blood vessel such as an aneurysm or a leaky arteriovenous malformation (AVM). Blood inside the brain produces a very severe headache, which is typically described by people as the worst headache of their lives.

As blood accumulates in the brain, the normal brain tissues are pushed against the walls of the skull. This process increases the pressure inside the brain, to the point that blood flow to the areas of highest pressure is completely interrupted. These areas cease to function, and cause symptoms which can range from dizziness, nausea and vomiting to a headache accompanied by typical stroke symptoms. Hemorrhagic stroke symptoms should never be ignored as very often they can evolve rapidly and in the worse cases they can lead to sudden death.

Causes of Stroke

There's isn't one smoking gun when it comes to stroke. There are many potential causes.

High Blood Pressure and Hemorrhagic Stroke

Did you know that high blood pressure is a major cause of strokes due to bleeding in the brain? Strokes usually occur due to a blockage of blood flow to a part of the brain, but approximately 15% of them occur due to bleeding. These are known as hemorrhagic strokes. And of all the causes of hemorrhagic stroke, high blood pressure is by far the most common one, accounting for approximately 80% of all cases.

High Blood Pressure as a Risk Factor for Stroke

No matter what stroke risk factors a person might carry with him, suffering from high blood pressure alone can significantly increase his risk of suffering a hemorrhagic stroke. This risk is even more pronounced in the elderly, in people who smoke, in men, in diabetics, and in people who drink alcohol.

High blood pressure causes intracerebral hemorrhage (ICH) by damaging the fragile walls of small arteries inside the deeper areas the brain. These are the same arteries affected by lacunar strokes, which are so common in white matter areas. However, the area most commonly damaged by ICH is called the basal ganglia. Other parts of the brain affected by bleeding due to high blood pressure include the thalamus and the cerebellum.

In some cases the bleeding caused by high blood pressure is so large that blood spills into the brain's ventricles causing an intraventricular hemorrhage, a condition which can result in life-threatening hydrocephalus.

What Are the Symptoms?

The symptoms of ICH caused by high blood pressure vary depending on the location and size of the bleeding. Symptoms can therefore consist of:

Weakness of the face and/or arm, and/or leg on one side of the body

Numbness in the face, and/or arm, and/or leg one side of the body

Inability to understand spoken language or inability to speak

Inability or difficulty writing or reading

Vertigo and/or gait imbalance with or without nausea or vomiting

Severe headache or double vision

In rare cases, the bleeding caused by high blood pressure is so profuse that it leads to a rapid increase in intracranial pressure, which causes patients to become unresponsive, paralyzed or comatose.

But by symptoms alone it is not possible to distinguish whether a given stroke is the result of poor blood flow, or profuse bleeding. This is an important reason why special tests are required to diagnose bleeding in the brain (see below).

How Is it Diagnosed?

When a person comes to the emergency room with stroke symptoms, physicians routinely perform tests to look for bleeding in the brain. The first test performed usually is a head CT , which is a rapid and reliable way to rule out this possibility. When bleeding is found but the source of the bleeding is not clear, other tests such as a cerebral angiogram or an MRI of the brain with contrast can be performed. These tests help to diagnose other causes of bleeding such as AVM , aneurysms , amyloid angiopathy , or brain tumors .

What Is the Treatment?

The treatment of bleeding in the brain from high blood pressure starts by bringing the patient to the intensive care unit for proper stabilization and diagnosis. This is done by physicians who specialize in critical care medicine . Usually, blood pressure is controlled in order to prevent further bleeding. Other possible interventions are decided based on the size of the bleeding, on the severity of the symptoms exhibited by the patient, and on whether the interventions being considered can be expected to make a difference in the overall outcome. In some cases, bleeding must be evacuated immediately, because it threatens to harm the brain. In other cases, the risks of surgery clearly outweigh the potential benefits, leading doctors and families to refrain from further treatment. And in the grimmest of cases, bleeding has caused so much damage to the brain that surgical intervention is futile.

How to Recognize Stroke Symptoms

Stroke symptoms usually come on suddenly, and should always be treated as a medical emergency. They can include a sudden onset of any of the following:

  • Weakness of the face, arm, and/or leg on one side of body
  • Numbness in the face, arm, and/or leg on one side of body
  • Inability to understand spoken language
  • Inability to speak
  • Inability to write
  • Vertigo and/or gait imbalance
  • Double vision
  • An unusually severe headache

Why do stroke symptoms start so suddenly?

The symptoms of stroke begin suddenly because they are caused by an abrupt interruption of blood flow to an area of the brain. When this happens, it only takes a few seconds for that part of the brain to stop functioning.

Only a small proportion of strokes produce headache symptoms. However, the sudden onset of a severe headache makes doctors suspect that there is bleeding inside the brain. Because of the high risk of death in these cases, people who come into the emergency room complaining of severe headache are rapidly screened for the presence of blood in the brain.

Are the symptoms of stroke permanent?

Whether or not the symptoms of a stroke will be permanent depends on how long the affected part of the brain remains without blood flow. While brief events of poor blood flow, or ischemia, lead to a complete recovery, longer events can leave permanent deficits.

What is a TIA?

What determines how severe the symptoms of a stroke will be?

The severity of stroke symptoms varies depending on the part of the brain that is affected. For instance, strokes that affect areas of the brain which have minimal importance in day-to-day brain activity typically produce mild or unnoticeable symptoms. By contrast, strokes that affect areas of the brain which have maximal importance in day to day brain activity cause the most debilitating and noticeable symptoms.

For instance, strokes affecting one of the smell areas of the brain rarely cause identifiable symptoms, but by contrast, strokes affecting one of the speech areas of the brain nearly always do.

Why do strokes usually affect only one side of the body?

For the most part, the left side of the brain controls the right side of the body, while the right side of the brain controls the left side of the body. When a blood vessel that carries blood to a given part of the brain is blocked, only the side of the brain where the blood vessel is located is affected. This causes symptoms in the opposite side of the body.

I think I am having a stroke, what should I do?

You should call 911 immediately. The earlier you get to the emergency room, the greater the chances are that you will receive a treatment, which can minimize and even reverse the long-term consequences of the stroke. After you call the ambulance, get ready to answer the following questions, which will help doctors select the best treatment:

What time did your symptoms start?

What is your complete medical history?

Have you ever had a stroke? Have you ever had bleeding inside of your brain?

Do you have any metal inside your body? (this is important in order to decide whether your head can be imaged using magnetic resonance imaging (MRI), as the MRI machine has a powerful magnet. Common metal items inside the body of people include pacemakers, joint prostheses, dental work, and even bullet fragments)

What medications and supplements do you take on a regular basis?

Do you suffer from a bleeding disorder?

Stroke Rehabilitation is a Critical Part Stroke Recovery

Several decades of scientific research now show that stroke rehabilitation is critical for optimal stroke recovery. The benefits come from helping the brain to reorganize itself with physical therapy, which in turn helps the stroke survivor to recover functions lost after brain injury. Below you will find important information about the process of physical therapy and rehabilitation, and about its potential to help you regain your life after stroke.

What is stroke rehabilitation?

Stroke rehabilitation is the process by which a stroke survivor works with a team of health care providers with the aim of regaining as much of the function lost after a stroke as possible. By joining a comprehensive rehabilitation program immediately after leaving the hospital, stroke survivors can maximize their chances of recovery, and in most cases they can regain a substantial portion of the functions they lost as a result of their stroke.

Some of the different types of medical professionals who participate in the care of stroke patients during the rehabilitation process include:

  • Physical Medicine and Rehabilitation Physicians (Physiatrists)
  • Physical Therapists
  • Speech Therapists
  • Occupational Therapists

Why is stroke rehabilitation important?

The importance of rehabilitation after stroke cannot be overemphasized. Studies have shown that rehabilitation is responsible for most of the recovery experienced by patients after a stroke, and that without it, little or no improvement can be accomplished. Stroke rehabilitation provides a targeted and organized plan to re-learn functions lost in the shortest period of time possible.

How long does stroke rehabilitation last?

The duration of your rehabilitation needs will depend on the type of stroke you suffered. On the average, immediately after leaving the hospital, people stay inside rehabilitation facilities for a total of 16 days. This brief period of in-house therapy is followed by further rehabilitation in an outside facility for the following several weeks.

Although most of your improvement will take place within this time, your brain can continue to learn and re-learn new and old tasks for as long as you live. This is why it is so important to continue with your own rehabilitation at home after you have completed your visits to the rehabilitation center. A successful outcome will require dedication, perseverance, and a great attitude. In fact, some studies suggest that successful and meaningful recovery is more likely to be accomplished if you are dedicated and keep a high level of motivation during your rehabilitation process.

Related

Urinary Incontinence Basics Inability to control when urine is often a symptom of stroke. Learn about this condition and what can be done to treat it

How to Know if You are Having a Stroke
Stroke symptoms can be confusing. Strokes are brain attacks, meaning that a stroke is caused by a decrease in blood supply to a portion of the brain. Unlike heart attacks, which are painful events, brain attacks are not usually painful. In fact, the symptoms of a stroke can be strange or puzzling. Some studies show that as many of 30% of strokes may go undiagnosed within the first 3 weeks.

Because stroke symptoms are rarely painful, it is important to know how to recognize a stroke to avoid missing this emergency problem. The symptoms of a stroke can vary and there are different signs and symptoms of stroke. There are also many different types of stroke. The symptoms depend on which blood vessel is affected and thus which corresponding part of the brain lacks adequate blood supply. There are a range of effects - some strokes cause vision changes, some cause weakness, some cause changes in sensation, some cause speech problems and some cause dizziness or headaches. Often, symptoms are subtle and they don’t ‘feel’ like an emergency. But when a stroke is handled as an emergency, with immediate evaluation and treatment, there is a better chance of a good prognosis with minimal long-term effects. Long term effects include weakness, trouble speaking, swallowing or thinking. In some situations, seizures or muscle atrophy can result.

How to know if you are having a stroke

If you experience weakness on one side of your face, arms, hands or legs, you should obtain medical attention right away. Facial weakness often manifests as eyelid drooping or slurred speech. Vision changes such as blurred vision, double vision, vision loss or partial vision loss can be the sign of a stroke or another serious eye emergency. Trouble with balance and coordination can make it difficult to walk or use hands. Abnormalities of sensation, such as numbness, tingling or burning may not be as noticeable as weakness or vision changes, but it may be the only sign of a stroke. Usually sensory deficits occur on one side of the body during a stroke.

Severe headaches or dizziness may signal a stroke or another urgent neurological condition. It is best to err on the side of caution and get medical attention right away. Time spent in deciding whether or not to obtain medical attention could end up as time wasted from getting the proper treatment.

If you experience trouble speaking, including trouble getting your words out, or understanding words, it is important to get attention right away. When your ability to communicate is impaired, that is when it is obviously most difficult to be able to ask for help.

If it is possible to call 911, that would be the best route for the best care for a possible stroke. But sometimes weakness and poor coordination or vision problems may make it difficult to call for emergency care yourself. In these situations, the best way to ask for help is simply to get the attention of people who are nearby, such as family, friends, coworkers or even strangers if you do not know any of the people around.

How to know if someone else is having a stroke

If you are a companion of someone who is complaining of weakness, loss of sensation, vision changes, severe dizziness or headaches, you should be aware that this could be an unstable situation and that your companion may get worse quickly. You should call for help immediately before the situation worsens.

Because a stroke can affect thinking, judgment and insight, sometimes a stroke victim is unaware of what is happening or may not be able to describe to you what is going on. When someone else is having a stroke, you may notice some changes such as a lack of symmetry of both sides of the face or a slumping of one side of the body. Stroke victims may be confused. In some instances, a stroke may manifest with falling.

The best response is to obtain care right away, rather than waiting to see if things get better. Whether your companion is experiencing a stroke or not, neurological symptoms are red flags and diagnosis and treatment is urgent.

Stroke Symptoms

Stroke is the third leading cause of death in the United States. It's important to recognize stroke symptoms as they are happening in order to get help to the victim before the damage is permanent. The National Institue of Neurological Disorders and Stroke (NINDS) identify the following signs and symptoms of stroke. If a victim suffers any of the following signs or symptoms of stroke, call 911 immediately!

