Stroke Prevention

By Kim Dutfield ,RN

January 2015

Stroke Impact

Stroke is widespread

►More than 62,000 admissions to emergency departments for stroke, including transient ischemic attack (TIA), each year in Canada

►Leading cause of disability

►Third leading cause of death in Canada

►Each year more than 13,000 Canadians die from stroke

►Women more likely to die when they have a stroke

► 1 in 5 for women, vs. 1 in 6 for men

HSF Stroke Report 2014; WSO 2014

Signs and Symptoms of Stroke

Sudden Weakness, numbness or tingling in the face, arm, or leg

Sudden trouble speaking or understanding

Sudden vision changes

SuddenHeadache

Sudden loss of balance

Shift from “Five” to FAST

Late 1990’s 2014

F

A

S

T

Think FAST

“Time Is Brain”

“Canadians need to understand

that the clock starts ticking at the

first signs of a stroke. And every

second of delay leads to more

brain cell death, and greater risk

of death or disability” –

Dr. Michael Hill

Age(most strokes occur after 65) Gender (women have lower risk before menopause

than men. But more women die of stroke) Ethnicity(increased risk for persons of Aboriginal,

African, or South Asian descent because of higher rates of high blood pressure and diabetes)

Family history( if parent or sibling had a stroke before 65)

Prior stroke or TIA

Risk Factors You Can’t Control

Hypertension

High blood cholesterol

Diabetes

Smoking

Being overweight

Physical inactivity

Excessive alcohol consumption

Stress (not managing stress), Depression

Sleep apnea

Women on birth control and HRT

Risk Factors You Can Control

Hypertension

THE greatest risk factor for stroke

Single most modifiable risk factor for stroke.

Target B/P - <140/90

Diabetics or Kidney disease- < 130/80

KNOW YOUR BLOOD PRESSURE

Lipid Management

Patients who have had a stroke or TIA should have their lipid levels assessed.

A statin should be prescribed for primary prevention of cardiovascular events, including stroke, to most patients with high risk

Achieve LDL of less than

2.0 mmol/l

Atrial Fibrillation

Alcohol Management

Alcohol reduction reduces stroke risk!

Recommendations:

* Men: up to 2 drinks, per day

*Women: up to 1 drink, per day

1 drink = 1.5 oz. of spirits,

12 oz. of beer, 5 oz. of wine

Thinking About Quitting?

Within 20 minutes of quitting…

20 Minutes After Quitting

Your heart rate drops

12 Hours After Quitting

Carbon monoxide level in blood drops to normal

2 Weeks to 3 Months After Quitting

Your heart attack risk begins to drop

Your lung function begins to improve

1 to 9 Months After Quitting Your coughing and shortness of breath

decrease.

1 Year After Quitting Your added risk of coronary heart disease is half

that of a smoker’s.

5 Years After Quitting Your stroke risk is reduced to that of a non-

smoker’s 5-15 years after quitting.

10 Years After Quitting Your lung cancer death rate is about half that

of a smoker’s

Your risk of cancers of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases

15 Years After Quitting Your risk of coronary heart disease is back to

that of a non-smoker’s

To help reduce your risk for stroke, the recommendations for physical activity are simple:

*Accumulate a minimum of 150 minutes (2 ½ hrs)

of moderate to vigorous exercise per week

*May do in segments of 10 minutes

Activity & Lifestyle

Keeping your blood sugar in a healthy range will help to reduce the damage to your blood vessels that leads to “hardening of the arteries” (atherosclerosis).

This can be achieved through: diet, exercise and possibly medication and regular monitoring of sugar levels.

Report to your doctor when blood sugars are often outside the 4-7 range. You may need another visit with the Diabetes Educator.

Good news! Well managed diabetes will also help to reduce your risk of developing high blood pressure or heart disease or having a stroke.

Diabetes Management

Sleep Apnea

Recommend screening for sleep apnea if experiencing:

*Frequent waking &/or snoring, especially if pauses are heard

*Broken sleep, wake with snort/gasp

*Poor concentration, sleepy in day

*BP, arrythmia hard to control

*More likely if overweight, short/wide neck, 1 in 4 men, 1 in 10 women, age >50

*Untreated sleep apnea can mean a significant increase in your stroke risk!

Body Weight

Waist Circumference

Stress. What is it?

Bad Stress

How do you cope with stress?

Just say NO

Get help when needed

Relaxation techniques

Exercise

Time management

Watch your diet-alcohol, caffeine, sugar, fats &

tobacco

Sleep and rest

Talk with others

Volunteer

Have fun!! Laugh!!

Be with people you enjoy!!

Don’t try and be perfect

Work off your anger

Tackle one thing at a time-Don’t try and do too much at once

Ease up on criticism of others

Give in occasionally-avoid quarrels whenever possible

Explore your spirituality

Know your risks and see your doctor to help reduce them.

Be Good to Yourself and your Farm!