If a clot clogs a vessel in the brain, it often has serious consequences for the patient. But the risks for a stroke can be influenced. What role do blood pressure, diet and exercise play? Sport can positively influence risk factors for stroke, for example, prevent high blood pressure, obesity, and diabetes.
It’s raining. Instead of the Alps in the Upper Bavarian Aschau all around today, only cloud mountains can be seen. No weather for a walk. Therese Schmid (66) is still on the way. “It can not always be the sun,” she says. Twice a week, she and her husband travel the distance from their home to the school. Not to learn, but because they are taking part in a study.
“Pressure down, activity up!” is the name of the prevention project in which older citizens from the village accompany children on their way to school. “Above all, we are interested in whether something can be done to combat high blood pressure – the most important risk factor for cardiovascular diseases such as stroke,” says the prevention researcher. Birgit Böhm from the Technical University of Munich, who supervises the project.
The lifestyle plays an important role
Stroke is one of the biggest threats to health in Germany. Every year, it affects around 270,000 people. The circulatory disorder of the brain usually occurs when a vessel in the head is narrowed or closed. Rarer is a brain hemorrhage behind it. For those affected, the consequences are often dramatic. No other event is responsible for so many cases of disability. The acute treatment of stroke has made progress in recent years. Even more important is prevention.
“The studies clearly show that many risk factors can be well influenced by the individual lifestyle,” says Professor Bernhard Krämer, CEO of the German Society for Hypertension and Prevention. Which factors are, researchers examined the data from more than 13 000 stroke patients from 32 countries. The result of this so-called interstroke analysis: Nine out of ten attacks are directly or indirectly related to the lifestyle. Most would be avoidable.
Prevention clarifies the risk factors of a stroke
Number one in the risk ranking is hypertension. The affected person is not always aware of this. Expert Krämer explains to patients that hypertension can damage the blood vessels throughout the body – including those in the brain. However, if you go against him, the stroke risk drops. “Ideally, patients with exercise, weight reduction, and a low-salt diet can bring about a significant improvement,” says Krämer. However, antihypertensive drugs are also often included.
When developing a stroke, various risk factors are closely linked. Lack of exercise, for example, also contributes to obesity. Both, in turn, promote diabetes and bad lipid levels – further risk factors for an attack. These connections are also in the Aschauer prevention project. Scientist Böhm works closely with a local pharmacy. “We advise people who have cardiovascular diseases here every day, so a healthy lifestyle and preventive care are very important to us,” says pharmacist Claudia Zangerl.
Together with Böhm, she organized two action days around the topic of cardiovascular health. Most of the study participants were found. “The willingness to talk about one’s own health is very high in the pharmacy, which is why prevention is in good hands there,” explains Böhm. Four times over the course of one and a half years, study participants are examined and their blood pressure is measured. Everyone gets an activity tracker that counts every step and monitors the heart rate. At least 10,000 steps a day, the subjects should go. Whether the values can be lowered – as hoped – will be demonstrated in the coming year.
These measures reduce the risk of stroke
- Lower your blood pressure, For experts the most important step. Good values can reduce the risk by up to 40 percent.
- Stop smoking, Every fifth attack could be avoided if patients overcome their nicotine addiction.
- Eat healthy and balanced, Lots of vegetables, fruits, and fish, little salt – that protects the vessels. Another tip: drink little or no alcohol
- Move enough, This benefits the cardiovascular system. In addition, the risk of hypertension, obesity and metabolic diseases decreases.
Risk factor atrial fibrillation: Listen to the heartbeat
But not all risk factors are as effective as hypertension. For example, atrial fibrillation also increases the risk. However, this widespread cardiac arrhythmia is often not discovered. “Cardiologists often do not see such patients until they have the first stroke,” says Dr. Philipp Sommer from the Heart Center Leipzig. When atrial fibrillation, the heart gets out of rhythm, it beats rhythmically and often clearly too fast. About 15 percent of all attacks are caused by it.
“Due to the irregular pumping activity, blood clots form in the heart, which in turn can block vessels in the brain,” explains expert Sommer. For a previous diagnosis, it would be important for people over 65 to “listen to their heart” more often. Because many sufferers feel the atrial fibrillation as a somewhat irregular, faster heartbeat. “You can then feel the pulse on your wrist and have any irregularities clarified,” explains Sommer. Sphygmomanometers also sometimes help to detect rhythm problems. “If the arrhythmia detection signal shines more often, you should take it seriously and go to the doctor,” says the cardiologist.
Prevention: It is never too late for exercise and healthy nutrition
This causes an ECG or long-term ECG in case of suspicion. After diagnosis, patients receive medications that inhibit blood clotting. This so-called anticoagulation offers in many cases good protection against clots in the heart. Even if someone has to take medicines, it is not too late for prevention, says Sommer. The risk factor model is not static, but dynamic. “It is also with one or more risk factors in your own hands to influence the risk cheap – and remains his own luck blacksmith!”
Study participant Therese Schmid has internalized this. The activity tracker on the wrist is still a motivation. “You can see exactly how much or how little you move.” When she sees her on the display in the evening, that she just can not keep up with the steps, she goes to an extra round with her husband. “We have become almost a bit ambitious.”
These three values count for the risk of stroke:
- Blood pressure: Values below 140/90 mmHg are usually considered ideal.
- Blood fat: Without further risk factors, the total cholesterol should be below 200 mg/dl, the LDL below 160 mg/dl.
- Blood sugar: Diabetics must discuss their individual goals with the doctor.
With this emergency rule also lay people recognize a stroke
If it comes to a stroke, the time runs for the person concerned. “Time is brain, in German time is brain – this is the most important rule for acute care,” says Professor Heinrich Audebert from the Center for Stroke Research at the Charité Berlin. As soon as the brain is no longer adequately supplied with oxygen, the nerve cells are mass-extinguished. Millions of them can be irretrievably lost, neural connections no longer work.
The faster the patient gets to the hospital, the better the damage can be limited. For years experts have worked to reduce the time between stroke and hospital admission. “Many sufferers first visit their family doctor instead of calling the emergency doctor right away,” says Professor Darius Nabavi of the German Stroke Society. As a result, valuable time is lost.
The so-called FAST test can help to interpret the most important symptoms correctly. However, there are other signs that the test does not capture. For example, suddenly appearing balance disorders, one-sided numbness, dizziness, unconsciousness or sudden onset of an extreme headache. Vision problems can also occur, including temporary blindness.
In case of such symptoms also call the ambulance – even if the symptoms disappear again or subside. They can be harbingers of a stroke. Meanwhile, apparently more people recognize the symptoms – and call the emergency doctor directly. Figures from Baden-Württemberg show that as late as 2006, one-third of stroke patients reached the clinic via the family doctor. Ten years later, this share has halved.