  • Sudden numbness or weakness of face, arm, or leg, especially on one side of the body.
  • Sudden confusion or trouble speaking or understanding speech.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, or loss of balance or coordination
  • Sudden severe headache with no known cause.

Causes of Stroke Symptoms

Stroke occurs when a section of the brain is suddenly starved of oxygen. Strokes can happen in two very different ways.

Ischemic stroke is a blockage of a blood vessel in the brain that results in death to the brain tissue. Usually, the blockage comes from a blood clot.

Hemorrhagic stroke occurs when a blood vessel in the brain bursts and causes bleeding in or around the brain.

Treatment of Stroke

Stroke is a true emergency, a good reason to call 911 . Treatment for both types of stroke require early recognition and access to emergency medical care. Using medication to dissolve clots in ischemic stroke should happen within three hours of onset. When suspecting stroke symptoms, be sure to take quick action.

  • Call 911 immediately. Be a good 911 caller and listen carefully to the call taker.
  • Follow the ABC's of First Aid. Pay close attention to the victim's airway; stroke victims have difficulty controlling their own airways.
  • Raise the victim's head. Raising the head helps decrease the pressure on the brain inside the skull.

Source: mail.aol.com/38815-816/aol-6/en-us/Suite.aspx

Blood Test For Stroke


Early diagnosis means faster treatment

When faced with a patient who may be having a stroke, most doctors are faced with a dilemma. If the patient is having a stroke, rapid treatment delivered within the first couple of hours is critical in preventing further damage to the brain structures and the resulting disabilities that go along with this damage. But knowing what exactly is the right treatment is the problem.

Strokes are caused by an interruption of the circulatory system in the brain, caused either by a blot clot in one of the vessels supplying the tissues of the brain, or by bleeding in the brain. The choice of treatment for each of these is very different and if the cause of the stroke is misdiagnosed and treated with an incorrect treatment, further damage or even death can result. The majority of strokes (80 %) are caused by blood clots blocking one or more arteries of the brain, with the rest caused by bleeding.

Stroke Victim

Stroke (cerebral vascular accident) kills nearly a quarter of those who suffer from one and cause disability for most. There are very effective drugs "clot busters" for treating those strokes caused by clots that if given within a window of three hours from the beginning of the stroke can break up the clot and prevent much of the brain damage that occurs. These same drugs if given to patients having strokes caused by bleeding will cause more bleeding in the brain increasing the damage and possibly leading to the death of the patient. Quickly diagnosing the cause of the stroke is problematic for doctors and often leads to delays in treatment. Stroke is difficult to diagnose because of a wide variety of symptoms patients may present to the emergency room with. These symptoms can also be caused by other conditions not related to stroke.

Computerized Tomography or CT scans are very effective at diagnosing bleeds in the brain but much less effective at pinpointing clots. Daniel Laskowitz, a neurologist at Duke University Medical Center in Durham, North Carolina and consultant for diagnostic company Biosite, has been working with that company to develop a blood test for strokes caused by blood clots. Early results are showing that the test they have developed that detects a set of six brain proteins released into the blood that strongly indicate a stroke caused by clots. Results can be obtained within 15 minutes allowing treatment to begin well within the window of effectiveness.

A larger clinical trial is to be undertaken to verify the result of this research. If the tests are found to be effective, this test could be eventually done in every emergency room or ambulance when a patient presents with stroke symptoms.

Side Effects of Coumadin, Plavix and Other Blood Thinners


Blood thinners are commonly used in the prevention of strokes. This is especially important for people who have already suffered one

stroke, as they have an increased risk of suffering another. In fact, about 30% of all strokes in a given year are repeat strokes, so stroke survivors must be diligent about stroke prevention . However, even if you've never suffered a stroke, but are at risk of getting one, you're likely taking a blood thinner.

Here is a list of common blood thinners used for stroke prevention, and their common side effects. For a complete review of these medications, please visit the latest edition of the physician’s desk reference.

Plavix:

Common side effects of Plavix include stomach pain, muscle aches, dizziness, and headache. Easy bruising and nose bleeds can also occur. People who have stomach ulcers might develop intestinal bleeding, which can be life threatening.

What to watch out for: if you find black or tarry-looking stools this is a sign of intestinal bleeding. This and any other forms of abnormal bleeding should prompt you to discontinue the medication and to go to the nearest emergency room.
Source: stroke.about.com/od/caregiverresources/a/blood_thinners.htm

10 Common Symptoms of a Stroke


A stroke, or cerebrovascular accident (CVA), is a scary experience. It occurs when the blood supply to the brain is impeded or cut off completely due to lack of blood flow (or ischemia), blockage (thrombosis, arterial embolism), or a brain hemorrhage. As a result, the brains stops functioning normally and oftentimes the muscles in the body, the reflexes, and the senses are all affected.

Luckily, a stroke can be treated, but getting emergency medical attention as quickly as possible is the key to survival. That’s why it’s vital to recognize the following ten warning signs of a stroke…

1. Loss of Balance

The onset of a stroke will cause extreme physical turmoil, so much so that often victims have trouble walking, lose their balance and coordination completely, and even have trouble sitting down without falling.

2. Weakness

A sudden loss of strength in the muscles of the face, arm, leg—even if it’s just temporary—can signal an oncoming stroke. Many patients complain of numbness or tingling in the left arm or shoulder that comes on suddenly and gradually worsens. Sometimes, complete muscle failure can occur, where you can’t lift an arm or bear weight on the affected leg.

3. Facial Paralysis

Oftentimes a stroke inflicts the facial muscles, where one side of the face droops or goes totally numb so the face appears non symmetrical when they try to talk or smile.

4. Difficult Speech

If an individual suddenly has difficulty speaking or forming intelligent sentences, it can indicate a stroke. Observers often explain it as watching someone helpless trying to talk, or a look of sudden confusion on the affected person’s face.

5. Impaired Vision

Those affected by a stroke often explain there is a period prior where they have trouble seeing or seeing clearly. This blurred vision might only be temporary, but observers can test visual aptitude by asking the victim how many fingers they are holding up. If they can’t tell, call 9-1-1.

6. Lack of Understanding

A person suffering a stroke will often have difficulty understanding certain statements and commands in the days leading up to the actual stroke.

7. Headache

The sudden onset of a severe, debilitating headache or migraine that is not normal or usual is common prior to a stroke. In fact, many stroke victims explain a headache so painful that it feels like being struck by lightning, causes extreme nausea, and even collapse.

8. Loss of Sensation

In the days leading up to a stroke, it’s common for a gradual, or even a total, loss of vibratory sensation (or feeling) on the skin. The other senses—such as smell, taste, and hearing can also be fully or partially affected.

9. Dizziness

Many victims of a stroke encounter a total loss of balance so severe that they feel like the world is spinning (i.e., vertigo).

10. Lack of Reflex

It is also common to experience a decrease or loss of reflex. For instance, many stroke victims complain of trouble swallowing when eating to the point where they gag.

What Does "Premature Death" Mean?


While there is no widespread definition adopted by all demographic researchers, premature death and premature mortality are terms generally referring to a death which occurs prior to the average life expectancy for a given population. Depending on the standard of public health in a country, the threshold age considered to be "premature" would differ.

For example, the US Centers for Disease Control and Prevention (CDC) describe a death before the age of 80 as premature in documents such as the Morbidity and Mortality Weekly Report.

In high income nations, death rates for middle-aged adults have declined dramatically since the 1970s, thanks to more people quitting smoking and better survival rates after heart attack and stroke.

Even better for those living in industrialized countries, notes epidemiologist and international public health researcher Prabhat Jha, health promotion strategies including better secondary treatment after a cardiovascular event, more effective diabetes control and anti-smoking campaigns have helped compress morbidity - meaning the onset of many age-related diseases is delayed until a person is older, and they stay healthier, longer.

What about poorer nations? "Global life expectancy is today 70 years," says Jha, "so an appropriate mark for premature deaths in low and middle income countries should be deaths before age 70."

Jha was one of an international team proposing in The Lancet in 2014 a 40% reduction in global premature deaths by the year 2030 could be achieved through measures such as reducing infant mortality, deaths from communicable diseases such as tuberculosis, HIV/AIDS and malaria, and by battling malnutrition and injuries.

Sources:

Prabhat, Jha. Professor of Epidemiology, University of Toronto Dalla Lana School of Public Health. Correspondence September 29, 2014.

Prabhat Jha, and Richard Peto. "Global Effects of Smoking, of Quitting, and of Taxing Tobacco" N Engl J Med 2014; 370:60-68 January 2, 2014. www.nejm.org/doi/full/10.1056/NEJMra1308383

Ole F Norheim, Prabhat Jha, Kesetebirhan Admasu, Tore Godal, Ryan J Hum, Margaret E Kruk, Octavio Go´mez-Dante´s, Colin D Mathers, Hongchao Pan, Jaime Sepu´lveda, Wilson Suraweera, Ste´phane Verguet, Addis T Woldemariam, Gavin Yamey, Dean T Jamison, Richard Peto. "Avoiding 40% of the Premature Deaths in Each Country 2010–30: Review of National Mortality Trends to Help Quantify the UN Sustainable Development Goal for Health." The Lancet 19 September 2014. www.cghr.org/wordpress/wp-content/uploads/SDG-40-perc-Reduction-in-deaths-2030-Lancet-2017.pdf

Paula W. Yoon, Brigham Bastian, Robert N. Anderson, Janet L. Collins, Harold W. Jaffe. "Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010." Morbidity and Mortality Weekly Report May 2, 2014 / 63(17);369-374. www.cdc.gov/mmwr/pdf/wk/mm6317.pdf

Source: longevity.about.com/od/Longevity-Terms-And-Concepts/fl/What-Does-Premature-Death-Mean.htm?utm_content=20150811&utm_medium=email&utm_source=cn_nl&utm_campaign=healthsl&utm_term=Health%20Channel%20Newsletter

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Menstuff® has compiled the following information on Strokes.

Top 10 Signs That You’re Headed for a Strokr

How Much Do You Know About Strokes? Take a quiz

Severe Strokes: Which Types of Strokes Are the Most Deadly?
How to Stop a Stroke from Starting
10 Common Symptoms of a Stroke
11 Signs and Symptoms of Stroke
7 Habits to Prevent a Stroke
Does Exercise Really Prevent Stroke?
Eating to Prevent Stroke
The Best News About Stroke Prevention...Chocolate

The Healthiest Chocolate

Blood Test For Stroke
What You Need to Know About a Mini Stroke
How Much You Sleep Affects Your Risk of Stroke
How Much Sleep Is Too Much Sleep?
Gender Differences in Stroke
Stroke - Know the symptoms, save a life!

What Does "Premature Death" Mean?
Faith May Help Stroke Patients Cope
Side Effects of Coumadin, Plavix and Other Blood Thinners
There's a Fourth Indicator of a Stroke - the Tongue
Heavy Drinking Boosts Stroke Risk

Top 10 Signs That You’re Headed for a Stroke


Nobody sees a stroke coming, but signs of danger are usually there. You could be at risk... Stroke is sometimes called a “brain attack” because what usually occurs is similar to what happens during a heart attack. In the most common form of stroke, an obstruction blocks flow in a blood vessel that supplies the brain. A fatty deposit on blood vessel walls often gets the obstruction started. Blood clots can then form at the site of the deposit and make the obstruction worse. Clots also can form elsewhere in the body, break free and migrate through the circulatory system toward the brain, where they can cause a stroke. Strokes from clots (ischemic strokes) account for 87% of strokes. They also occur when a blood vessel ruptures and bleeds into the brain (hemorrhagic strokes). Knowing the underlying cardiovascular factors that put you at risk for stroke can help you avoid its potential disabilities or death. Here are the top stroke risks and what you can do to improve your odds.

1. Being a man... or a woman The stroke risk: Men are more likely than women to have a stroke... until age 75, according to statistics from the American Heart Association. Then the chance evens out; after age 85, women are at greater risk. “There’s a misconception that stroke is a disease of old men,” says Larry B. Goldstein, M.D., chairman of the Department of Neurology and co-director of the Kentucky Neuroscience Institute at the University of Kentucky.

