By: Sandra Gordon
Each year, 55,000 fewer men experience a stroke than women.
The “brain attack” occurs when a blood vessel that carries oxygen and glucose to the brain gets blocked by a clot or bursts, which impedes blood flow to the brain. Still, stroke is far from a woman’s disease.
“Stroke is more prevalent in women because they tend to live longer and stroke occurs more often at older ages,” says Dr. Rohan Arora, a vascular neurologist at North Shore University Hospital in Manhasset, New York.
The risk of stroke doubles for every decade after age 55.
“But men have a higher risk for stroke,” Dr. Arora says. In fact, a major study in Stroke that reviewed 98 studies involving stroke and gender found that men had a 33 percent higher risk of stroke than women, with a mean age of the first-ever stroke at around age 68 (for women it was 72.9).
During a stroke, 1.9 million brain cells die every minute, which can lead to disability or even death.
The good news? According to the American Heart Association, 80 percent of strokes are preventable. Are you doing all you can to stay healthy, especially as you get older? These six tips can help stop a stroke before it stops you.
1. Know your numbers
To lower your stroke risk, check in with your doctor to learn where you stand in terms of blood pressure, total cholesterol, body mass index (BMI), waist circumference, and A1c, an average of your blood glucose level over three months, and see how your numbers stack up to what’s considered optimal.
According to the American Heart Association, optimal blood pressure for people with diabetes is less than 140/90, while optimal total cholesterol is 180.
Your BMI should be 18.6 to 24.9 and your waist circumference should be less than 40 inches.
Your A1c should also be less than 6 percent if you have prediabetes.
If you have already been diagnosed with diabetes, your A1c should be less than 7 percent, with a pre-meal glucose reading of 70 to 130 mg/dl and post-meal peak glucose reading of less than 180 mg.
“Men are at more risk for stroke because they don’t adequately control their risk factors,” Dr. Arora says. “If your numbers aren’t where they should be, ask your doctor what you can do to improve them.”
2. Log your fingersticks
Your health numbers are just a snapshot in time of where you’re at physiologically. To help your doctor get a better idea of what’s going on in real time, track them at home.
In addition to having your A1c taken every two to three months, for example, “Keep a diary of your daily fingersticks for several weeks, including the day and time, and show them to your doctor,” says Dr. Carolyn Brockington, director of the Stroke Center at Mount Sinai St. Luke’s and Mount Sinai Roosevelt Hospital in New York City.
Your fingerstick data can help your doctor spot trends and recommend changes to fine-tune your diet and your glucose control, if necessary.
The extra homework is worth it.
“Elevated blood sugar over time causes crevices to form on the inside of your arteries that platelets and other particles in the blood can stick to,” Dr. Brockington says.
Even if your blood sugar hasn’t been on target for a while, getting it under better control can prevent clot-forming vascular conditions from progressing.
3. Monitor your blood pressure.
High blood pressure (greater than 140/90) is a major risk factor for stroke.
More than two-thirds of people over age 65 have high blood pressure.
If your blood pressure is higher than it should be in the doctor’s office, you may be a candidate for blood-pressure-lowering medication.
To be sure, “Take your blood pressure with a home monitor at the same time every day and keep a written record for several weeks,” Dr. Brockington says.
If there’s a lot of fluctuation, your doctor might ask you to wear an ambulatory blood pressure monitor for 24 hours—a blood pressure cuff on your arm that’s attached to a small belt.
The monitor’s readings can help your doctor see when your blood pressure rises and falls.
“Everyone’s blood pressure has its own pattern,” Dr. Brockington says.
By tracking your blood pressure at home or with a wearable monitor over an entire day, your doctor can prescribe medication, if necessary, that works when you need it most, to maximize its effectiveness.
4. Quit it!
If you’re among the 20.9 percent of men who still smoke in the U.S., make it your mission to kick the habit.
Smoking doubles the risk of stroke because it increases blood pressure, stiffens arteries, and contributes to plaque build-up.
People with diabetes are four times more likely to develop heart disease or stroke than adults without diabetes, according to the American Heart Association.
Adding smoking to the mix is a set up for disaster. To increase your chances of success, don’t go it alone.
Talk with your doctor and meet with a smoking cessation counselor or call 1-800-QUIT-NOW.
