New Year’s Resolutions

Here are the top 5 things you can do to prevent a stroke. 

Once upon a time, a stroke was called a cerebrovascular accident. Not anymore. “That’s because strokes are not accidental; most strokes are preventable,” says Sheryl Martin-Schild, M.D., PhD, Medical Director of Neurology and Stroke at Touro Infirmary and New Orleans East Hospital.

A more apt term is “brain attack,” due to the suddenness of stroke and the damage it can cause to your brain. And just like calling 911 for a heart attack, Dr. Martin-Schild says, the speed of treatment for stroke is absolutely critical and can mean the difference between recovery and lifelong disability. Every minute matters.

Age, race and family history play an unavoidable role, but Dr. Martin-Schild recommends her patients follow at least these five steps to reduce risk.

1. Maintain normal blood pressure.
“Controlling blood pressure is definitely job No. 1,” Dr. Martin-Schild says. “High blood pressure explains almost half of all strokes.”

Many first-time stroke victims don’t even have doctors and are unaware of conditions making stroke more likely. Step one is to see a primary care physician regularly. With untreated high blood pressure, you don’t realize you may already have damage to the heart and the arteries leading to brain, eyes, kidneys and limbs.

Resolution: Measure your blood pressure regularly and maintain it at less than 140/90.
How-to: Reduce salt; get more exercise; maintain a healthy weight; and limit alcohol use. See your doctor about your blood pressure and embrace medications, when recommended.

2. Maintain normal blood sugar.
“Having high blood sugar damages blood vessels over time, making clots more likely to form inside them,” Dr. Martin-Schild says. “But first you have to be aware you have diabetes or impaired glucose tolerance (its precursor). Treatment can help delay the onset or arrest ongoing blood vessel damage.”

Resolution: Have a fasting blood sugar test at least once per year.

How-to: Call your doctor. In the meantime, good diet and exercise certainly can’t hurt.
3. Quit smoking.
Of all the modifiable risks, this one is the most obvious — even if not the easiest to manage. “I tell my patients, ‘They’re not smoking sticks, they’re stroking sticks,’” Dr. Martin-Schild says. “There’s compelling data that within a few years of stopping smoking, the risk of stroke is reduced.”

Smoking accelerates the damage of your artery walls and encourages the growth of plaque that eventually obstructs blood flow. “You can see plaque developing in patients as young as 20,” Dr. Martin-Schild says.

Resolution: Try visualizing quitting as slicing stroke risk this year. Each attempt is one step closer to successfully beating the habit.

How-to: See your doctor about behavior modification, nicotine patches and medications.

4. Control sleep apnea.
Physicians are beginning to understand the ways that untreated sleep apnea is a precursor to multiple body system issues. “It’s related to poorly controlled blood pressure, heart failure, dementia and stroke,” Dr. Martin-Schild says.

Not everyone who snores has sleep apnea and not everyone with sleep apnea snores. But with sleep apnea, the tissues of the throat and neck relax and obstruct the airway leading to interrupted sleep, poor health and premature pruning of brain cells.

Resolution: If recommended by your doctor, get that polysomnogram (sleep study) this year. If diagnosed with sleep apnea, commit to the recommended treatment.

How-to: Weight loss can also help snoring and sleep apnea, but you might need a device to assist with air flow and better sleep.

5. Drink in moderation.
“Readers won’t mind this part: Two drinks or less a day is actually protective from stroke,” Dr. Martin-Schild says. But more than that starts to put strain on the heart and can increase the chances of having a stroke.

Beyond two daily drinks, increased risk is dramatic. Blood pressure management gets challenging and brain hemorrhage is more likely.

Resolution: Skip the big bash and keep your sipping social.

How-to: Alternate each beverage with a glass of water. Red wine may be a better choice for cardiac benefits.

Dr. Martin-Schild also counsels her patients and at-risk people to control cholesterol, obesity and anxiety and her prescription for all of the above is always going to include better fitness.

“I ask my patients to engage in something I like to call commercial exercise,” she says. “That means when they’re watching TV, they need to work out during every commercial.” She recommends keeping three- or five-pound weights on the coffee table and marching in place.
She also tells patients to ‘live prepared, not scared.’ That means being aware of risk and being committed to reducing risk through lifestyle and sometimes medical management.

“I’d like to be forced into retirement because I prevented all the strokes in my city,” she says.

Dr. Martin-Schild is also Medical Director of Stroke for the Louisiana Emergency Response Network. touro.com/stroke