The good news? For both men and women, as many as 9 out of 10 strokes are preventable by minimizing risk factors, according to a July 2016 study of 26,000 people by McMaster University in Ontario, Canada. Reduce it: You’ve cut your risk just by reading this, because knowledge is power. Next, lower your chances of having a stroke by focusing on factors you can control, especially if you didn’t think you had anything to worry about.

2. Your family tree The stroke risk: If your father, mother, brother or sister already has had a stroke, your risk of stroke is one-third higher.

In some cases, the risk lies in a genetic disorder that can lead to stroke. Sickle cell disease is one example. A gene mutation called CADASIL (cerebral autosomal dominant arteriopathy with sub-cortical infarcts and leukoencephalopathy) is another.

Your ethnicity also plays a role. African Americans have a much higher risk of stroke than Caucasians, partly because they’re more likely to have a range of cardiovascular risks that contribute to stroke.

The odds of having a first stroke are twice as high for African Americans as they are for Caucasians; they also die of their strokes more often as well.

Reduce it: You can’t change your genes, so do everything you can to change bad lifestyle habits.

3. Smoking. The stroke risk: Smoking damages cells that line blood vessels, thickens and narrows arteries and encourages the formation of clots.

It also boosts blood pressure, lowers HDL (“good”) cholesterol and raises triglycerides — all of which can make strokes more likely.

Reduce it: Avoid all tobacco smoke — both your own and other people’s.

Exposure to second-hand smoke increases the risk of stroke by 30%, even among nonsmokers, according to a paper published in the July 2015 issue of the American Journal of Preventive Medicine.

“If you find it hard to quit smoking for your own sake, do it for the sake of the people around you, especially children,” Dr. Goldstein advises.

4. Multiple drinks. The stroke risk: Heavy drinking is associated with unhealthy changes in blood pressure and can make blood clots more likely.

In fact, alcohol may raise stroke risks even higher than other cardiovascular risk factors in middle-aged heavy drinkers. Their risks are 34% higher than those of light drinkers, according to research in the January 2015 American Heart Association journal Stroke.

Regardless of genetic and early-life risk factors, people in their 50s and 60s who drink too heavily are likely to have a stroke five years sooner than they would have otherwise, according to the National Stroke Association.

Reduce it: Men should have no more than one to two drinks per day; women should have no more than one. A single drink is at most 12 ounces of beer, 5 ounces of wine or 1.5 ounces of liquor.

“Don’t think that avoiding alcohol all week means you can binge on Friday night,” Dr. Goldstein warns. “If you drink excessively, you’re at much higher risk of having a stroke in the next 12 hours.”

5. Excess weight. The stroke risk: Having a body mass index (BMI) of 25 or higher boosts cardiovascular risks, according to the National Stroke Association. These include:

(Find out your BMI, a number determined by your weight and height.)

Weight-related risks tend to occur together in metabolic syndrome — which is a cluster of these and other conditions — and stroke is one of the key dangers of having it.

Reduce it: Losing as little as 10 pounds can significantly reduce stroke risk factors, such as lowering blood pressure and improving cholesterol levels.

Eating more fruits and vegetables is key in any weight-loss plan. A Mediterranean diet that includes nuts, olive oil and whole grains may also help reduce your risk of stroke.

6. Lack of exercise. The stroke risk: A sedentary lifestyle increases your risk for stroke and a lot of the factors that contribute to it.

In fact, inactive people are 20% to 25% more likely to have a stroke than those who are moderately or highly active, according to a 2015 review of past studies published in the journal Stroke.

Reduce it: Get 30 minutes of moderate exercise, such as brisk walking or biking, at least five days a week.

If you can’t squeeze a half-hour workout into your schedule almost every day, aim for 150 minutes of exercise a week in any combination. Even bouts of activity lasting as little as 10 minutes count.

7. High blood pressure. The stroke risk: High blood pressure may be the single most important treatable risk for stroke.

That’s because too much pressure inside blood vessels can damage their inner lining. That in turn can make artery walls thick and stiff, which can contribute to blockages and clots that lead to ischemic stroke.

High blood pressure can also cause weak spots in artery walls that can lead to ruptures and bleeding that are typical of hemorrhagic stroke.

Reduce it: High blood pressure has no symptoms, so you won’t know you have it unless you get it checked.

Make sure a doctor, nurse — or even a blood pressure machine in your local pharmacy — measures your blood pressure at least once a year.

Lifestyle measures such as a diet with lots of fruits and vegetables and minimal amounts of salt can help bring pressure down. If more action is needed, medications can help.

Discuss all your medications and symptoms with your doctor so that he or she can make sure you avoid adverse drug interactions and address any side effects.

8. A quivering heart. The stroke risk: With a condition called atrial fibrillation, or AFib, the top two chambers of the heart (the atria) quiver instead of contracting fully.

That can allow blood to pool and clump in the atria, increasing the risk of clots that could break loose, travel to the brain and cause a stroke.

Reduce it: Uncontrolled high blood pressure is a major cause of atrial fibrillation, so bringing blood pressure down can help lower stroke risk from AFib.

Blood-thinning medications, or anticoagulants, can also reduce risks specifically from AFib.

“All medications have pluses and minuses, but a general plus for newer anticoagulants is that they tend to be safer than older drugs in terms of bleeding complications,” Dr. Goldstein says.

9. Diabetes. The stroke risk: Having diabetes means having high blood sugar. And high blood sugar damages blood vessels throughout the body, causing numerous complications, including a higher risk for stroke.

In fact, people with diabetes have a 1.5 times higher risk of having a stroke than people without the disease.

Reduce it: Getting blood sugar under control includes many of the same steps that reduce risks for stroke — such as eating a healthy diet and staying physically active.

Whether taking diabetes medication lowers stroke risk has been less clear. But one of the most recent studies on that question found a stroke risk benefit in people who tightly regulated blood sugar through a combination of lifestyle and drugs.

Findings published in the June 2015 issue of the New England Journal of Medicine revealed that those who monitored their condition closely over a 10-year period didn’t necessarily live longer than those who managed their blood sugar less stringently, but they did have fewer cardiovascular problems — including stroke.

10. High cholesterol. The stroke risk: Excess cholesterol — a fatty, waxy substance that travels through the blood — can build up on artery walls to form deposits called plaque. Plaque can narrow blood vessels and create obstructions, but can also burst and send clots through the blood to the brain.

LDL (“bad”) cholesterol, which makes up most of the body’s cholesterol, is especially prone to build plaque.

HDL cholesterol gathers up bad cholesterol and ushers it to the liver, which excretes it from the body, so it’s good to have higher levels of HDL.

Reduce it: Get cholesterol checked at least every five years if you don’t have other cardiovascular risks — more often if you do.

As with high blood pressure, you can’t feel high cholesterol, so it’s important to have your cholesterol counts monitored.

Taking charge of other risk factors through healthy eating habits and physical activity will help bring cholesterol to healthier levels as well.

If you have an unhealthy balance of LDL and HDL, your doctor may also recommend taking medications such as statins to lower cholesterol — and bring down your risk of stroke.
Source: www.lifescript.com/health/centers/stroke/articles/top_10_signs_that_youre_headed_for_a_stroke.aspx?utm_source=aol&utm_medium=syn&utm_campaign=stroke

How Much Do You Know About Strokes?


Whether you call it a "stroke" or a "brain attack," it is a serious concern that strikes about 800,000 Americans each year. A stroke occurs when blood flow to a part of the brain is reduced or cut off completely. This can happen when a clot forms in an artery or a blood vessel ruptures. Take this quiz to see how much you know about preventing stroke and dealing with its outcomes.
Source: www.lifescript.com/quizzes/health/how_much_do_you_know_about_strokes.aspx

QUIZ

1. The most important stroke preventive measure against having a stroke is getting your blood sugar checked and treated. true/false

2. Atrial fibrillation – a heart condition – is related to strokes. true/false

3. By living a healthy lifestyle, you can eliminate your chances of having a stroke. true/false

4. Using street drugs such as cocaine or methamphetamine increases your chances of having a stroke. true/false

5. Strokes are becoming more common in people in their 30s and 40s. true/false

6. Hemorrhagic stroke is the most common type. true/false

7. A stroke on the left side of the brain will most likely cause speech and language difficulties. true/false

8. It’s important to get to the hospital immediately if someone appears to be having a stroke. true/false

9. A sudden, intense headache is one sign of possible stroke. true/false

10. It takes a minimum of five years to recover from a stroke. true/false

Answers

Severe Strokes: Which Types of Strokes Are the Most Deadly?


Brainstem Strokes, Bilateral Watershed Strokes, Hemorrhagic Strokes and More

All types of stroke are dangerous, but a few of them are notorious for causing severe disability and/or a rapid progression to death. Below we describe the most common strokes which are known for having the potential to cause severe disability and even death.

Brainstem Strokes:

All of the nerve impulses from the brain that go to the body must go through the brainstem, which is why brainstem strokes can be even more devastating than a spinal cord injury.

The brainstem also controls many of our most important functions, such as breathing, blood pressure, and heart rate, and contains the brain's awareness center, which allows us to stay conscious of the world around us. Therefore depending of the severity of a brainstem stroke, a person may become hemiplegic, paralyzed, or permanently unconscious.

Bilateral Watershed Strokes

Watershed strokes inherit their name from their effect on brain areas commonly referred to as the "watershed areas." These areas receive their blood supply from the farthest-end branches of two adjacent vascular territories and require adequate blood pressure to ensure that enough blood is pumped into them at all times. Because of this, watershed areas in both sides of the brain are at high risk of developing ischemia, or lack of blood flow, during times of extremely low blood pressure, which can be caused by extreme dehydration, heart attacks, and sepsis (widespread infections), among others.

Watershed strokes cause severe disability because they affect large muscle groups on both sides of the body (e.g., shoulders and hips).

People with advanced carotid stenosis (clogging of the neck arteries) on both sides of the neck are particularly vulnerable to suffering this type of stroke.

Hemorrhagic Strokes

Hemorrhagic strokes are caused by bleeding in the brain. There are multiple reasons why people develop bleeding inside the brain, but some of the most dangerous ones include:• Arteriovenous malformations

Hemorrhagic strokes are extremely dangerous because blood in the brain can sometimes lead to dangerous conditions such as hydrocephalus, increased intracranial pressure, and dangerous blood vessel spasms. If not treated aggressively, these conditions can lead to severe brain damage, brain herniation, and even death. This is why even minor episodes of bleeding inside the brain require emergency evaluation by a neurosurgeon.

Large Thrombotic Strokes

Thrombotic strokes are caused by large blood clots which either form inside of, or migrate into, one of the main blood vessels of the brain. These large blood clots are especially dangerous because they can completely stop blood from flowing through the largest, and thus most important, blood vessels in the brain.

The so-called “malignant middle cerebral artery (MCA) syndrome” is an example of such as stroke. Here, the MCA is blocked by a large blood clot causing the massive infarction (i.e., death) of almost one entire side of the brain. The potent swelling that ensues as a result of such a massive event causes a rapid increase in brain pressure throughout the entire brain. In turn, this high pressure leads to global brain dysfunction, impaired consciousness and very often, to brain herniation and death.

Large thrombotic strokes are commonly the result of medical conditions in which people have a tendency to form blood clots inside the blood vessels of the brain, inside the heart, or inside blood vessels that that bring blood into the brain. Such conditions include carotid, vertebral, or basilar artery dissection, and atrial fibrillation.

Symptoms

Unfortunately the symptoms of large strokes can be deceiving, and can originally seem like a simple episode of dizziness or headache. However certain strokes have a tendency to cause very specific symptoms. For instance, a classic symptom of hemorrhagic strokes (bleeding inside the brain) is the sudden onset of a headache which is typically described by people as the "worst headache of my life."

