Good News – Bad News

Posted by Steven Reinberg, HealthDay Reporter

While progress is being made in reducing the number of stroke deaths, it seems that more people who experience these brain attacks have significant stroke risk factors, a new study reveals.

The rates of high blood pressure, diabetes, abnormal cholesterol, smoking and drug abuse have all been on the rise in stroke patients over recent years, the study authors said.

The study included over 900,000 people hospitalized for stroke between 2004 and 2014. Each year, prevalence of high blood pressure went up by 1 percent, diabetes rose by 2 percent, high cholesterol went up by 7 percent, smoking increased by 5 percent, and drug abuse jumped 7 percent, the researchers found.

“The risk of dying from a stroke has declined significantly, while at the same time the risk factors are increasing,” said researcher Dr. Ralph Sacco. He’s a professor of neurology at the University of Miami Miller School of Medicine.

“We are not exactly sure why these increases are occurring,” Sacco said.

It’s possible that doctors are getting better at diagnosing risk factors. Or certain lifestyle factors may play a role, Sacco suggested. These include obesity, lack of exercise, poor diet and smoking.

The increase of drug abuse among younger patients is especially concerning, he added.

Although the increases in risk factors were seen in all racial and ethnic groups, increases in high blood pressure among blacks and diabetes among Hispanics stood out, Sacco noted.

He stressed that patients need to know their blood pressure, blood sugar and cholesterol levels. “There are great medications that can be used to treat those conditions,” Sacco said.

“We need to go further in controlling risk factors, like diet and exercise,” he advised.
According to Dr. Salman Azhar, director of stroke at Lenox Hill Hospital in New York City, “The challenge now is to prevent strokes, and if they have had a stroke, trying to prevent a second stroke. This is where the importance of these risk factors comes in.”

The responsibility to reduce risk factors lies with patients, but also with the community, he continued.

“It’s up to communities to provide access to better food and places to exercise. We have a responsibility as a community and a health system,” Azhar said.

The 922,000 people included in the study had been hospitalized for an ischemic stroke, which is caused by a blocked blood vessel in the brain. These are the most common types of stroke.

The number of stroke patients who had one or more risk factors increased from 88 percent in 2004 to 95 percent in 2014, the findings showed.

For hospitalized stroke patients during the 10-year study period, high cholesterol rates more than doubled, from 29 percent to 59 percent, and the rate of diabetes went from 31 percent to 38 percent.

In addition, high blood pressure rates increased from 73 percent to 84 percent, and the prevalence of drug abuse doubled from 1.4 percent to 2.8 percent. Also, kidney failure increased each year by 13 percent, and plaque buildup in the carotid (neck) arteries rose by 6 percent each year, the investigators found.

Dr. David Katz is director of the Yale-Griffin Prevention Research Center in Derby, Conn. He said the improvement in stroke survival “suggests we are relying on advances in treatment while neglecting prevention.”

Katz, who is also president of the American College of Lifestyle Medicine, said, “Treating disease is never as good as preserving health and vitality. This study is a precautionary tale of the questionable and costly choices we seem to be making as a culture.”

The report was published online Oct. 11 in the journal Neurology.

Copyright © 2017 HealthDay. All rights reserved.

Nutrition Tips

Healthy food habits can help you reduce three risk factors for stroke — poor cholesterol levels, high blood pressure and excess weight. Diets high in saturated fat and trans fat can raise blood cholesterol levels. Diets high in sodium can contribute to increased blood pressure, and high-calorie diets can contribute to obesity. A diet with five or more servings of fruits and vegetables per day may reduce the risk of stroke.

The American Heart Association/American Stroke Association offers these recommendations for a healthy diet:

  • Eat a diet rich in vegetables and fruits.
  • Choose whole-grain, high-fiber foods.
  • Eat fish at least twice a week.
  • Limit saturated fat and trans fat. Avoiding partially hydrogenated oils will reduce trans fats.
  • Choose lean meats and poultry, and prepare them without using saturated or trans fats.
  • Select low-fat dairy products.
  • Cut back on drinks and foods with added sugars. The AHA recommends that no more than half of your discretionary calories should come from added sugars. For most American women, the discretionary calorie allowance is no more than 100 calories and no more than 150 calories for men.
  • Choose and prepare foods with little salt (sodium).The AHA recommends consuming less than 1500 mg of sodium a day.
  • If you drink alcohol, do so in moderation. Limit yourself to one drink per day if you’re a non-pregnant woman or two drinks if you’re a man.
  • Read our full dietary guidelines for more information.
  • Get tips for dining out.
  • Prepare healthy recipes at home — try one of our free recipes tonight.
  • Find more nutrition resources including how to read food labels in our nutrition center.

