Controllable Risk Factors – Diabetes

People with diabetes are up to 4 times as likely to have a stroke as someone who does not have the disease, mainly because many people with diabetes have health problems that are also stroke risk factors.

In New Zealand (total population 4.3 million with 70% Caucasian, 7.9% Maori, 5.7% Asian, 4.4% Pacific peoples, 7.8% mixed, 3.8% unspecified) the Ministry of Health estimates that 210, 000 people will be affected with diabetes by 2010. Estimated diabetes prevalence data for 2010 in persons over the age of 15 of different ethnic groups are as follows: South Asians 12.4%, Maori 7.8%, Pacific peoples 11.6%, Caucasians 5.3% and a national average of 6.1%.

What is diabetes?
Diabetes is a disease that affects a person’s ability to move blood sugar, or glucose, out of the blood and into the cells where it is used as the body’s primary source of fuel.

There are 2 types of diabetes, Type I (insulin dependent) and Type II (non-insulin dependent). Type I diabetes usually emerges in childhood and is characterised by the body’s inability to produce enough insulin. Insulin is the hormone the body uses to convert sugar, starches and other food into energy needed for daily life.

Type II diabetes is more common. More than 90 percent of New Zealanders with diabetes have Type II diabetes. With Type II, the body is able to produce insulin, but tissues develop a resistance to it and blood sugar levels rise above normal. It generally develops during adulthood and may escape notice for some time because many symptoms of the disease frequent urination, excessive thirst, extreme hunger, unusual weight loss, increased fatigue, irritability and blurry vision seem harmless.

Diabetes Type 2 Causes

How is diabetes linked to stroke?
Many people with diabetes have health problems that increase their risk for stroke.

Uncontrolled high blood pressure, or hypertension, is a major risk factor and leading causes of stroke. As many as 2 out of 3 adults with diabetes have high blood pressure.

Heart attack and atrial fibrillation (a type of irregular heart beat) are also common among people with diabetes, and both increase the risk for stroke.

Many people with diabetes also have high cholesterol, increasing their risk for stroke. Build-up of LDL cholesterol, sometimes called the “bad” cholesterol, can block blood vessels and reduce blood flow to the brain. Any time blood flow to the brain is decreased, the risk for stroke increases.

Brain damage may be more severe and extensive if blood sugar is high when a stroke happens. Careful regulation of blood sugar, either with insulin or blood sugar-lowering pills, can help.

Diagnosis
Being tested for diabetes is quick and easy with the help of a doctor. A doctor’s office will collect a blood sample and then check blood sugar levels with a fasting plasma glucose (FPG) test. High blood sugar levels may signal diabetes.

Treatments for Diabetes
Both types of diabetes can be controlled, reducing the risk of long-term health problems such as stroke. Type I is treated by closely monitoring blood sugar and taking daily shots of insulin. Type II, which is worsened by obesity, can frequently be controlled through weight loss, exercise and changes in eating habits. Daily insulin injections are not always necessary.

The good news? Stroke risk can be reduced by managing diabetes — it’s never too late to better manage personal health with a doctor’s help.

Other ways to help manage diabetes:

  • Foot Care: Inspect feet daily for signs of trouble. Have foot sores or calluses checked by a doctor or podiatrist.
  • Eye Care: See the eye doctor at least once a year. Diabetes can lead to eye disease, but there are treatments available if problems are caught early.
  • Dental Care: See the dentist every six months. Excess blood sugar in the mouth makes it a good home for bacteria, which can lead to infection.
  • Be More Active: Physical activity can lower blood sugar, blood pressure and cholesterol; help insulin work more effectively; improve blood circulation; and keep joints flexible.
  • Eat a Healthy Diet: Eat smaller portions, more fruits and vegetables, and foods that are high in fiber. Also, watch salt, fat and sugar intake.

aheadofstroked03ar03ap01zl_icon-washington3a_sml1.jpgA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.