Large brainstem strokes typically cause double or blurry vision, vertigo, unsteadiness of gait, and/or severe nausea and vomiting. Depending on the part of the brain they affect, large thrombotic strokes can cause a sudden onset of weakness and or numbness on one entire side of the body. Large strokes can also cause sudden loss of consciousness. Needless to say, should you, or someone you know, ever be affected by these symptoms act quickly and call 911 without delay.
Source: stroke.about.com/od/causesofstroke/a/deadly_strokes.htm?utm_source=cn_nl&utm_medium=email&utm_term=Health%20Channel%20Newsletter&utm_campaign=healthsl&utm_content=20150519

11 Signs and Symptoms of Stroke


Stroke signs and symptoms can affect different parts of the body. You probably aren't sure whether or not you would be able to recognize the signs and symptoms of a stroke if you or someone else had any. Most signs and symptoms of stroke are unsettling enough that they would be hard to ignore. Whether you are at work, at a family or social gathering or even in a public setting, you could save someone's life if you recognize the 11 signs and symptoms of stroke.

You should not attempt to medically aid a stroke victim- but you should call 911 right away.

If you experience any of these 11 signs or symptoms do not wait - call 911 or get attention from someone nearby to call 911 for you.

1. Slurred Speech

Sudden onset of slurred speech may be the result of a stroke. Drugs and alcohol in high quantities may also produce slurred speech due to toxic effects on the speech centers of the brain. Additionally, some illegal drugs can also cause stroke. Slurred speech is a serious warning sign to get medical attention right away.

2. Falling

Weakness of one or both legs can cause falling. A stroke that affects the balance center of the brain can cause a stroke victim to fall. Serious strokes can also induce sudden loss of consciousness, which may manifest as falling. If you or someone nearby falls, this is an urgent situation that requires emergency medical care.

3. Uneven Appearing Face

The brainstem controls the muscles of the face and eyelids. If your face or someone else’s face appears lopsided or if the eyelids are uneven, this is caused by a weakness of the muscles that move the face.

A brainstem stroke can start subtly with a painless droopy mouth, but can progress very quickly to stop breathing. Anyone who has a sudden appearance of asymmetry of the face needs an expert evaluation ASAP.

4. Changes in Vision or Double Vision

Normal vision requires a complex serious of interactions between the eyes, the nerves and several regions of the brain to produce a 'picture' of vision. When any of the connections are disrupted by a stroke, double vision or loss of a section of vision results. This is painless, but disturbing. Sudden visual changes including double vision require emergency evaluation and treatment to help preserve as much vision as possible for the long-term.

5. Can't Say the Right Words

When you notice that someone is using the wrong words or obviously misunderstanding speech, this is a typical sign of stroke. Language is controlled by several large areas of the brain that are particularly vulnerable to stroke due to the arrangement of blood vessels in the brain. Some stroke victims are aware of the language deficit, while others are completely unaware of the problem and need help from a stroke care team immediately.

6. Dropping Objects

Weakness most often manifests with dropping items or inability to lift items. When this happens, particularly on one side of the body involving the hand or the whole arm, the cause often turns out to be a stroke or a TIA.

7. Confusion

A variety of medical emergencies cause confusion, and stroke is one of the most commonly associated with confusion. It is impossible to diagnose the cause without a thorough medical evaluation- and postponing care for sudden confusion is undoubtedly the worst possible thing to do.

8. Inappropriate Behavior

Inappropriate behavior can be annoying or offensive- it may make you actually want to avoid a stroke victim. However, because the brain is responsible for integrating high-level decision-making, any stroke can interfere with judgment. People who appear to demonstrate sudden changes in behavior need medical attention. Not only is the stroke an urgent emergency- prevention of dangerous consequences that can result from faulty decision-making is crucial as well.

9. Numbness

This is the most often brushed off symptom of stroke. Often, only the patient is aware of this problem and may not tell companions. However, numbness is one of the signs of stroke and TIA and assessing it right away can help prevent other more disabling effects from occurring.

10. Clumsiness

This can result from a stroke affecting the cerebellum, the brainstem or the cerebral cortex. Clumsiness results from lack of balance, weakness, sensation problems or a combination of any of these.

11. Loss of Consciousness

Large strokes or even small strokes located in the brainstem can cause loss of consciousness or passing out. It is absolutely crucial to get emergency help right away – as a stroke that results in loss of consciousness can be fatal.

You can recognize stroke symptoms. The good news is that with emergency medical attention and treatment, most stroke victims can survive and experience significant neurological recovery.
Source: stroke.about.com/od/Symptoms-and-Warnings/fl/11-Signs-and-Symptoms-of-Stroke.htm

The Best News About Stroke Prevention...Chocolate


One of your favorite and most decadent snacks has been strongly associated with a reduced risk of stroke. A recent research study from the UK and the Netherlands titled the European Prospective Investigation into Cancer, the EPIC- Norfolk analysis, examined 20,951 men and women. Careful analysis of a food diary distributed to men and women who participated in the study determined that those who reported the highest levels of consistent chocolate consumption experienced lower rates of stroke, while enrolled participants who reported no chocolate consumption or very low chocolate consumption had the highest rates of stroke throughout an almost 20 year follow up period.

This study was consistent with several other research studies at different institutions, which also looked at the association between chocolate and stroke risk.

A large analysis from Sweden followed 37,103 Swedish men for ten years. The Swedish results similarly showed that those who reported the highest chocolate consumption, averaging 62.9 grams per week, were the group who had the lowest stroke risk. An even larger investigation examined a bigger group, a total of 157, 809 participants from nine different studies, and confirmed the same trend.

How much chocolate should you eat to protect yourself from stroke?

The research investigations were pretty consistent in reporting that the highest group’s chocolate consumption was measured between 16-99 grams of chocolate per day, which is about half an ounce to 3.5 ounces per day. That is the equivalent of eating about of 10 chocolate chips per day up to one regular size chocolate bar, or a few snack size chocolate bars per day.

What kind of chocolate helps protect against stroke?

The benefits of chocolate are found in both milk chocolate and dark chocolate.

But this is where it gets a little tricky. The healthy effects specifically come from chocolate produced by the cocoa plant, not from imitation chocolate flavoring, food coloring, artificial chocolate smells or sugars. Read labels because many chocolate flavored snacks and candies do not contain actual chocolate made with cocoa. Instead, some processed chocolate flavored products are made with small amounts of chocolate and are passed off as chocolate because they contain food coloring and other additives that can make them resemble chocolate.

Dark chocolate and milk chocolate are both made from cocoa, while white chocolate is not made with the same cocoa ingredients that protect against stroke.

Why does chocolate protect you from a stroke?

Chocolate is a tasty treat, but when you eat it, the cocoa in chocolate also has several biological and chemical effects on your body. These biochemical actions include protecting the inside lining of your blood vessels, which works to prevent stickiness that contributes to the formation of harmful blood clots. Blood clots in the brain cause ischemic strokes. Healthy blood vessels are also more resistant to the risk of tearing and leaking that results in sudden bleeding. Thus, cocoa serves to protect you from another type of stroke, which is a hemorrhagic stroke.

Additionally, cocoa beans have been scientifically proven to provide anti-oxidant effects, which is important in counteracting the toxic brain damage induced by a stroke.

Chocolate has been established as a means to reduce feelings of stress and the perception of stress. Severe stress increases your risk of stroke, and the long-term buildup of chronic stress also raises the likelihood that you will have a stroke.

The best news about stroke prevention

The best news about stroke prevention is that is isn't expensive, unusual or hard to do. A variety of easy and enjoyable life style modifications can go a long way in reducing your risk of stroke. Eating and sharing moderate amounts of chocolate just might be the most pleasant way to protect yourself and your loved ones from having a stroke.

If you want to learn more about how you can be a part of scientific studies like the chocolate studies, find out more here.

Sources:

Chocolate consumption and risk of stroke: a prospective cohort of men and meta-analysis, Larsson SC, Virtamo J, Wolk A, Neurology, September 2012

Habitual chocolate consumption and risk of cardiovascular disease among healthy men and women, Kwok CS, Boekholdt SM, Lentjes MA, Loke YK, Luben RN, Yeong JK, Wareham NJ, Myint PK, Khaw KT, Heart, June 2015

Flavanols, proanthocyanidins and antioxidant activity changes during cocoa (Theobroma cacao L.) roasting as affected by temperature and time of processing, Ioannone F, Di Mattia CD, De Gregorio M, Sergi M, Serafini M, Sacchetti G, Food Chemistry, May 2015

Source: stroke.about.com/od/Your-Lifestyle-Can-Lower-Your-Risk-of-Stroke/fl/The-Best-News-About-Stroke-PreventionhellipChocolate.htm?utm_content=20150815&utm_medium=email&utm_source=cn_nl&utm_campaign=healthsl&utm_term=Health%20Channel%20Newsletter

The Healthiest Chocolate


Less Processing, Greater Benefit

One of the best pieces of news to emerge over the last several years is that chocolate may help you live longer, probably by reducing cardiovascular events like heart attacks and stroke. After all –- how often is a remedy this easy to take? But which type of chocolate is really the healthiest?

Cocoa and the Kuna Indians: Chocolate has been used for medicinal effect for thousands of years, but its recent recognition as a possible heart-healthy food came to light in the early 1990s.

Harvard Medical School researchers, led by Norman Hollenberg, investigated why Kuna Indians, living in the San Blas Islands off the Caribbean coast of Panama, had low blood pressure, even with increasing age. This was true despite a high level of salt consumption, which exceeded that of most Western populations.

If the Kunas had their genetic makeup to thank for healthy blood pressure, moving to an urban environment on the mainland shouldn’t make any difference. But it did –- migration to cities corresponded with a rise in blood pressure, with increasing age. Further investigation showed island-dwelling Kunas also lived longer than their mainland cousins, with low rates of cardiovascular disease and cancer. After allowing for factors like stress and lack of pollution, Hollenberg and his team concluded the most striking difference in the Kuna Indians’ island environment was dietary, including a dramatic average daily consumption of more than 5 cups of cocoa, per person.

There’s a big difference between the cocoa the Kunas drink, and the cocoa and chocolate people usually purchase in a grocery or specialty store -- mostly due to how it’s processed and its formulation.

Processing: Cocoa beans grow as the seed of the berry-like fruit of the cacao tree. After shelling and roasting, the beans are ground into a suspension called cocoa liquor, made up of cocoa butter (fat) and solids. Pressing removes most of the cocoa butter, resulting in a hard, dry cake, which is ground into what we use as cocoa powder.

This powder contains most of the flavanols, a family of flavonoids, or antioxidants, that have since been credited with most of chocolate’s health benefits. Flavanols affect the way nitric oxide is produced in the body, helping blood vessels to relax, and thereby improving blood flow to the heart, the brain, and extremities. They also may reduce inflammation, and the proliferation of dangerous free radicals produced in regular cell metabolism.

At this stage, cocoa powder remains quite bitter. As a result, it’s often processed by treatment with alkali -- most commonly sodium bicarbonate, or baking soda -- to make it darker, less acidic, and easier to mix into beverages. Unfortunately, this 200-year-old method, also known as "Dutch-processing," has been shown to destroy the active flavanol content by as much as 80%. Thus, the percentage of cocoa contained in a piece of chocolate, whether it’s 60%, 70% or higher, is no indication of its flavanol content, argues Hollenberg in a 2007 editorial in the journal Circulation. He and other nutrition researchers have argued for labeling chocolate products with flavanol values instead.

The Kuna Indians drink largely homegrown, unprocessed cocoa powder, containing very high flavanol levels.

Formulation: Cocoa butter’s unique property of having a melting point that matches human body temperature –- allowing it to literally “melt in your mouth” –- makes it delicious. Its fat content, however, puts chocolate-lovers at risk of weight gain if they don’t compensate for those calories elsewhere. A 3.5 oz (100g) bar of chocolate contains more than 500 calories (compared with just 12 calories in a tablespoon of unsweetened cocoa). Obesity increases the risk of cardiovascular disease, diabetes, and cancer, so don’t try to extend your life by eating chocolate if it results in gaining weight. Indeed, a very small amount of chocolate may be sufficient for improved longevity.