To Get the Nutrition You Need

Some stroke survivors have a loss of appetite. For others, eating may be difficult due to swallowing problems or limited hand or arm movement. In any case, talk to your healthcare team to make sure you’re getting the nutrition you need. To make eating a little easier again, try these steps:

  • Choose healthy foods with stronger flavors, such as broiled fish and citrus fruits. Also, spices add flavor to food and serve as a good substitute for salt.
  • Choose colorful, visually appealing foods, such as salmon, carrots and dark green vegetables.
  • Cut foods into small pieces to make them easier to chew.
  • Pick softer, easier-to-chew foods, such as yogurt, bananas, whole-grain hot cereals and low sodium soups.
  • If you have trouble swallowing, talk to your speech therapist or doctor. This condition can be treated.
  • If weakness in arms or hands is a problem, you might try adaptive eating utensils. Some types of flatware have thicker handles that are easier to hold, and “rocker knives” make it possible to cut food using one hand.

Making Mealtime Easier

When stroke survivors have lost their appetites, caregivers can help by:

  • Sharing meals with the survivor at regular times during the day.
  • Setting a leisurely pace for the meal.
  • Serving foods that the survivor wants.
  • Encouraging healthy snacks or small meals throughout the day.
  • Reducing distractions during meals.
  • Watching for any problems the survivor may have with chewing or swallowing.

Food For Thought
A heart-healthy diet is also good for your brain. Learn why.

Cooking for Health
What you eat and how you prepare it can help reduce your risk of stroke and heart disease. The right diet can help improve your cholesterol levels and blood pressure and can help you feel better and have more energy.

Nourishing Good Eating Habits (PDF)
For many stroke survivors, loss of appetite is a common problem. Even when appetite isn’t affected, other challenges can make getting the proper nutrition seem like a chore. But a healthy diet is an important part of recovery, and it helps reduce the risk of another stroke.

Heart-Healthy Grocery Shopping Made Simple
Create your free, heart-healthy grocery list with our Grocery List Builder.

The Stroke Risk Factors All Women Should Know

Strokes aren’t just an old-person problem—and not recognizing seemingly-innocent symptoms (such as neck pain) may put you in danger!

It was 4 a.m. on morning in November 2014, and Merideth Gilmor, a publicist who represents athletes like Maria Sharapova, was looking forward to finally going to sleep. The day had started early, with her usual eight-mile run. Then she and her husband had gone to her best friend’s wedding, where they spent the night “partying like rock stars,” she says. By the time she got back to her hotel room, she was more than ready to fall into bed and conk out. But as she did just that, she felt something weird. “I’ll never forget it; it felt just like I’d snorted a huge dandelion up my nose. Then my vision went black,” she remembers. “I could hear, but I couldn’t communicate and I couldn’t move.”

Gilmor, then only 38 years old, had just had a massive stroke.

A Growing Problem
Gilmor’s far from alone. “Stroke prevalence in younger women has been on the rise,” says Philip B. Gorelick, M.D., the medical director at the Mercy Health Hauenstein Neuroscience Center in Grand Rapids, MI. Between 1988 to 1994 and 1999 to 2004, stroke prevalence in women aged 35 to 54 tripled; men experienced virtually no change, says Gorelick. While it’s one of the top five medical diagnoses young women don’t expect, overall, about 10 percent of strokes occur in people younger than 50. (Another shocking stat: Stroke kills two times as many women as breast cancer each year.)

“It’s hard to know if the prevalence is increasing, or if we’re just becoming better at recognizing strokes in younger adults,” says Caitlin Loomis, M.D., an assistant professor of neurology at the Yale School of Medicine, and a neurologist at Yale-New Haven Hospital. But Gorelick theorizes that strokes are becoming more common, in part because high blood pressure and high cholesterol levels, two risk factors for stroke, are affecting more women at younger ages. (Did you know there’s a link between insomnia and high blood pressure?)