This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

Controllable Risk Factors – Cholesterol

What is cholesterol?
Cholesterol is a soft, waxy fat (lipid) that is made by the body. It is found in the bloodstream and in all of your body’s cells. The body needs cholesterol to form cell membranes, some hormones and vitamin D.

Cholesterol is also found in some foods, such as eggs, meats and dairy products.

Because cholesterol does not dissolve in the blood on its own, it must be carried to and from cells by particles called lipoproteins. There are two main types of lipoproteins: low-density lipoproteins (LDL) and high-density lipoproteins (HDL).

High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain
High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain

LDL is often called the “bad” cholesterol. It can cause plaque build-up. Plaque is a thick, hard substance that can clog arteries. Recent studies show that high levels of LDL and triglycerides (blood fats) raise the risk of ischemic stroke. Plaque can also increase risk of a transient ischemic attack (TIA) where stroke symptoms go away within 24 hours.

The second main type of cholesterol is high-density lipoprotein (HDL), often called the “good” cholesterol. High levels of HDL may reduce stroke risk.

  • How does cholesterol affect stroke risk?
    High cholesterol or plaque build-up in the arteries can block normal blood flow to the brain and cause a stroke. High cholesterol may also increase the risk of heart disease and atherosclerosis, which are both risk factors for stroke.
  • What increases cholesterol levels?
    Many things can affect cholesterol levels. Some can be changed and some cannot.

Things you can change:

  1. Diet — Foods high in saturated fat and cholesterol can increase cholesterol levels.
  2. Weight — Being overweight can increase your cholesterol levels.
  3. Exercise — People who are not active tend to have higher cholesterol levels.

Things you cannot change:

  1. Family History — If someone in your family has high cholesterol, you are more likely to have high cholesterol.
  2. Age — Most people experience an increase in cholesterol levels until about the age of 65.
  3. Gender — Women under age 50 tend to have lower cholesterol and those in menopause have higher levels.

How often should I be checked for high cholesterol?

  • All adults age 20 and older should have their cholesterol checked at least once every five years.
  • Cholesterol should be checked more frequently in men older than 45 and women older than 55.
  • People with a family history of high cholesterol should be checked more often.
  • People who have high cholesterol should be checked more often.

What can I do to manage my cholesterol?

  1. Eat a healthy diet
  2. Eat low-fat foods especially foods low in saturated fat. This includes vegetables, fruits, lean meats such as chicken and fish, low-fat dairy products and a limited number of egg yolks.
  3. Bake, broil, steam or grill your food (instead of frying).
  4. Add fibre to your diet, including whole grains or dried beans.
  5. Talk to your doctor about any necessary medical treatment that may help control cholesterol levels

A Head of Stroke Dedicated to Reconnection after Stroke

A Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community. We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.

This is a New Zealand Web site. Its content is intended for New Zealand resident use.

This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

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Controllable Risk Factors – Tobacco Use & Smoking

How is smoking linked to stroke?
Smoking doubles the risk for stroke when compared to a non-smoker. It reduces the amount of oxygen in the blood, causing the heart to work harder and allowing blood clots to form more easily. Smoking also increases the amount of build-up in the arteries, which may block the flow of blood to the brain, causing a stroke. The good news is that smoking-induced strokes and overall stroke risk can greatly reduced by quitting smoking.

Smoking doubles the risk for stroke when compared to a non-smoker.
Smoking doubles the risk for stroke when compared to a non-smoker.