Bottom line: Research on the indigenous Kuna Indian population of Panama suggests that unprocessed cocoa may be the healthiest form, due to its high flavanol content. Since flavanols are destroyed through chemical Dutch-processing, or alkalization, look for cocoas labeled "natural," as they have not been treated with alkali.

Sources:

Andres-Lacueva C., et al. “Flavanol and flavonol contents of cocoa powder products: influence of the manufacturing process.” J Agric Food Chem. 2008. May 14;56(9):3111-7. Epub 2008 Apr 16.

Claims About Cocoa. US National Institutes of Health Information Sheet. Accessed January 27,2011.http://newsinhealth.nih.gov/issue/aug2011/feature1

Kenneth B. Miller et al. Impact of Alkalization on the Antioxidant and Flavanol Content of Commercial Cocoa Powders. J. Agric. Food Chem., 2008, 56 (18), pp 8527–8533. DOI: 10.1021/jf801670p.

Norman K. Hollenberg, MD, PhD and Naomi D.L. Fisher, MD. “Is It the Dark in Dark Chocolate?” Circulation. 2007; 116: 2360-2362.http://circ.ahajournals.org/content/116/21/2360.full

K. Hollenberg N. Vascular action of cocoa flavanols in humans: the roots of the story. J Cardiovasc Pharmacol. 2006;47 Suppl 2:S99-102; discussion S119-21.

Source: longevity.about.com/od/lifelongnutrition/a/The-Healthiest-Chocolate.htm

7 Habits to Prevent a Stroke


A stroke can be a devastating event with serious long-term consequences. Advances in stroke treatment have made the long term outcome for stroke patients better. However, there is often a short window of time for effective treatment. One important approach to stroke care includes prevention, especially for people who are at risk. Not every stroke is preventable but there are some known preventable risk factors that can be modified with lifestyle habits.

It is helpful to know some of the controllable causes of stroke and to learn how to control them.

1. Lower high blood pressure

Hypertension is chronic high blood pressure. It raises the risk of stroke and it also contributes to the development of heart disease and cerebrovascular disease- 2 well-known stroke risk factors. The first step in effective management of hypertension requires diagnosis through regular blood pressure screenings. Treatment of hypertension can include a diet low in salt, weight management, regular exercise or stress control. Sometimes medication to lower blood pressure is required. Your doctor can advise you on the best approaches for you when it comes to maintaining a normal blood pressure.

2. Control heart disease

Heart disease can be present at birth. It may occur later in life due to hereditary. Heart disease can develop a result of hypertension, obesity, diabetes or high cholesterol. Heart disease can include coronary artery disease (disease of the blood vessels that supply the heart), heart valve problems, heart muscle problems, an enlarged heart or an irregular heartbeat.

There are many effective ways to diagnose and treat heart disease, depending on the cause. As with hypertension, the best approach is to have regular check ups with your doctor to detect problems early before they progress.

3. Lower high cholesterol

High cholesterol contributes to heart disease and cerebrovascular disease. It is usually the result of a diet high in unhealthy kinds of fat. Lowering cholesterol requires a diet with moderate fat intake, moderate exercise and sometimes medication.

4. Control diabetes

Diabetes can contribute to cardiovascular disease and cerebrovascular disease. Diabetes is a disorder of blood sugar metabolism. Diabetes may be inborn or acquired. People with type 1 diabetes require close management of blood sugar levels, usually with insulin treatment. People with type 2 diabetes require management of food intake, weight management and sometimes medication to maintain desirable levels of blood sugar.

5. Manage obesity

Obesity is also a risk factor for stroke. It can contribute to hypertension and high cholesterol. Obesity is often managed by diet and exercise. Sometimes, weight loss supplements or surgical procedures for weight loss can help when it is difficult to lose weight with diet and exercise alone. Genetics play a role in obesity as some people are more predisposed to being overweight than others, making weight loss a bigger challenge.

6. Stop smoking

Smoking contributes to heart disease, cerebrovascular disease and hypertension. Smoking can be a difficult habit to break. Different approaches, including behavioral control, counseling, support groups, nicotine patches and smoking cessation programs can be used to help quit smoking. Research shows that many of the harmful effects of smoking can be reversed over time when smoking is discontinued. Often, smoking cessation is more successful when guided by a trained health care professional.

7. Manage stress

Stress can contribute to stroke risk by contributing to hypertension, heart disease, diabetes and cerebrovascular disease. Management of stress and anxiety often involves a comprehensive approach to behavior and emotional responses. Stress is not objectively measurable and requires a long term approach for optimal control

Other less common causes of stroke may be more complex such as autoimmune disease and blood clotting disorders. These medical problems require long-term close medical management by a physician.
Source: stroke.about.com/od/strokeprevention/fl/7-Habits-to-Prevent-a-Stroke.htm

Does Exercise Really Prevent Stroke?


Physical fitness is often recommended as one of the practical ways to prevent a stroke. Exercise provides easy to observe, obvious benefits when it comes to weight loss and maintaining an attractive appearance. But it is quite a bit more difficult to picture the more undetectable long-term benefits of exercise and physical activity when it comes to a disease like stroke.

For some people, working out is fun, exhilarating and energizing.

For others, exercise is truly a source of dread. Most of us are somewhere in between- exercise sounds like fun but it sure is a lot of trouble. And how do I know if it is really worth it? Many people would exercise for a long-term benefit only if they knew for sure that exercise could actually produce a long-term advantage.

Does Exercise Really Work in Stroke Prevention?

To help find the answer to that question, scientists have done numerous research experiments to measure the benefits of exercise. When it comes to stroke, scientific studies time and time again have verified that working out, even in moderate doses, can help prevent a stroke.

What Kind of Exercise?

One study published in the January 2014 issue of Stroke evaluated over 4000 patients and demonstrated a decreased risk of stroke associated with time spent walking. Another research article published in the journal Cerebrovascular Disease reported that patients who had already had a stroke and later participated in aerobic exercise had a better overall improvement.

Aerobic exercise is the type of exercise that requires fast paced energy, as opposed to weight lifting or stretching exercises. Water therapy is another very interesting type of exercise that is generally gentler on the muscles and has been shown to help increase blood flow to the brain, which can be immensely helpful in preventing stroke and in stroke recovery.

Because so many different types of exercise have been shown to prevent stroke, exercise does not have to be painful and does not have to be one size fits all. Tailoring your exercise to your personality, preferences and abilities is definitely the best way to go. There are so many different ways to stay physically fit that it doesn't have to be a bitter pill- it can be a fun, no matter who you are.

How Does it Work?

One of the well-understood ways that exercise helps in preventing stroke is through heart fitness. Another very interesting way that exercise can help prevent stroke is through actual neuroplasticity caused by growth of neurons in the brain.

Staying Safe

The possibility that exercise could be risky for stroke patients has been a long-standing concern for patients, their loved ones and health care professionals. A recent article out of Spain published in ‘The European Journal of Internal Medicine’ has provided reassurance that exercise is safe for stroke patients. Check with your doctor to make sure that you do not have a physical reason to avoid a particular type of exercise and then- get started!

Sources

Pang MY, Charlesworth SA, Lau RW, Chung RC, Using aerobic exercise to improve health outcomes and quality of life in stroke: evidence-based exercise prescription recommendations, Cerebrovascular Disease, February 2014

Jefferis BJ, Whincup PH, Papacosta O, Wannamethee SG, Protective effect of time spent walking on risk of stroke in older men, Stroke, January 2014

Ploughman M, Austin MW, Glynn L, Corbett D, The Effects of Poststroke Aerobic Exercise on Neuroplasticity: A Systematic Review of Animal and Clinical Studies, Translational Stroke Research, July 2014

Pugh CJ, Sprung VS, Ono K, Spence AL, Thijssen DH, Carter HH, Green DJ, The Impact of Water Immersion during Exercise on Cerebral Blood Flow, Medicine and Science in Sports and Exercise, June 2014

Bouzas-Mosquera Mdel C, Bouzas-Mosquera A, Peteiro J, Broullón FJ, Alvarez-García N, Castro-Beiras A, Exaggerated exercise blood pressure response and risk of stroke in patients referred for stress testing, European Journal of Internal Medicine, July 2014
Source: stroke.about.com/od/Screening-and-Prevention/fl/Does-exercise-Really-Prevent-Stroke.htm

How Much Do You Know About Strokes? - Answers


The test questions are here. The good news is we have the information for you. First and foremost, get your blood pressure checked and under control to prevent stroke. A healthy diet, exercise and treatment for atrial fibrillation, a heart condition, go a long way to ward off strokes. Read on for the answers and more on this serious condition:

1. False. The most important thing you can do is have your blood pressure – not sugar – checked and treated. “Also quit smoking and make sure diabetes is treated – but controlling high blood pressure is absolutely the biggest,” says Rhode Island neurologist Brian Silver, M.D., spokesperson for the American Stroke Association. One study estimated that if all cases of high blood pressure were treated, the rate of stroke would decrease by 40%. That means 320,000 fewer strokes a year.

2. True. About 15% of women who suffer a stroke have an undetected or untreated condition called atrial fibrillation (a-fib). This condition causes an irregular heartbeat and allows blood to pool in the heart, increasing the risk of clotting and stroke, says David Meyerson, M.D., director of cardiology at Johns Hopkins University Medical School in Baltimore and a spokesman for the American Heart Association (AHA).

3. False. Yes, you can reduce your risk by getting high blood pressure treated, exercising and eating healthfully. “Roughly 80%, of stroke risk can be controlled by adopting healthy lifestyle habits,” Meyerson says. But some risks are uncontrollable, such as being female, age 55 or older, having a family history of stroke or heart disease, and being of African-American descent, he says.

4. True. Taking street drugs like cocaine and methamphetamines raises your risk of stroke, Meyerson says. Besides avoiding illicit drugs, get high blood pressure and cholesterol treated, maintain a healthy weight, avoid smoking, exercise regularly and drink alcohol only in moderation, he says.

5. True. “We’re seeing more people in their 30s and 40s having strokes,” says Brian Silver, M.D., a Rhode Island Hospital neurologist and spokesperson for the American Stroke Association. According to Silver, the rising rates of obesity, high blood pressure and diabetes in younger people likely contribute to the growing rate of stroke.

6. False. Ischemic stroke is actually the most common type. “About 87% of strokes are ischemic,” Silver says. Ischemic stroke happens when a blood vessel gets blocked by a piece of a clot. The other type of stroke – hemorrhagic – is when blood vessels burst. About 13% of strokes are hemorrhagic.

7. True. The left side of your brain controls speech and language abilities for most people, says John Whapham, M.D., a neurologist and head of the stroke center at Loyola University Health Systems outside Chicago. “The right side of your brain controls spatial and perceptual abilities, short-term memory, behavior and judgment,” he says.

8. True. A clot-busting medication called tPA can be administered if someone having a stroke gets to a hospital within 4. 5 hours, Silver says. “Getting stroke victims to the hospital quickly can do wonders,” he says. “A tPA can limit dramatically limit the damage of an ischemic stroke.” About one-third to one-half of people with ischemic stroke can benefit from tPA. “For hemorrhagic stroke, unfortunately, we don’t currently have anything like this treatment,” he says.

9. True. A sudden severe headache is definitely a warning sign. So is sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, trouble speaking or understanding; trouble walking, dizziness or loss of coordination. If you or someone you know may be having a stroke, get to the hospital as quickly as possible.

10. False. “Most people get the maximum recovery they’re going to get within six months,” Whapham says. If you’ve had a severe stroke, though, some things may never come back. “Other things may take several months or a year,” he says.
Source: www.lifescript.com/quizzes/health/how_much_do_you_know_about_strokes.aspx

Eating to Prevent Stroke


11 Ways to Incorporate a Healthy Diet into Your Routine

A stroke is often related to cerebrovascular disease and cardiovascular disease. This means disease in the blood vessels of the heart and the blood vessels of the brain. Narrowing, stiffening and cholesterol buildup inside the blood vessels can lead to blot clots, which cause stroke. These conditions have a hereditary component but can be exacerbated by certain lifestyle habits.