This free telephone support service can help you develop a personalized quit plan.
Use medication therapy too, such as nicotine replacement, bupropion (Zyban), or varenicline (Chantix).
5. Push yourself
Exercise reduces your risk of stroke by lowering blood pressure, improving glucose control and making your blood less likely to clot.
“It also increases your body’s sensitivity to diabetes and blood pressure medications,” Dr. Arora says. If you’re on medication, working out regularly may help you get by on a lower dose. The latest American Stroke Association guidelines for preventing stroke recommend 40 minutes of aerobic activity three to four days per week.
Frequency and intensity are key. A recent Stroke study found that men who exercised four or more times per week – hard enough to break a sweat – were significantly less likely to have a stroke than those who didn’t.
6. Watch your sodium intake
Sodium can increase blood pressure by causing your body to retain fluid.
The American Heart Association recommends consuming less than 1500 mg of sodium daily, which is the amount of sodium in less than ¾ teaspoon salt.
Most Americans, however, consume 3,500 mg, which doesn’t include salt added at the table.
To help manage your blood pressure even if you’re on high blood pressure medication, try to cook from scratch as often as possible.
“If you’re eating out of a box, bag, can, bottle, or off a menu, you’re eating too much sodium,” says Dr. Janet Brill, RDN, a spokesperson for the American Heart Association and author of Blood Pressure Down.
Focus on consuming plenty of plant foods, such as fruit, vegetables, beans and legumes as well as lean protein, such as fish.
Look for ways to flavor your home cooking without salt. “I often use lemon juice, herbs, and garlic,” Brill says.
1 – American Heart Association. Women and Stroke. http://www.strokeassociation.org/STROKEORG/AboutStroke/UnderstandingRisk/Women-Have-a-Higher-Risk-of-Stroke—Text-Version_UCM_460399_Article.jsp.
2 – What is a stroke? American Stroke Association. http://www.stroke.org/understand-stroke/what-stroke.
3 – Interview: Rohan Arora, M.D., vascular neurologist, North Shore University Hospital, Manhasset, New York.
4 – Uncontrollable risk factors. American Stroke Association. http://www.stroke.org/understand-stroke/preventing-stroke/uncontrollable-risk-factors
5- Appelros, P, et al. Sex Differences in Stroke Epidemiology. Stroke. 2009; 40: 1082-1090.
6- Signs and Symptoms of Stroke. American Stroke Association. http://www.stroke.org/understand-stroke/recognizing-stroke/signs-and-symptoms-stroke
7 – Stroke Facts. American Stroke Association. http://www.stroke.org/understand-stroke/what-stroke/stroke-facts
8 – Know Your Health Numbers. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Diabetes/PreventionTreatmentofDiabetes/Know-Your-Health-Numbers_UCM_313882_Article.jsp
9 – Interview: Carolyn Brockington, M.D., director of the Stroke Centre at Mount Sinai St. Luke’s and Mount Sinai Roosevelt Hospital, New York, New York.
10 – Guidelines for the Primary Prevention of Stroke. American Stroke Association. http://stroke.ahajournals.org/content/early/2014/10/28/STR.0000000000000046
11 – Men’s Health. Centers for Disease Control and Prevention. http://www.cdc.gov/nchs/fastats/mens-health.htm
12 – Cardiovascular Disease & Diabetes. American Heart Association. http://www.heart.org/HEARTORG/Conditions/Diabetes/WhyDiabetesMatters/Cardiovascular-Disease-Diabetes_UCM_313865_Article.jsp
13 – Quit Tips. Centers for Disease Control and Prevention. http://www.cdc.gov/tobacco/quit_smoking/how_to_quit/quit_tips/index.htm
14 – McDonnell, M. et al. Physical Activity Frequency and Risk of Incident Stroke in a National US Study of Blacks and Whites. Stroke. 2013; 44: 2519-2524. http://stroke.ahajournals.org/content/44/9/2519.full.pdf+html
15 – Shake the Salt Habit. American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Shaking-the-Salt-Habit_UCM_303241_Article.jsp
16 – Sodium and Food Sources. Centers for Disease Control and Prevention. http://www.cdc.gov/salt/food.htm
17 – Interview: Janet Brill, PhD, RDN, spokesperson for the American Heart Association.
Updated by dLife Editors 11/18.