Smokers often have concerns about quitting smoking. Following are tips for dealing with those concerns

  • “I’ll gain weight if I quit smoking.”
    Weight gain varies from person to person. The average person gains less than 5 kilos. Exercise and a low-fat diet can help. Eat plenty of fruits and vegetables, whole grain cereals and pasta. Low-sugar candy may also help. Try to get enough sleep. Talk to a doctor about how to quit smoking while maintaining your weight.
  • “What do I do when I get the urge to smoke?”
    When possible, stay away from places where others might be smoking. Ask others not to smoke around you. When you do feel the urge to smoke, distract yourself and stay busy. If you can make it three minutes, the urge probably will go away. You can also ask your doctor about prescription medications or nicotine replacement therapy, including over-the-counter patches and gum.
  • “Smoking relaxes me. I get too nervous and anxious if I don’t smoke.”
    First, try to take it easy. It is best to warn those around you that you have quit smoking. Try going for a walk if you get tense. Exercise can help you relax.
  • “I blew it. What do I do now?”
    Smoking cigarettes again does not mean that you have failed. You have already had some success. You got through a number of minutes, days or months without smoking. Don’t let relapses serve as excuses to start smoking again. You are an ex-smoker and can continue to be one.
  • “I’ve tried to quit smoking before. What makes this time different?”
    You can choose to be a non-smoker and be successful. It is important enough to your health to make another attempt. Set a goal for yourself. Think about why you smoke and different ways to handle those reasons without smoking. Help is out there if you ask for it. Ask your doctor or pharmacist for information about local support groups.

New Zealand is recognised internationally as having a comprehensive tobacco control programme, structured around evidence-based interventions proven to reduce smoking. Smoking, however, remains the single largest preventable cause of death and disease, with approximately 5000 deaths attributable to smoking in New Zealand each year. Reduce your risk now!

Tips to quit smoking:

Set a “Quit Date.” Mark calendars at home and at work.

Tell family, friends and co-workers about the plan to quit. Ask for their support.

Ask a doctor about nicotine replacement therapy or medication that can help control the urges to smoke.

Throw away all cigarettes, ashtrays, lighters and matches before the “Quit Date”.

Reward yourself for doing well. Buy something nice with the money saved on cigarettes.

A Head of StrokeA Head of Stroke” is dedicated to those affected by Stroke re-contributing to their community.We aim to provide impartial educational information on Stroke prevention, awareness, the effects, rehabilitation, reconnection, tips and tricks that can benefit those most affected by Stroke.

This is a New Zealand Web site. Its content is intended for New Zealand resident use.This Web site does not provide medical advice. Information provided on this site is not designed or intended to constitute medical advice or to be used for diagnosis. Due to unique individual needs and medical history, please consult your own personal physician who will be able to determine the appropriateness of the information for your specific situation and they will assist you in making any decisions regarding treatment and/or medication.

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Controllable Risk Factors – High Blood Pressure (Hypertension)

High blood pressure is the most important risk factor for stroke

What is blood pressure? Blood pressure, also called hypertension, is the force of blood pushing against the walls of the arteries.

What is a blood pressure reading? Your blood pressure reading is expressed with two numbers — for example, 120/75. The first number, known as systolic blood pressure, is a measurement of the force your blood exerts on blood vessel walls as your heart pumps. The second number, known as diastolic blood pressure, is a measurement of the force that blood exerts on blood vessel walls when the heart is at rest between beats.

What is high blood pressure? High blood pressure means the heart is pumping harder to move blood through the body. This can weaken blood vessels and damage major organs, such as the brain. Left untreated, high blood pressure can lead to stroke.

High blood pressure
Controllable Risk factors -Blood Pressure can be easy to  monitor and control.

Blood pressure, like a person’s heart rate, will vary occasionally with exercise or stress. For people over age 18, an optimal blood pressure reading is considered 120/75 or lower. A blood pressure reading consistently higher than 120/75 is considered “pre-hypertension.” High blood pressure or “stage one hypertension” is a measurement of 140/90 or higher.

People who have high blood pressure have more than half the lifetime risk of having stroke compared to those who consistently have optimal blood pressure of 120/75. Anyone who has had a previous heart attack, stroke, is diabetic, has kidney disease, high cholesterol or is overweight should speak with a doctor about aggressively controlling and lowering blood pressure. Maintaining a blood pressure reading below 140/90 may reduce the risk of further complications.