A healthy diet low in junk food, cholesterol and saturated fats has been associated with lower stroke risk. Exercise, smoking cessation and lowering stress and anxiety are also healthy habits that can help decrease the risk of stroke. When it comes to maintaining a healthy diet, changing habits is key. One of the difficulties with changing lifestyle habits is that habits are just that- habitual. It is always easier to follow the path of least resistance and to continue doing what you are doing than to switch gears and adopt new habits, even when you know the new habits will be beneficial. One of the reasons the bad habits started in the first place is because they are easier.

A great strategy to adopting healthy eating habits is to work on making healthy habits convenient so that healthy eating can become an easier part of your daily routine.

How to Incorporate a Healthy Diet into Your Routine

One of the roadblocks to maintaining a healthy diet is convenience. Healthy foods such as fruit and vegetables have a shorter shelf life than junk food, which is made to last.

Additionally, junk food is often pre-cooked or very easy to prepare. Staying stocked up on fresh fruits an vegetables requires frequent shopping and meal planning in order to eat or prepare the fresh food before it spoils.

So what is the solution for healthy eating?

11 Solutions

1. Create a healthy menu of meals and snacks so you won't have to think about healthy recipes to prepare or eat when you are rushed or hungry. You could create a menu for the whole week prior to your grocery shopping.

2. Put healthy items on your shopping list to avoid impulse purchases. Make sure you think ahead about ingredients for your menu and include enough healthy snacking options.

3. Eat before you go grocery shopping. When you are hungry while shopping, you may be tempted to stock up on ready-made food and junk food.

4. Pay attention to the cost when you shop. One of the deterrents to eating healthy is that some fresh produce can be expensive. But they do not have to be. In-season fruits and vegetables tend to be less costly. When produce is in season- it tends to taste better too.

5. Stock up on frozen or canned produce, especially items that you plan to bake or boil because most vitamins and minerals are maintained in canned or frozen fruits and vegetables. Opt for choices with little or no preservatives, artificial sauces or juice.

6. Don't buy too much junk food when you shop. Calculate the cost that you are saving with each purchase that you pass up and consider saving on an account for a luxury purchase, an enjoyable outing or a contribution to a good cause. However, some favorites are ok. When you don’t have any on hand, you might crave some items so much that you could end up buying fast food or raiding the vending machines while you are out. This can be unnecessarily costly, when in reality, just some ice cream at home would have satisfied your sweet tooth.

7. Avoid buying foods just because they are healthy- stick to the healthy choices you like. You could end up paying for a few types of vegetables that you don’t enjoy simply because you know they are healthy. Remember, you do not have to eat every type of healthy item, just a reasonable variety.

8. Cut up fruit and veggies for yourself in the morning to last all day. This will put healthy food on par with junk good for convenience.

9. Decide ahead of time how much of each type of item you should have for the day. For example, if donuts are your weakness, you could decide how many are suitable for you ahead of time, and make sure you have enough healthy satisfying food available and on hand so that donuts aren’t the only item to turn to when you are hungry.

10. Consider using a fitness app on your phone or electronic device. Many of them track your calories as well as your intake of vitamins, minerals, protein and types of cholesterol. You can watch your progress throughout the day. After a few days or weeks, you can decide to adapt some habits to achieve healthier results. This way you can see for yourself how many donuts you can have and still maintain adequate calories and vitamins and minerals. You can see if you are having too much fat or too little protein and swap some of your regular go-to items.

11. If you need to have some less healthy ingredients on hand for special recipes, keep them in less convenient storage in the kitchen and keep healthier items in more accessible spots.

Overcoming the inconvenience of eating healthy is a great first step to stroke prevention and recovery.
Source: stroke.about.com/od/strokeprevention/fl/Eating-to-Prevent-Stroke.htm

What You Need to Know About a Mini Stroke


In order to understand what a mini stroke, or transient ischemic attack (TIA) is, you must first understand the meaning of the word ischemia.

What is brain ischemia?

The healthy brain requires a constant delivery of oxygen- and nutrient-rich blood to each one of its approximately 100 billion neurons. To accomplish this, and thus to ensure normal brain function, blood travels across multiple blood vessels to every part of the brain.

In some people, however, blood vessels become blocked by blood clots, or cholesterol plaques, leaving discrete brain areas transiently disconnected from their blood supply. The resulting lack of oxygen and nutrients in these areas is known as ischemia. Neurons in ischemic areas starve and rapidly stop functioning.

What is a Mini Stroke or TIA?

A mini stroke then, which as stated previously is also known as a TIA, is a brief period of lack of blood flow to an area of the brain. Because ischemia impairs the function of brain cells, a person suffering a TIA develops symptoms of brain function impairment, such as difficulty speaking or moving the arm and leg on one side of their body. The symptoms of a TIA can last from a few minutes to a few hours, but by definition they go away in less than 24 hours.

Up to 20% of people who experience TIA symptoms go on to have a major stroke in the next three months. Unfortunately, many people fail to seek medical attention and suffer a stroke before they are seen by a doctor.

The symptoms of a mini stroke begin suddenly and vary depending on the part of the brain that is affected. Mini strokes that affect areas of the brain used minimally in day to day function cause symptoms that are mild or almost unnoticeable. By contrast mini strokes affecting areas of the brain used heavily in normal day to day function cause symptoms which can be extremely debilitating.

For instance a person who suffers a mini stroke in the hand area of the brain may develop difficulty writing for a few minutes or hours. A different person who experiences a mini stroke of a similar size in the brainstem, an area of the brain which harbors the centers for gait balance, voice control, and eye movements, might feel temporarily unable to carry on with his or her day because of vertigo, difficulty speaking, or double vision.

Mini strokes most commonly affect parts of the brain which control movement and feeling in the face, arm, and leg. They can also affect our ability to understand and produce speech. Here is a list of the most common symptoms of a mini stroke:

What is the difference between a mini stroke and a stroke?

By the current definition, the symptoms of mini stroke/TIA disappear completely within 24 hours. Strokes on the other hand leave long-lasting physical impairments. But when one compares the brain of a person who suffered a stroke, with the brain of a person who suffered a mini stroke using MRI, very often one cannot tell which is which. Why is this? This is currently a subject of intense study and definitive answers have yet to be produced, but this suggests that even though mini strokes only cause temporary symptoms, they can still cause permanent damage to the brain.

I think I had a mini stroke. What should I do?

The more we learn about mini strokes, the more convinced we become that they are a sign that a debilitating stroke is on the way. This is why no matter how mild or short-lived the symptoms of a mini stroke might be, it is extremely important that you go to the nearest emergency room immediately after you start feeling stroke-like symptoms.

Even if you had a mini stroke a few days ago you should still seek medical attention as soon as possible. The urgency of this matter cannot be overemphasized as up to 20% of people who suffer a TIA will go on to suffer a stroke within 90 days.

The high risk of stroke after a mini stroke has motivated many medical institutions to keep all mini stroke patients in the hospital for observations and thorough testing even in cases when symptoms have resolved completely by the time the patient arrives in the Emergency Room. In many cases an early search for the cause of a mini stroke allows for early intervention and successful stroke prevention.
Source: stroke.about.com/od/whatisatia/a/TIAs.htm

How Much You Sleep Affects Your Risk of Stroke


A new study of 200,000 Americans has found that if somebody has high blood pressure – a condition that affects one third of the country – their risk of stroke is significantly affected by how much they sleep.

Specifically, people who sleep less than 5 hours per night and more than 8 hours per night were found to have an 83 percent and 74 percent higher risk of stroke, respectively.

Most strokes are triggered by a blood clot in the brain, and they’re relatively common: about 800,000 people each year have a stroke in the U.S., and it’s a leading cause of disability. So what can you do to minimize your risk?

How Much Sleep Is Too Much Sleep?


Sleep Needs Vary for Everyone

Although most people should be concerned about not sleeping enough, you may wonder: How much sleep is too much sleep?

First, it is important to determine how much you sleep you need, which can be accomplished with a simple experiment. Individual sleep needs are largely determined by genetics, but other factors may include your general health and even your age. Most adults need 7.5 to 8.5 hours of sleep per night.

When you get less than the sleep you need, you begin to experience sleep deprivation. With chronic loss of sleep you may gradually accumulate a sleep debt. You may experience excessive daytime sleepiness and you may find yourself taking frequent, prolonged naps or sleeping more on the weekends.

But, ultimately, how much sleep is too much? If you are a long-sleeper based on your genetics, you may sleep 8 to 10 or more hours a day to feel rested. Just as there are exceptional people who can get by on 4 hours of sleep per night, other people may require 12 hours, though both scenarios are rare.

If your personal sleep needs have changed dramatically, or if you suffer from symptoms of sleep disorders such as feeling too sleepy, you may wish to speak with your doctor or a sleep specialist. Certain medical conditions such as hypothyroidism or depression may leave you sleeping too much and these may require treatment.

For those who have always required a little extra sleep than average, there is no reason for feeling guilty about sleeping too much.

It’s not too much; it’s just what you need.
Source: sleepdisorders.about.com/od/sleepdisorderevaluation/a/How-Much-Sleep-Is-Too-Much-Sleep.htm?utm_source=cn_nl&utm_medium=email&utm_term=Health%20Channel%20Newsletter&utm_campaign=healthsl&utm_content=20150519

Heavy Drinking Boosts Stroke Risk


Men who down seven or more drinks a day have a significantly increased risk of atrial fibrillation, the irregular heartbeat that can lead to stroke, a study finds.
Source: The New York Times News Service, 9/12/05

There's a Fourth Indicator of a Stroke - the Tongue


During a BBQ, a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) .....she said she had just tripped over a brick because of her new shoes.

They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening

Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 pm Ingrid passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don't die.... they end up in a helpless, hopeless condition instead.

It only takes a minute to read this...

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke... totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

Recognizing a Stroke

Thank God for the sense to remember the '4' steps, STRT. Read and Learn!

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke. Now doctors say a bystander can recognize a stroke by asking three simple questions:

S * Ask the person to SMILE.

T * Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently) ( i.e. It is sunny out today)

R * Ask the person to RAISE BOTH ARMS.

T * Ask the person to stick out their TONGUE. If the tongue is 'crooked', if it goes to one side or the other, that is also an indication of a stroke.

If they have trouble with ANY ONE of these tasks, call 999/911 immediately and describe the symptoms to the dispatcher.

Two requests:

1. Copy this section, put it in an email and send it to 10 friends. That simple effort will probably save a life.

2. Print out Stroke Signals on thick paper, cut it up, put on in your wallet where it shows if someone opens your wallet to see if you have a medical card and give the rest out to family and friends. That may save your life.

Gender Differences in Stroke


Spanish researchers publishing in this month's Stroke find an abundance of differences between male and female victims of stroke.

Most significantly, women are more likely to suffer a more severe stroke than men, and women are more likely to have a stroke at an older age.

Stroke is the third-leading cause of death in women. While stroke is more common in men, in the year 2000 about 61 percent of all deaths from stroke occurred in females, and statistics indicate about one in six women will eventually die of stroke. This compares to one in 25 dying of breast cancer. Many studies on stroke have involved women, but few have looked at factors that may be putting women at higher risk for stroke or how women fare after the event.

Researchers from Spain decided to clarify the data with a study of around 1,500 stroke patients, 772 of them women. Results showed the average age of female stroke patients was 75, compared to 69 for men. For men, the predominate risk factors were peripheral artery disease and overuse of alcohol. For women, stroke was most often predicated on a higher frequency of atrial fibrillation, an irregular heartbeat.

Stroke outcomes also differed between the genders. Nearly 30 percent of the women were left with the inability to use or understand words, compared to 22 percent of the men. Visual impairments were seen in about 17 percent of the women vs. 14 percent of the men. About 20 percent of the women experienced chewing or swallowing difficulties, compared to 14 percent of the men.

Noting treatment with anticoagulants can help people with atrial fibrillation reduce their risk for stroke, the authors write, "Stroke prevention with anticoagulation in atrial fibrillation is a priority in both men and women; however, women obtain the most benefit from it."
Source: www.healthcentral.com/news/NewsFullText.cfm?id=8006405  

How to Stop a Stroke from Starting


It’s practically guaranteed that at some point in your life, you or a loved one will have a brush with stroke. In fact, every 45 seconds someone suffers a stroke in the United States, and it’s the third most common cause of death.

