We often read about ways to prevent heart attacks: Control blood pressure, control diabetes, quit smoking, lose weight, exercise and so on. Roughly 20 percent of Americans who die each year do so from coronary heart disease, the leading cause of death in the United States, so the necessary effort to change lifestyle and prevent heart attack can potentially reap large rewards.
We read less about stroke prevention, in part because stoke is less common. About 1.25 million coronary events occur annually, compared to some 700,000 strokes. About 450,000 die from these cardiac events and 160,000 die from stroke. So, although stroke is less common than heart attack, stroke obviously takes a great toll and is America’s third leading cause of death. Besides, stroke has its own particular devastation because it causes paralysis and cognitive injury. Many people believe a major stroke is worse than death. Even though we treat stroke patients every day at Atlanta Hyperbaric, like doctors generally, we are always looking for ways to prevent the very illnesses we treat; we are always looking for ways to put ourselves out of business!
The American Heart Association has put together some guidelines to identify patients at high risk for stroke. We cannot change the basics: Risk of stroke doubles for each decade of life after age 55; Blacks and Hispanics have about twice the risk of Whites; Men have about 1.5 times the risk of Women. Certain risk factors, however, are modifiable: Just like for coronary disease, smoking and blood pressure control are highly important. Smoking doubles the risk of stroke. The higher the blood pressure, the higher the stroke risk. Although diabetics have more strokes than non-diabetics, unfortunately, sugar control doesn’t have a great effect on stroke prevention. Anticoagulation for atrial fibrillation and drugs like Lipitor and Crestor for cholesterol control reduce stroke incidence. Carotid surgery for known narrowing seems to be beneficial. Oral contraceptive use, sickle cell disease and exercise are also on the list of risk factors that patients can modify to reduce stroke incidence.
Prevention is almost always better than treatment and stroke is no different. As much as we’ve seen stroke patients benefit from hyperbaric oxygen treatment, it would be wonderful if we could prevent the stroke in the first place.