Who has high blood pressure? As many as 75% of Adult New Zealanders have high blood pressure. Of the 1 in every 5 adults with high blood pressure, 31.6 percent are not aware they have it.

How is high blood pressure related to stroke?Doctors have long called high blood pressure “the silent killer” because a person can have high blood pressure and never have any symptoms. If left untreated, high blood pressure can lead to life-threatening medical problems such as stroke, heart attack or kidney failure.

High blood pressure is one of the most common causes of stroke because it puts unnecessary stress on blood vessel walls, causing them to thicken and deteriorate, which can eventually lead to a stroke. It can also speed up several common forms of heart disease.

When blood vessel walls thicken with increased blood pressure, cholesterol or other fat-like substances may break off of artery walls and block a brain artery. In other instances, the increased stress can weaken blood vessel walls, leading to a vessel breakage and a brain hemorrhage.

If a person has had a stroke, it is especially important to keep blood pressure controlled to reduce the risk of recurrent stroke.

What causes high blood pressure? In most cases, it’s impossible to pinpoint an exact cause of high blood pressure. There are, however, a number of factors that have been linked to high blood pressure including:

  • A family history of high blood pressure.
  • Age: The incidence of high blood pressure rises in men after age 35 and in women after age 45.
  • Gender: Men are more likely to have high blood pressure than women until age 45. From ages 45 to 64, men and women have similar risk. After that, women are more likely to have high blood pressure.
  • Race: Approximately 41 percent of Maori, Polynesian or Samoan’s have high blood pressure, compared to 28 percent of Caucasians. Nearly half about 44% of Maori women have high blood pressure. Samoan have a slightly higher risk for high blood pressure than Caucasians.

Other factors that can lead to high blood pressure include excess weight, excessive alcohol consumption, diabetes, lack of exercise and a high-salt diet.

How can high blood pressure be treated? In most people, high blood pressure can be controlled through diet, exercise, medication or a combination of all three.

A diet that is low in salt and rich in vegetables, fruits and low-fat dairy products may help lower blood pressure. Recent studies have also shown that increasing potassium intake, (for example, eating fresh fruits and vegetables), may help lower blood pressure.

A program of regular exercise — appropriate to a person’s age and fitness level, and approved by a doctor — may not only aid in weight loss, but also help to lower blood pressure.

Finally, a wide range of medications is available to treat high blood pressure. A doctor may have to try several different drugs before you find one that works best for a person’s needs. This is common problem that doctors are used to handling. It is important to take any medications exactly as prescribed, even when a person feels fine. There are a vast number of prescription antihypertensive drugs on the market from which to choose. In many patients, some antihypertensive drugs may cause side effects such as dizziness or nausea. Doctors can work with patients to select the best antihypertensive for their medical profile and lifestyle. Various antihypertensive drugs work differently some decrease the volume of plasma in the blood or slow the rate of blood flow through the body, while others relax the heart by affecting the passage of certain elements in the blood. Factors to consider in the selection of antihypertensive drugs include cost, convenience, side effects and interaction with other drugs.

Where can I get more information on high blood pressure? Speak with a doctor about how to control high blood pressure. The key to keeping blood pressure within the normal range is for a person to commit to being an active participant in their healthcare with a doctor.

Types of Stroke

This bulletin provides a clear overview of the several different types of stroke, with different causes.

Ischaemic Stroke In everyday life, blood clotting is beneficial. When you are bleeding from a wound, blood clots work to slow and eventually stop the bleeding. In the case of stroke, however, blood clots are dangerous because they can block arteries and cut off blood flow, a process called ischaemia. An ischaemic stroke can occur in two ways: embolic and thrombotic strokes.

