As a nurse working in a neurocritical care, I witnessed the sudden and devastating effects of stroke on survivors and their carers .
Author
- Siobhan Mclernon
Senior Lecturer, Adult Nursing and co-lead, Ageing, Acute and Long Term Conditions. Member of Health and Well Being Research Center, London South Bank University
Following my nursing career, I became a researcher specialising in stroke. Knowledge of stroke risk factors in the general public is poor, so stroke prevention is a priority for public health.
Stroke is a leading cause of death and disability in England - yet it is largely preventable . It's often considered an older person's illness but, although stroke risk does increase with age, it can happen at any time of life. In fact, stroke incidence is increasing among adults below the age of 55 years.
Stroke risk factors that tend to be more common among older people - such as high blood pressure (hypertension), high cholesterol, obesity, diabetes, smoking, physical inactivity and poor diet - are increasingly found in younger people. Other lifestyle risks include heavy alcohol consumption or binge drinking and recreational drugs such as amphetamines, cocaine and heroin.
Some risk factors are not modifiable such as age, sex, ethnicity, family history of stroke, genetics and certain inherited conditions. Women, for example, are particularly susceptible to strokes - and women of all ages are more likely than men to die from a stroke.
Stroke risks unique to women include pregnancy and some contraceptive pills (especially for smokers), as well as endometriosis, premature ovarian failure (before 40 years of age), early-onset menopause (before 45 years of age) and oestrogen for transgender women.
Also, inherited vascular abnormalities such as cerebral aneurysms - a weakness in the artery wall - can increase the risk of haemorrhagic stroke .
Some risk factors are social rather than biological, however. Studies have found that people with a lower income and education level are at a higher risk of having a stroke. This is due to a combination of factors. Unhealthy lifestyle habits, such as smoking, heavier drinking and lower physical activity levels are more common in people with lower incomes.
However, research also shows that people with lower socioeconomic status are less likely to receive good quality healthcare than people with higher incomes.
But, regardless of biological or social risk factors, there are things you can do - right now - to reduce your risk of having a stroke.
Essential eight
1. Stop smoking Smokers are more than twice as likely to have a stroke than non-smokers. Smoking causes damage to blood vessel walls, increases blood pressure and heart rate but reduces oxygen levels. Smoking also causes blood to become sticky , further increasing the risk of blood clots that can block blood vessels and cause a stroke.
2. Keep blood pressure in check High blood pressure damages the walls of blood vessels, making them weaker and more prone to rupture or blockage. It can also cause blood clots to form, which can then travel to the brain and block blood flow, leading to a stroke. If you're over 18 years of age, get your blood pressure checked regularly so, if you do show signs of developing high blood pressure, you can nip it in the bud and make appropriate changes to your lifestyle to help reduce your risk of stroke.
3. Keep an eye on your cholesterol According to the UK Stroke Association your risk of a stroke is nearly three and a half times higher if you have both high cholesterol and high blood pressure. To lower cholesterol, aim to keep saturated fat - found in fatty meats, butter, cheese, and full-fat dairy - below 7% of your daily calories, stay active and maintain a healthy weight.
4. Watch your blood sugar High blood glucose levels are linked to an increased risk of stroke. This is because high blood sugar damages blood vessels, which can lead to blood clots that travel to the brain. To reduce blood glucose levels, try to take regular exercise, eat a balanced diet rich in fibre, drink enough water, maintain a healthy weight, and try to manage stress .
5. Maintain a healthy weight Being overweight is one of the main risk factors for stroke. It is associated with almost one in five strokes, and increases your stroke risk by 22% . Being obese raises that risk by 64%. Carrying too much weight increases your risk of high blood pressure, heart disease, high cholesterol and type 2 diabetes, which all contribute to higher stroke risk.
6. Follow a Mediterranean diet One way to eat a fibre-rich balanced diet and maintain a healthy weight is to follow a Mediterranean diet . This has been shown to reduce the risk of stroke , especially when supplemented with nuts and olive oil.
7. Sleep well Try to to get seven to nine hours of sleep daily. Too little sleep can lead to high blood pressure , one of the most important modifiable risk factors for stroke. Too much sleep, however, is also associated with increased stroke risk , so try to stay as active as possible so you can sleep as well as possible.
8. Stay active The NHS recommends that people should avoid prolonged sedentary behaviour and aim for at least 150 minutes of moderate intensity activity or 75 minutes of vigorous intensity activity a week. Exercise should be spread evenly over four to five days a week, or every day. Do strengthening activities , usually more than two days per week.
The good news is that while the effects of stroke can be devastating and life-changing, it is largely preventable. Adopting these eight simple lifestyle changes can help to reduce stroke risk and optimise both heart and brain health.
Siobhan Mclernon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