But despite all of this, could you say exactly what a stroke is if you were asked? Would you know how to recognize a stroke? Would you know if you were having one right now? This may sound clichéd, but don’t wait until it’s too late: Strokes can be prevented, and you’re the one to help.

What Is Stroke?

You have heard the term over and over again but you still wonder: What is stroke anyway? Stroke is a sudden impairment in brain function. One may suffer an inability to speak or speak clearly, walk, or move a limb because blood has stopped flowing to an area of the brain. Usually, this is caused by the blockage, or the rupture, of a blood vessel.

Unlike ministrokes, which are also known as transient ischemic attacks (TIA), whose symptoms resolve on their own in less than 24 hours, strokes leave behind long-lasting neurological impairments. The severity of these impairments depends on how large the damage is to the brain, and on the part of the brain that is affected.

What Are The Different Types of Stroke?

There are two major categories of stroke: ischemic and hemorrhagic.

Ischemic Stroke

This type of stroke is caused by the physical blockage of blood flow to an area of the brain. The most common forms of ischemic stroke are:

1) Embolic Stroke

This type of stroke occurs when a blood clot or a cholesterol plaque wanders into the brain until it reaches a narrow point where it becomes trapped. This causes a blockage of the artery and prevents blood from reaching a section of the brain. There are other, less frequent causes of embolic strokes which include:

Septic Emboli

Atmospheric Air

Embolic Myxoma

Deep Venous Thromboses

2) Thrombotic Stroke

In this type of stroke a blood clot forms along the inside of a blood vessel causing the interruption of blood flow to an area of the brain. Such a blood clot, also known as a thrombus, usually affects very small blood vessels in the brain, especially in people who have high cholesterol.

Because small blood vessels in the brain bring blood to proportionally small brain areas, thrombotic strokes tend to be small, and are sometimes referred to as lacunar strokes . In some rare instances, however, a large blood clot can form inside of one the large blood vessels in the neck, and later break off causing a large embolic stroke .

Hemorrhagic Stroke

This type of stroke occurs when a blood vessel inside of the brain ruptures, allowing blood to pool inside or around healthy brain tissue. In many cases this is the result of uncontrolled high blood pressure.

High Blood Pressure Basics

Depending on the location of bleeding, a hemorrhagic stroke is further subdivided into

Intracerebral Hemorrhage: Bleeding takes place inside the brain tissue.

Subarachnoid Hemorrhage: Bleeding takes place along a space between two of the membranes that cover the brain.

Intraventricular Hemorrhage: Bleeding takes place inside the ventricles of the brain, which do not contain brain tissue, but instead are filled with a fluid known as cerebro-spinal fluid. Blood inside the ventricles rarely causes a stroke by itself, but it has the potential to cause hydrocephalus a condition in which elevated intracraneal pressure can cause stroke and even death.

Subdural Hemorrhage: Bleeding takes place outside of the brain tissue near the skull.

Hemorrhagic strokes are most often caused by a ruptured blood vessel such as an aneurysm or a leaky arteriovenous malformation (AVM). Blood inside the brain produces a very severe headache, which is typically described by people as the worst headache of their lives.

As blood accumulates in the brain, the normal brain tissues are pushed against the walls of the skull. This process increases the pressure inside the brain, to the point that blood flow to the areas of highest pressure is completely interrupted. These areas cease to function, and cause symptoms which can range from dizziness, nausea and vomiting to a headache accompanied by typical stroke symptoms. Hemorrhagic stroke symptoms should never be ignored as very often they can evolve rapidly and in the worse cases they can lead to sudden death.

Causes of Stroke

There's isn't one smoking gun when it comes to stroke. There are many potential causes.

High Blood Pressure and Hemorrhagic Stroke

Did you know that high blood pressure is a major cause of strokes due to bleeding in the brain? Strokes usually occur due to a blockage of blood flow to a part of the brain, but approximately 15% of them occur due to bleeding. These are known as hemorrhagic strokes. And of all the causes of hemorrhagic stroke, high blood pressure is by far the most common one, accounting for approximately 80% of all cases.

High Blood Pressure as a Risk Factor for Stroke

No matter what stroke risk factors a person might carry with him, suffering from high blood pressure alone can significantly increase his risk of suffering a hemorrhagic stroke. This risk is even more pronounced in the elderly, in people who smoke, in men, in diabetics, and in people who drink alcohol.

High blood pressure causes intracerebral hemorrhage (ICH) by damaging the fragile walls of small arteries inside the deeper areas the brain. These are the same arteries affected by lacunar strokes, which are so common in white matter areas. However, the area most commonly damaged by ICH is called the basal ganglia. Other parts of the brain affected by bleeding due to high blood pressure include the thalamus and the cerebellum.

In some cases the bleeding caused by high blood pressure is so large that blood spills into the brain's ventricles causing an intraventricular hemorrhage, a condition which can result in life-threatening hydrocephalus.

What Are the Symptoms?

The symptoms of ICH caused by high blood pressure vary depending on the location and size of the bleeding. Symptoms can therefore consist of:

Weakness of the face and/or arm, and/or leg on one side of the body

Numbness in the face, and/or arm, and/or leg one side of the body

Inability to understand spoken language or inability to speak

Inability or difficulty writing or reading

Vertigo and/or gait imbalance with or without nausea or vomiting

Severe headache or double vision

In rare cases, the bleeding caused by high blood pressure is so profuse that it leads to a rapid increase in intracranial pressure, which causes patients to become unresponsive, paralyzed or comatose.

But by symptoms alone it is not possible to distinguish whether a given stroke is the result of poor blood flow, or profuse bleeding. This is an important reason why special tests are required to diagnose bleeding in the brain (see below).

How Is it Diagnosed?

When a person comes to the emergency room with stroke symptoms, physicians routinely perform tests to look for bleeding in the brain. The first test performed usually is a head CT , which is a rapid and reliable way to rule out this possibility. When bleeding is found but the source of the bleeding is not clear, other tests such as a cerebral angiogram or an MRI of the brain with contrast can be performed. These tests help to diagnose other causes of bleeding such as AVM , aneurysms , amyloid angiopathy , or brain tumors .

What Is the Treatment?

The treatment of bleeding in the brain from high blood pressure starts by bringing the patient to the intensive care unit for proper stabilization and diagnosis. This is done by physicians who specialize in critical care medicine . Usually, blood pressure is controlled in order to prevent further bleeding. Other possible interventions are decided based on the size of the bleeding, on the severity of the symptoms exhibited by the patient, and on whether the interventions being considered can be expected to make a difference in the overall outcome. In some cases, bleeding must be evacuated immediately, because it threatens to harm the brain. In other cases, the risks of surgery clearly outweigh the potential benefits, leading doctors and families to refrain from further treatment. And in the grimmest of cases, bleeding has caused so much damage to the brain that surgical intervention is futile.

How to Recognize Stroke Symptoms

Stroke symptoms usually come on suddenly, and should always be treated as a medical emergency. They can include a sudden onset of any of the following:

Why do stroke symptoms start so suddenly?

The symptoms of stroke begin suddenly because they are caused by an abrupt interruption of blood flow to an area of the brain. When this happens, it only takes a few seconds for that part of the brain to stop functioning.

Only a small proportion of strokes produce headache symptoms. However, the sudden onset of a severe headache makes doctors suspect that there is bleeding inside the brain. Because of the high risk of death in these cases, people who come into the emergency room complaining of severe headache are rapidly screened for the presence of blood in the brain.

Are the symptoms of stroke permanent?

Whether or not the symptoms of a stroke will be permanent depends on how long the affected part of the brain remains without blood flow. While brief events of poor blood flow, or ischemia, lead to a complete recovery, longer events can leave permanent deficits.

What is a TIA?

What determines how severe the symptoms of a stroke will be?

The severity of stroke symptoms varies depending on the part of the brain that is affected. For instance, strokes that affect areas of the brain which have minimal importance in day-to-day brain activity typically produce mild or unnoticeable symptoms. By contrast, strokes that affect areas of the brain which have maximal importance in day to day brain activity cause the most debilitating and noticeable symptoms.

For instance, strokes affecting one of the smell areas of the brain rarely cause identifiable symptoms, but by contrast, strokes affecting one of the speech areas of the brain nearly always do.

Why do strokes usually affect only one side of the body?

For the most part, the left side of the brain controls the right side of the body, while the right side of the brain controls the left side of the body. When a blood vessel that carries blood to a given part of the brain is blocked, only the side of the brain where the blood vessel is located is affected. This causes symptoms in the opposite side of the body.

I think I am having a stroke, what should I do?

You should call 911 immediately. The earlier you get to the emergency room, the greater the chances are that you will receive a treatment, which can minimize and even reverse the long-term consequences of the stroke. After you call the ambulance, get ready to answer the following questions, which will help doctors select the best treatment:

What time did your symptoms start?

What is your complete medical history?

Have you ever had a stroke? Have you ever had bleeding inside of your brain?

Do you have any metal inside your body? (this is important in order to decide whether your head can be imaged using magnetic resonance imaging (MRI), as the MRI machine has a powerful magnet. Common metal items inside the body of people include pacemakers, joint prostheses, dental work, and even bullet fragments)

What medications and supplements do you take on a regular basis?

Do you suffer from a bleeding disorder?

Stroke Rehabilitation is a Critical Part Stroke Recovery

Several decades of scientific research now show that stroke rehabilitation is critical for optimal stroke recovery. The benefits come from helping the brain to reorganize itself with physical therapy, which in turn helps the stroke survivor to recover functions lost after brain injury. Below you will find important information about the process of physical therapy and rehabilitation, and about its potential to help you regain your life after stroke.

What is stroke rehabilitation?

Stroke rehabilitation is the process by which a stroke survivor works with a team of health care providers with the aim of regaining as much of the function lost after a stroke as possible. By joining a comprehensive rehabilitation program immediately after leaving the hospital, stroke survivors can maximize their chances of recovery, and in most cases they can regain a substantial portion of the functions they lost as a result of their stroke.

Some of the different types of medical professionals who participate in the care of stroke patients during the rehabilitation process include:

Why is stroke rehabilitation important?

The importance of rehabilitation after stroke cannot be overemphasized. Studies have shown that rehabilitation is responsible for most of the recovery experienced by patients after a stroke, and that without it, little or no improvement can be accomplished. Stroke rehabilitation provides a targeted and organized plan to re-learn functions lost in the shortest period of time possible.

How long does stroke rehabilitation last?

The duration of your rehabilitation needs will depend on the type of stroke you suffered. On the average, immediately after leaving the hospital, people stay inside rehabilitation facilities for a total of 16 days. This brief period of in-house therapy is followed by further rehabilitation in an outside facility for the following several weeks.

Although most of your improvement will take place within this time, your brain can continue to learn and re-learn new and old tasks for as long as you live. This is why it is so important to continue with your own rehabilitation at home after you have completed your visits to the rehabilitation center. A successful outcome will require dedication, perseverance, and a great attitude. In fact, some studies suggest that successful and meaningful recovery is more likely to be accomplished if you are dedicated and keep a high level of motivation during your rehabilitation process.

Related

Urinary Incontinence Basics Inability to control when urine is often a symptom of stroke. Learn about this condition and what can be done to treat it

How to Know if You are Having a Stroke
Stroke symptoms can be confusing. Strokes are brain attacks, meaning that a stroke is caused by a decrease in blood supply to a portion of the brain. Unlike heart attacks, which are painful events, brain attacks are not usually painful. In fact, the symptoms of a stroke can be strange or puzzling. Some studies show that as many of 30% of strokes may go undiagnosed within the first 3 weeks.

Because stroke symptoms are rarely painful, it is important to know how to recognize a stroke to avoid missing this emergency problem. The symptoms of a stroke can vary and there are different signs and symptoms of stroke. There are also many different types of stroke. The symptoms depend on which blood vessel is affected and thus which corresponding part of the brain lacks adequate blood supply. There are a range of effects - some strokes cause vision changes, some cause weakness, some cause changes in sensation, some cause speech problems and some cause dizziness or headaches. Often, symptoms are subtle and they don’t ‘feel’ like an emergency. But when a stroke is handled as an emergency, with immediate evaluation and treatment, there is a better chance of a good prognosis with minimal long-term effects. Long term effects include weakness, trouble speaking, swallowing or thinking. In some situations, seizures or muscle atrophy can result.