Stroke Types

Embolic Stroke In an embolic stroke, a blood clot forms somewhere in the body (usually the heart) and travels through the bloodstream to your brain. Once in your brain, the clot eventually travels to a blood vessel small enough to block its passage. The clot lodges there, blocking the blood vessel and causing a stroke. The medical word for this type of blood clot is embolus.

Thrombotic Stroke In the second type of blood-clot stroke, blood flow is impaired because of a blockage to one or more of the arteries supplying blood to the brain. The process leading to this blockage is known as thrombosis. Strokes caused in this way are called thrombotic strokes. That’s because the medical word for a clot that forms on a blood-vessel deposit is thrombus.

Blood-clot strokes can also happen as the result of unhealthy blood vessels clogged with a buildup of fatty deposits and cholesterol. Your body regards these buildups as multiple, tiny and repeated injuries to the blood vessel wall. So your body reacts to these injuries just as it would if you were bleeding from a wound; it responds by forming clots. Two types of thrombosis can cause stroke: large vessel thrombosis and small vessel disease (or lacunar infarction.)

Large Vessel Thrombosis Thrombotic stroke occurs most often in the large arteries, so large vessel thrombosis is the most common and best understood type of thrombotic stroke. Most large vessel thrombosis is caused by a combination of long-term atherosclerosis followed by rapid blood clot formation. Thrombotic stroke patients are also likely to have coronary artery disease, and heart attack is a frequent cause of death in patients who have suffered this type of brain attack.

Small Vessel Disease/Lacunar Infarction Small vessel disease, or lacunar infarction, occurs when blood flow is blocked to a very small arterial vessel. The term’s origin is from the Latin word lacuna which means hole, and describes the small cavity remaining after the products of deep infarct have been removed by other cells in the body. Little is known about the causes of small vessel disease, but it is closely linked to hypertension (high blood pressure).

Haemorrhagic Stroke Strokes caused by the breakage or “blowout” of a blood vessel in the brain are called haemorrhagic strokes. The medical word for this type of breakage is haemorrhage. Haemorrhages can be caused by a number of disorders which affect the blood vessels, including long-standing high blood pressure and cerebral aneurysms. An aneurysm is a weak or thin spot on a blood vessel wall. These weak spots are usually present at birth. Aneurysms develop over a number of years and usually don’t cause detectable problems until they break. There are two types of haemorrhagic stroke: subarachnoid and intracerebral.

In an intracerebral hemorrhage, bleeding occurs from vessels within the brain itself. Hypertension (high blood pressure) is the primary cause of this type of haemorrhage.

In a subarachnoid haemorrhage, an aneurysm bursts in a large artery on or near the thin, delicate membrane surrounding the brain. Blood spills into the area around the brain, which is filled with a protective fluid, causing the brain to be surrounded by blood-contaminated fluid.

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4 Ways to Train Your Brain for Positivity

Not a natural optimist? Use these simple exercises to train your brain to more easily pick out the positive.

Not a natural optimist? Use these simple exercises to train your brain to more easily pick out the positive.
Not a natural optimist? Use these simple exercises to train your brain to more easily pick out the positive.

You know how when you play Tetris for awhile, even after you stop, you can still see those little falling blocks in your mind’s eye?

The persistence of Tetris isn’t simply an annoying effect of a cleverly designed game, according to scientists. Instead it’s a reflection of something deeply positive about our brains–their plasticity.

That’s a according to a recent post by iDoneThis founder Walter Chen on productivity blog buffer. He cites studies on Tetris (yes, there is such a thing, and yes, this is going somewhere helpful to non-video game addicted entrepreneurs), which found that playing the game for a few hours a week over a period of months, actually changed the brains of players.

“Every time you reactivate a circuit, synaptic efficiency increases, and connections become more durable and easier to reactivate,” Chen writes, before summarising the importance of the findings: “Whenever you do specific tasks over and over again, they take up less of your brain power over time.”