While awareness of the problem is certainly growing, because strokes are so much more common in older adults, many people—doctors included—fail to recognize symptoms when they occur in younger women. About 13 percent of stroke sufferers are misdiagnosed, according to a recent study in the journal Diagnosis. But the researchers found that women are 33 percent more likely to be misdiagnosed, and people under age 45 are seven times more likely to be given a wrong diagnosis.

And that can be devastating: Every 15 minutes a stroke sufferer goes without getting treatment adds another month of disability to their recovery time, according to research in Stroke.

Luckily, Gilmor’s husband recognized her symptoms—partial paralysis in her face, confusion, slurred speech—as a stroke. “I heard him call 911, and I thought, I should get dressed. But I couldn’t move my limbs,” she says. At the hospital, the doctor’s confirmed what her husband feared: She’d had an ischemic stroke, which account for about 90 percent of all strokes and occur when something, usually a clot, obstructs a vessel supplying blood to the brain. (Hemorrhagic strokes, on the other hand, occur when a blood vessel tears or ruptures.)

Carolyn Roth wasn’t quite so fortunate. In 2010, she was just 28 when she developed her first warning sign: serious pain in her neck after a trip to the gym. She wrote it off as a pulled muscle. She also managed to explain away the diamond-like spots that clouded her vision as she drove home that night and the neck pain that kept her popping Tylenol the entire next day.

Finally, the next morning she was concerned enough to call her father, who took her to the hospital. She went in around 8 a.m., and a few hours later a doctor told her she’d had a stroke. “They knew right away, because my eyes weren’t responding to light,” she says. But she was floored. While she’d felt pain, nausea, confusion, and vision impairment, she hadn’t experienced some of the more “typical” symptoms, such as left-side paralysis. That may be because her stroke was caused by a dissection, or a tear in an artery, usually the result of some sort of trauma like a car accident or violent coughing fit. (Certain symptoms—like these top warning signs—you should never ignore.)

“When it comes to stroke recovery, time is of the essence,” says Loomis. “Certain medications are only useful when delivered within a three to 4.5-hour window, so it’s essential that stroke victims are brought to a hospital as soon as possible and evaluated quickly.”

The Aftermath
Stroke recovery looks different for every patient. “A lot depends on the size of the stroke and the location in the brain,” notes Loomis. And while it’s true that recovery can be a long, slow road, contrary to what many people believe, a stroke isn’t necessarily a sentence for a lifelong disability. That’s especially true for younger patients, who Loomis says tend to do better than older patients when it comes to physical therapy and rehab. (Some health issues also affect men and women differently.)

Both Gilmor and Roth say they were lucky to have flexible jobs that allowed them to get plenty of rest. “Sleep is so important in the beginning, since your brain is trying to fix itself. It takes a long time,” says Roth. After taking a few months off from the gym to recover, she slowly began exercising again. “I’ll do any exercise now—I even ran the New York City marathon in 2013!” she says. (Thining of running? Check out 17 Things to Expect When Running Your First Marathon.)

Gilmor also credits her support system—her doctors, who she calls her “Stroke Squad” (Loomis was one of them), family, clients, coworkers, and friends—with her recovery. “I tried to see humor in everything, which I think helped,” she says. In addition to physical therapy, Gilmor, who still experiences weakness in her left side, slowly started rock climbing with her son as a way to rebuild her strength.

But running was her real end goal. “My son said to me, ‘Mom, I think you’ll be better when you can run again.’ Of course that made me be like, ‘Okay—I gotta run!’” says Gilmor. She’s currently training for the 2015 New York City Marathon, and, in fact, just finished a 14-mile long run.

“It’s not easy, trying to run a marathon,” says Gilmor. “But you just take baby steps. My whole outlook now is this: You’ve got to get past your excuses. You might be scared, but you’ve got to be bigger than the fear.”

What You Can Do Now
There’s nothing you can do to guarantee that you’ll never have a stroke. But these seven strategies can help minimize your risk—and support present-day survivors.

