A stroke happens when blood supply to the brain is interrupted. It is caused by a blocked or burst blood vessel. Anyone can suffer a stroke, although the risks can be substantially reduced by a healthy lifestyle.
The risk factors are:
° High blood pressure
° Cigarette smoking
° High blood cholesterol
° Being overweight
° High blood sugar
° For women - contraceptive pill
High Blood Pressure
In at least half of all strokes, the reason why blood vessels become damaged in the 1st place is because they are exposed to high blood pressure.
In New Zealand, 36% of strokes are attributed to high blood pressure. Therefore, it makes sense to have your blood pressure checked.
Cigarette Smoking
People who smoke 20 cigarettes/day are about 3 times more likely to have a stroke than those who don't smoke. It is obviously very important not to smoke.
In New Zealand, 37% of strokes are attributed to smoking.
High Blood Cholesterol
There is evidence that high levels of cholesterol play a part in damaging blood vessels, especially those in the brain.
Therefore, it is wise to reduce intake of foods rich in cholesterol, which are mainly those containing animal fats (see 'About Your diet' supplement). It is the reduction in average fat intake that matters.
Being Overweight
Being overweight can cause an increase in blood pressure because the blood vessels become lined with fat called atheroma, which means that the heart has to work harder.
It is worthwhile controlling your weight by watching the intake of fats (e.g. dairy produce, eggs) and carbohydrates (e.g. bread, cakes).
High Blood Sugar
Strokes are more common in people with diabetes, especially women. Therefore, your urine or blood sugar should be checked by a doctor, particularly if you have relatives with diabetes, as this can be passed from one generation to another.
The Contraceptive Pill
There is an increased risk of a stroke in women taking the contraceptive pill, particularly with smokers, those over 35 and when there is a strong family history of arterial disease. In such circumstances it is worth considering some other form of contraception.
Elderly people in particular, should avoid overdenthusiastic treatment of high blood pressure. There is no single cause of a stroke, it occurs when a combination of factors are present. It is up to you to avoid these risks.
REDUCING THE RISK OF A CORONARY
A coronary heart attack, or coronary thrombosis, occurs when the blood supply to the heart muscle is so inadequate that an area of muscle is damaged and functions poorly.
Each year, more and more people (both men and women) are affected by coronary thrombosis. About 25% don't survive the 1st attack. The only solution is to reduce the risks.
Main risks are:
° Cigarette smoking
° High blood pressure
° High blood cholesterol
° Being overweight
° Lack of exercise
° Stress
° Excessive alcohol intake
Cigarette smoking
The more you smoke, the greater the risk. Smoking 20 cigarettes/day more than doubles the chance of having a coronary heart attack. If other factors are present, the risk is greater still.
Cigarette smoking damages the circulation in 2 ways:
° Carbon monoxide in tobacco smoke reduces available oxygen intake into body
° Nicotine in tobacco smoke causes contraction of arteries which reduces blood flow. This is 1 possible cause of development of atheroma in artery walls
If a person stops smoking, the risk gradually lessens.
High Blood Pressure
The higher your blood pressure, the greater the chance of developing coronary heart disease. It makes sense to have your blood pressure checked periodically.
High Blood Cholesterol
A high blood cholesterol level can cause damage to the coronary arteries. By changing the type of fat in your diet, your blood cholesterol level can be reduced (see 'diet' section).
Being Overweight
If you're overweight, the heart has to pump harder to provide oxygen to a larger body mass. The blood vessels become lined with fat (atheroma), and this can cause an increase in blood pressure. Your doctor will be able to prescribe a suitable diet.
Lack Of Exercise
Exercise is vital for good health. If you exercise regularly, your heart becomes more efficient using oxygen and pumps more blood with each beat, so it doesn't have to beat so fast.
Exercise can also be beneficial in coronary heart disease because it may help the growth of new blood vessels to replace the narrowed ones.
Stress
A heart attack may be caused by acute mental stress (e.g. bereavement). This is more likely if other risk factors are present - such as high blood pressure or smoking.
Excessive Alcohol Intake
Alcohol may cause you to put on weight. Large quantities can damage the heart muscle and cause disturbances to the natural rhythm of the heartbeat.