How to know if you are having a stroke

If you experience weakness on one side of your face, arms, hands or legs, you should obtain medical attention right away. Facial weakness often manifests as eyelid drooping or slurred speech. Vision changes such as blurred vision, double vision, vision loss or partial vision loss can be the sign of a stroke or another serious eye emergency. Trouble with balance and coordination can make it difficult to walk or use hands. Abnormalities of sensation, such as numbness, tingling or burning may not be as noticeable as weakness or vision changes, but it may be the only sign of a stroke. Usually sensory deficits occur on one side of the body during a stroke.

Severe headaches or dizziness may signal a stroke or another urgent neurological condition. It is best to err on the side of caution and get medical attention right away. Time spent in deciding whether or not to obtain medical attention could end up as time wasted from getting the proper treatment.

If you experience trouble speaking, including trouble getting your words out, or understanding words, it is important to get attention right away. When your ability to communicate is impaired, that is when it is obviously most difficult to be able to ask for help.

If it is possible to call 911, that would be the best route for the best care for a possible stroke. But sometimes weakness and poor coordination or vision problems may make it difficult to call for emergency care yourself. In these situations, the best way to ask for help is simply to get the attention of people who are nearby, such as family, friends, coworkers or even strangers if you do not know any of the people around.

How to know if someone else is having a stroke

If you are a companion of someone who is complaining of weakness, loss of sensation, vision changes, severe dizziness or headaches, you should be aware that this could be an unstable situation and that your companion may get worse quickly. You should call for help immediately before the situation worsens.

Because a stroke can affect thinking, judgment and insight, sometimes a stroke victim is unaware of what is happening or may not be able to describe to you what is going on. When someone else is having a stroke, you may notice some changes such as a lack of symmetry of both sides of the face or a slumping of one side of the body. Stroke victims may be confused. In some instances, a stroke may manifest with falling.

The best response is to obtain care right away, rather than waiting to see if things get better. Whether your companion is experiencing a stroke or not, neurological symptoms are red flags and diagnosis and treatment is urgent.

Stroke Symptoms

Stroke is the third leading cause of death in the United States. It's important to recognize stroke symptoms as they are happening in order to get help to the victim before the damage is permanent. The National Institue of Neurological Disorders and Stroke (NINDS) identify the following signs and symptoms of stroke. If a victim suffers any of the following signs or symptoms of stroke, call 911 immediately!

Causes of Stroke Symptoms

Stroke occurs when a section of the brain is suddenly starved of oxygen. Strokes can happen in two very different ways.

Ischemic stroke is a blockage of a blood vessel in the brain that results in death to the brain tissue. Usually, the blockage comes from a blood clot.

Hemorrhagic stroke occurs when a blood vessel in the brain bursts and causes bleeding in or around the brain.

Treatment of Stroke

Stroke is a true emergency, a good reason to call 911 . Treatment for both types of stroke require early recognition and access to emergency medical care. Using medication to dissolve clots in ischemic stroke should happen within three hours of onset. When suspecting stroke symptoms, be sure to take quick action.

Source: mail.aol.com/38815-816/aol-6/en-us/Suite.aspx

Blood Test For Stroke


Early diagnosis means faster treatment

When faced with a patient who may be having a stroke, most doctors are faced with a dilemma. If the patient is having a stroke, rapid treatment delivered within the first couple of hours is critical in preventing further damage to the brain structures and the resulting disabilities that go along with this damage. But knowing what exactly is the right treatment is the problem.

Strokes are caused by an interruption of the circulatory system in the brain, caused either by a blot clot in one of the vessels supplying the tissues of the brain, or by bleeding in the brain. The choice of treatment for each of these is very different and if the cause of the stroke is misdiagnosed and treated with an incorrect treatment, further damage or even death can result. The majority of strokes (80 %) are caused by blood clots blocking one or more arteries of the brain, with the rest caused by bleeding.

Stroke Victim

Stroke (cerebral vascular accident) kills nearly a quarter of those who suffer from one and cause disability for most. There are very effective drugs "clot busters" for treating those strokes caused by clots that if given within a window of three hours from the beginning of the stroke can break up the clot and prevent much of the brain damage that occurs. These same drugs if given to patients having strokes caused by bleeding will cause more bleeding in the brain increasing the damage and possibly leading to the death of the patient. Quickly diagnosing the cause of the stroke is problematic for doctors and often leads to delays in treatment. Stroke is difficult to diagnose because of a wide variety of symptoms patients may present to the emergency room with. These symptoms can also be caused by other conditions not related to stroke.

Computerized Tomography or CT scans are very effective at diagnosing bleeds in the brain but much less effective at pinpointing clots. Daniel Laskowitz, a neurologist at Duke University Medical Center in Durham, North Carolina and consultant for diagnostic company Biosite, has been working with that company to develop a blood test for strokes caused by blood clots. Early results are showing that the test they have developed that detects a set of six brain proteins released into the blood that strongly indicate a stroke caused by clots. Results can be obtained within 15 minutes allowing treatment to begin well within the window of effectiveness.

A larger clinical trial is to be undertaken to verify the result of this research. If the tests are found to be effective, this test could be eventually done in every emergency room or ambulance when a patient presents with stroke symptoms.

Side Effects of Coumadin, Plavix and Other Blood Thinners


Blood thinners are commonly used in the prevention of strokes. This is especially important for people who have already suffered one

stroke, as they have an increased risk of suffering another. In fact, about 30% of all strokes in a given year are repeat strokes, so stroke survivors must be diligent about stroke prevention . However, even if you've never suffered a stroke, but are at risk of getting one, you're likely taking a blood thinner.

Here is a list of common blood thinners used for stroke prevention, and their common side effects. For a complete review of these medications, please visit the latest edition of the physician’s desk reference.

Plavix:

Common side effects of Plavix include stomach pain, muscle aches, dizziness, and headache. Easy bruising and nose bleeds can also occur. People who have stomach ulcers might develop intestinal bleeding, which can be life threatening.

What to watch out for: if you find black or tarry-looking stools this is a sign of intestinal bleeding. This and any other forms of abnormal bleeding should prompt you to discontinue the medication and to go to the nearest emergency room.
Source: stroke.about.com/od/caregiverresources/a/blood_thinners.htm

10 Common Symptoms of a Stroke


A stroke, or cerebrovascular accident (CVA), is a scary experience. It occurs when the blood supply to the brain is impeded or cut off completely due to lack of blood flow (or ischemia), blockage (thrombosis, arterial embolism), or a brain hemorrhage. As a result, the brains stops functioning normally and oftentimes the muscles in the body, the reflexes, and the senses are all affected.

Luckily, a stroke can be treated, but getting emergency medical attention as quickly as possible is the key to survival. That’s why it’s vital to recognize the following ten warning signs of a stroke…

1. Loss of Balance

The onset of a stroke will cause extreme physical turmoil, so much so that often victims have trouble walking, lose their balance and coordination completely, and even have trouble sitting down without falling.

2. Weakness

A sudden loss of strength in the muscles of the face, arm, leg—even if it’s just temporary—can signal an oncoming stroke. Many patients complain of numbness or tingling in the left arm or shoulder that comes on suddenly and gradually worsens. Sometimes, complete muscle failure can occur, where you can’t lift an arm or bear weight on the affected leg.

3. Facial Paralysis

Oftentimes a stroke inflicts the facial muscles, where one side of the face droops or goes totally numb so the face appears non symmetrical when they try to talk or smile.

4. Difficult Speech

If an individual suddenly has difficulty speaking or forming intelligent sentences, it can indicate a stroke. Observers often explain it as watching someone helpless trying to talk, or a look of sudden confusion on the affected person’s face.

5. Impaired Vision

Those affected by a stroke often explain there is a period prior where they have trouble seeing or seeing clearly. This blurred vision might only be temporary, but observers can test visual aptitude by asking the victim how many fingers they are holding up. If they can’t tell, call 9-1-1.

6. Lack of Understanding

A person suffering a stroke will often have difficulty understanding certain statements and commands in the days leading up to the actual stroke.

7. Headache

The sudden onset of a severe, debilitating headache or migraine that is not normal or usual is common prior to a stroke. In fact, many stroke victims explain a headache so painful that it feels like being struck by lightning, causes extreme nausea, and even collapse.

8. Loss of Sensation

In the days leading up to a stroke, it’s common for a gradual, or even a total, loss of vibratory sensation (or feeling) on the skin. The other senses—such as smell, taste, and hearing can also be fully or partially affected.

9. Dizziness

Many victims of a stroke encounter a total loss of balance so severe that they feel like the world is spinning (i.e., vertigo).

10. Lack of Reflex

It is also common to experience a decrease or loss of reflex. For instance, many stroke victims complain of trouble swallowing when eating to the point where they gag.

What Does "Premature Death" Mean?


While there is no widespread definition adopted by all demographic researchers, premature death and premature mortality are terms generally referring to a death which occurs prior to the average life expectancy for a given population. Depending on the standard of public health in a country, the threshold age considered to be "premature" would differ.

For example, the US Centers for Disease Control and Prevention (CDC) describe a death before the age of 80 as premature in documents such as the Morbidity and Mortality Weekly Report.

In high income nations, death rates for middle-aged adults have declined dramatically since the 1970s, thanks to more people quitting smoking and better survival rates after heart attack and stroke.

Even better for those living in industrialized countries, notes epidemiologist and international public health researcher Prabhat Jha, health promotion strategies including better secondary treatment after a cardiovascular event, more effective diabetes control and anti-smoking campaigns have helped compress morbidity - meaning the onset of many age-related diseases is delayed until a person is older, and they stay healthier, longer.

What about poorer nations? "Global life expectancy is today 70 years," says Jha, "so an appropriate mark for premature deaths in low and middle income countries should be deaths before age 70."

Jha was one of an international team proposing in The Lancet in 2014 a 40% reduction in global premature deaths by the year 2030 could be achieved through measures such as reducing infant mortality, deaths from communicable diseases such as tuberculosis, HIV/AIDS and malaria, and by battling malnutrition and injuries.

Sources:

Prabhat, Jha. Professor of Epidemiology, University of Toronto Dalla Lana School of Public Health. Correspondence September 29, 2014.

Prabhat Jha, and Richard Peto. "Global Effects of Smoking, of Quitting, and of Taxing Tobacco" N Engl J Med 2014; 370:60-68 January 2, 2014. www.nejm.org/doi/full/10.1056/NEJMra1308383

Ole F Norheim, Prabhat Jha, Kesetebirhan Admasu, Tore Godal, Ryan J Hum, Margaret E Kruk, Octavio Go´mez-Dante´s, Colin D Mathers, Hongchao Pan, Jaime Sepu´lveda, Wilson Suraweera, Ste´phane Verguet, Addis T Woldemariam, Gavin Yamey, Dean T Jamison, Richard Peto. "Avoiding 40% of the Premature Deaths in Each Country 2010–30: Review of National Mortality Trends to Help Quantify the UN Sustainable Development Goal for Health." The Lancet 19 September 2014. www.cghr.org/wordpress/wp-content/uploads/SDG-40-perc-Reduction-in-deaths-2030-Lancet-2017.pdf

Paula W. Yoon, Brigham Bastian, Robert N. Anderson, Janet L. Collins, Harold W. Jaffe. "Potentially Preventable Deaths from the Five Leading Causes of Death — United States, 2008–2010." Morbidity and Mortality Weekly Report May 2, 2014 / 63(17);369-374. www.cdc.gov/mmwr/pdf/wk/mm6317.pdf

Source: longevity.about.com/od/Longevity-Terms-And-Concepts/fl/What-Does-Premature-Death-Mean.htm?utm_content=20150811&utm_medium=email&utm_source=cn_nl&utm_campaign=healthsl&utm_term=Health%20Channel%20Newsletter

 

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