1. Know all the signs: The acronym FAST is a good place to start. It stands for Face drooping, Arm weakness, Speech difficulty, and Time to call 911—which covers the main symptoms of most strokes. “But I would say the more important thing to remember is that if anyone changes suddenly in front of your eyes, get help,” says Dr. Loomis. In addition to FAST symptoms, suddenly developing vision problems, being unable to talk or stand upright, slurred speech, or otherwise just not seeming like one’s normal self can all be signs of a stroke.

2. Be wary of certain meds: Gilmor’s doctors believe her risk for having a stroke was elevated due to the type of birth control she took. “Any hormonal contraception that contains estrogen, including many birth control pills, patches, and vaginal rings, do increase your risk for forming a clot,” says Loomis. Usually, those clots wind up in a vein, not an artery. But if you have other risk factors, like high blood pressure, you may want to talk to your ob-gyn about switching birth control. (One writer shares why she’ll never take the Pill again.)

3. Never ignore neck pain: About 20 percent of ischemic strokes in adults under age 45—including Roth’s—are caused by cervical artery dissection, or a tear in the blood vessels leading to the brain, research in The Open Neurology Journal shows. Car crashes, coughing or vomiting fits, and sudden twisting or jerking motions can all cause these tears. Loomis says that doesn’t mean you should avoid yoga (after all, millions of people twist and jerk their heads around every day and nothing happens), but you should pay close attention to how you feel after doing anything that causes abrupt movements to the neck. If you feel extreme pain or nausea, or notice any vision problems after, get to a doctor stat.

4. Stretch it out: You’ve heard the warnings about making sure to stand up and stretch when you’re flying. Chances are, you’ve also ignored them—especially if you’ve been in a window seat. But flying can encourage blood to pool in your legs, increasing your risk of forming clots that could then move toward your brain, says Loomis. (Gilmor’s doctors think a recent plane ride, combined with her Pill use, is what triggered her stroke.) A good rule of thumb: Get up and stretch or walk the aisles at least once an hour.

5. Keep tabs on these numbers: Make sure to get your blood pressure and cholesterol taken regularly, and if the numbers start creeping up into the “higher than normal” zone, ask your doctor what you can do to get them back down, suggests Gorelick. High blood pressure damages blood vessels, and high cholesterol may increase your chances of developing a clot.

6. Stick to a heart-healthy diet: Loomis recommends the Mediterranean diet, which has been shown to reduce cardiovascular disease. “It’s high in fish, nuts, and vegetables, and low in red meats and fried things,” she says. Get started with these Mediterranean Diet recipes. Eating this kind of clean diet will also help you maintain a healthy weight, which Gorelick and Loomis agree is one of the easiest ways to reduce your risk of stroke.

7. Support survivors: If you haven’t personally been affected by stroke, you probably don’t have to look that far to find someone who has: Every 40 seconds, someone has one, and today there are 6.5 million stroke survivors living in the U.S. And as Loomis says, “A stroke is a life-changing event that can be hard to get through, physically, and emotionally. Having a network of support makes a huge difference.” To help support survivors, the National Stroke Association just launched their Come Back Strong movement. There are tons of ways to get involved: changing your profile picture to the Come Back Strong logo, donating money, or taking part in the Comeback Trail event on September 12—dedicate a local trail to a stroke survivor you know, and walk it in honor of his or her path to recovery on that day.

Diet…or exercise?


When it comes to losing weight, what is more important: diet…or exercise?  It depends on who you ask.  Watch this 5 minute video clip from the Today Show and find out the TRUE answer.

Click on image to get full story.

Screen Shot 2015-06-03 at 11.39.54 AM

I will give you a hint:  Jill is AMAZING; she has me on the correct path!  How does she know so many wise things?

How do you need to care for your heart?

IMG_0547Jill delivered her speech at a Wellness Seminar this week end.

Imagine what life would be like if each person you knew actually followed these directions? These are the items were “hear” all the time but don’t necessarily follow them.

Think about what it would be like NOT worrying about these factors?  Imagine if people quit smoking….or lost weight…or worked out regularly?   Can you picture what life would be like?

It is this easy!  Sure…things are going to just happen. That’s life.  But wouldn’t it make sense to minimize those fears?  Think about it!

If you have over weight friends in your life, people who need to exercise, etc, show them this blog and have them call me to talk about it.  People can change!