Understanding strokes

2013-09-26 00:00

ABOUT half of all deaths from heart disease and strokes are caused by high blood pressure, and unfortunately our country has one of the highest rates of hypertension globally. In South Africa, 240 people a day suffer a stroke and 130 people a day have a heart attack. This means that every hour, 10 South Africans will have a stroke and five will have a heart attack.

Cardiovascular disease refers to any disease related to the heart and blood vessels. The most common are strokes, heart attacks and heart failure. Although strokes are most common in people over the age of 65, even children can suffer a stroke. Recently, a dear friend in his 50s suffered a stroke and it has brought home to me, once again, the frailty of the human body and the immense blessing that good health is.

Shocking statistics show us that 80% of all cardiovascular diseases are preventable. Today, I’d like to uncover some truths about strokes and point us on a road of reducing the risks for this debilitating disease.

As with all organs, the brain depends on a steady supply of oxygen and nutrients, which are carried to it by the bloodstream. If this blood supply to the brain is interrupted, brain cells begin to die. The severity of a stroke depends on the degree of blood-flow interruption and the area of the brain affected. A stroke’s results can vary from a passing weakness or tingling in a limb, to a profound paralysis, coma or death. A stroke is also known as a cerebrovascular accident (CVA) and there are two main types. Either a blood vessel to the brain ruptures, causing bleeding (haemorrhagic stroke); or a blood vessel becomes blocked by a blood clot (ischaemic stroke). Over 80% of all strokes are ischaemic, where blood flow is stopped due to a blood clot blocking an artery.

The main cause of a haemorrhagic stroke is high blood pressure, which can weaken the arteries in the brain and make them prone to splitting or rupturing. Smoking, drinking, lack of exercise, excess weight and stress are the main factors increasing the risk of this less-common stroke.

The main cause of the more common ischaemic stroke is blood clots forming in narrowed or blocked arteries. This narrowing is typically from fatty cholesterol deposits known as plaques. As we get older, our arteries do become narrower, but certain factors such as smoking, high blood pressure and cholesterol, obesity and excessive alcohol intake can dangerously accelerate the process.

Risk factors that cannot be changed include family history of strokes or heart attack and being 55 years old or more. Men have a higher risk of strokes than women, and women are usually older when they do have strokes. A large proportion of risk, however, can be reduced by making lifestyle changes.

• Cut down on fats. High-fat foods can increase your cholesterol and lead to the build-up of fatty plaques in your arteries, obstructing blood flow. A high-fat diet will also increase the likelihood of being overweight, which causes an increase in blood pressure. Reduce high-fat foods such as sausages, ribs, boerewors, pies, cream, butter and ghee, hard cheeses and foods that contain coconut or palm oil.

• Include five portions of fruit and vegetables every day.

• Limit salt intake. Try to avoid using high-salt condiments such as soup powders, stock cubes, soya sauce and Worcestershire sauce. Avoid crisps and salted crackers or biscuits.

• Include small amounts of beneficial fats. These are unsaturated fats found in oily fish (sardines, pilchards, mackerel), avocados, almonds, cashews, pecan nuts, walnuts, sunflower seeds, canola and olive oil.

• Exercise regularly. This will improve your blood circulation and make your heart more efficient as a pump. Aim for 30 minutes of exercise five days of the week.

• Stop smoking. Smoking narrows arteries and makes blood more likely to clot. It doubles the risk of having a stroke.

• If you drink alcohol, drink moderately. Limit intake to a maximum of two drinks per day for men, and one drink per day for women. Excessive alcohol consumption can lead to high blood pressure, irregular heart beat and weight gain. Heavy drinking multiplies the risk of a stroke by more than three times.

The best way to prevent a stroke is to eat a healthy diet, exercise regularly and avoid smoking and excessive consumption of alcohol. If you do have high blood pressure or diabetes, pay close attention to controlling these well.

• Sharon Hultzer is a consulting dietitian. She can be reached at eatsmart@iburst.co.za

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