Learning Positivity

That’s probably not a shock to anyone who has learned to play the piano, speak a foreign language or even hit a tennis ball roughly where you want it to go. So what’s the big deal? This same brain plasticity allows you to master simple skills or sports, also allows you to train yourself to be more positive.

Chen quotes Shawn Achor, the author of The Happiness Advantage who has previously spoken about his work on the brain and happiness to Inc. Just like we can train our brains to more easily recognize the patterns of Tetris, “we can retrain the brain to scan for the good things in life—to help us see more possibility, to feel more energy, and to succeed at higher levels,” Achor says, dubbing this ability “the positive Tetris effect.”

Happiness Homework

So how do you do this? Chen offers four very simple interventions that can, over time, actually rewire your brain to see things more positively:
Scan for the 3 daily positives. At the end of each day, make a list of three specific good things that happened that day and reflect on what caused them to happen. The good things could be anything — bumping into an old friend, a positive remark from someone at work, a pretty sunset. Celebrating small wins also has a proven effect of powering motivation and igniting joy. As you record your good things daily, the better you will get and feel.

Give one shout-out to someone (daily). I love this technique. Take the positive things you’re getting better at recognising and let people know you’ve noticed. Take a minute to say thanks or recognise someone for their efforts, from friends and family to people at work. A great way to go about this is by sending 1 daily email to someone. It can be your old school teacher, whose advice you are now appreciating every day. A co-worker or someone you’ve only met. Show courage and say thanks.
•Do something nice. Acts of kindness boost happiness levels. Something as small and simple as making someone smile works. Pausing to do something thoughtful has the power to get you out of that negativity loop. Do something nice that is small and concrete like buying someone a coffee.
Mind your mind. Mindfulness is paying attention to the present moment without judgment. Opening our awareness beyond the narrowness of negativity can help bring back more balance and positivity into the picture.

Looking for more details? Chen’s post has much more on the science and what actually happens physically in your brain. You can also check out Achor’s interview about how happiness affects brain function (hint: it doesn’t make it worse), or get tips on how to reframe situations more positively in the moment from my colleague Geoffrey James. Finally, if you’re looking to add more mindfulness to your day, check out this post on how many entrepreneurs incorporate meditation into their lives.

Do you agree that it’s possible to alter you basic orientation towards the world and become more positive?

I found this great article written a few days ago now by .

Anything that relates to plasticity, brain training or neuroplasticity could be of benefit to those having experienced a stroke. Enjoy!

Stroke Myths

Myth: Stroke is unpreventable

Reality: Stroke is largely preventable

Myth: Stroke cannot be treated

Reality: Stroke requires emergency treatment

Myth: Stroke only strikes the elderly

Reality: Stroke can happen to anyone

Myth: Stroke happens to the heart

Reality: Stroke is a “Brain Attack”

Myth: Stroke recovery only happens for a few months following a stroke

Reality: Stroke recovery continues throughout life

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What is Stroke?

Stroke is the third leading cause of death in New Zealand (about 2000 people every year) and a leading cause of adult disability.Up to 80% of strokes are preventable; you can prevent a stroke! Around 10 percent of stroke deaths occur in people under 65.

What is a stroke?A stroke or “brain attack” occurs when a blood clot blocks an artery (a  blood vessel that carries blood from the heart to the body) or a blood  vessel (a tube through which the blood moves through the body) breaks,  interrupting blood flow to an area of the brain.  When either of these  things happen, brain cells begin to die and brain damage occurs.When brain cells die during a stroke, abilities controlled by that  area of the brain are lost.  These abilities include speech, movement  and memory.  How a stroke patient is affected depends on where the  stroke occurs in the brain and how much the brain is damaged.

What is Stroke?
A cross section Image of the brain
For example, someone who has a small stroke may experience only minor problems such as weakness of an arm or leg.  People who have larger  strokes may be paralysed on one side or lose their ability to speak.   Some people recover completely from strokes, but more than 2/3 of  survivors will have some type of disability.