Another is coffee; in a recent study published in the British Medical Journal, it was found that people who drink 9+ cups of coffee/day had a significantly increased risk of death from coronary disease.
Some risks - such as family history - cannot be altered. This makes it even more important to control the risks that you can do something about.
SOME FACTS ABOUT HIGH BLOOD PRESSURE
The heart is a muscular pump, slightly larger than your fist. Each minute it will beat around 70 times, and move nearly a gallon (5 litres) of blood around the body.
The continuous pumping of the heart creates blood pressure, without which, blood could not flow around the body.
Blood pressure can vary substantially. Exercise, excitement, anger, or anxiety will make the heart beat faster and so increase blood pressure. These are temporary variations and it returns to normal afterwards.
The problem for some people is that their blood pressure goes up, but does not fall back to normal again. This is the condition of high blood pressure, or hypertension.
Tendencies to have high blood pressure run in families. So if a relative is affected, it is worth having regular checks. Blood pressure also rises with age. If you are 35+, it is a good idea to have a checkdup every 5yrs.
The trouble with high blood pressure is that you can have it for a long time and not show any symptoms, so checkdups are important.
Causes of high blood pressure include:
° Stress
° Kidney disease
° diet
° Smoking
° Being overweight
° Lack of exercise
These factors may accelerate the formation of fatty deposits (atheroma) which line the walls of blood vessels causing them to be smaller in diameter. Blood pressure may increase because the heart has to pump blood faster through the vessels in order to carry the same amount to the muscles.
When blood is forced through your arteries at an abnormally high pressure, it is more likely to damage the artery walls.
There is a chance of clots forming on the fatty deposits. If the clot stays there it is called a thrombosis.
Sometimes the clot breaks away and is washed along the blood vessel to another place (embolus). A clot can cut off the blood supply to part of the body.
A coronary heart attack occurs when blood supply to the heart is obstructed, whereas a stroke occurs when blood supply to part of the brain is cut off.
Sometimes, it is necessary to take tablets regularly, as prescribed by a doctor, to lower blood pressure. Other factors which help reduce the risk of high blood pressure are:
° Watching your weight
° Limiting alcohol consumption
° Not smoking
° Eating less salt
° Avoiding situations which cause stress or anxiety
° Regular exercise
Remember - it is wise to have your blood pressure checked, especially if you are 35+ or if a relative suffers high blood pressure.
ANGINA
Angina is a pain in the chest. As well as being felt in the chest it can spread to the arm, neck or jaw.
The Cause Of Angina
The heart consists mainly of muscle. The muscle pumps blood around the rest of the body. The blood carries oxygen to provide energy for the body.
Like all muscles, the heart needs a good blood supply to provide energy. The heart gives this by pumping blood to itself through the coronary arteries.
When muscles are starved of oxygen they become painful. The same is true of the heart. If the heart doesn't get enough oxygen it becomes painful. This may be angina.
It often occurs because of narrowing of the coronary arteries, reducing the supply of blood (see 'Heart disease' section).
The Cause of an Attack of Angina
When relaxed and resting, the heart does little work. With exercise, the heart needs to pump harder as it needs more energy from oxygen in the blood. If the arteries are narrowed, the heart may not get enough blood and angina will result.
This is why angina occurs during exercise (e.g. digging the garden, walking up a steep hill, carrying heavy shopping, housework, climbing stairs).
It can also be brought on by emotions, such as excitement, anger or fear. Sometimes, attacks have no obvious cause.
Angina will usually be relieved by resting for a few minutes. Various tablets also ease pain. Occasionally, with severe angina, drug treatments alone are not successful and surgery may be needed.
HEART DISEASE
This is a general term to describe any abnormal condition of the heart and includes:
° disease of coronary arteries
° disease of heart valves and heart muscle
° Poor function of heart due to high blood pressure or lung disease
Coronary artery disease is a major threat to the health of middledaged and elderly people in the Western world. Occasionally, disease of heart valves may follow rheumatic fever.
Heart muscle disease may be due to a variety of causes, including viral infections, alcohol abuse or general medical conditions. Fortunately, treatment is available to cure or improve many of these conditions.
Coronary Artery disease
Coronary artery disease occurs when coronary arteries become narrowed. This is caused by formation of fatty deposits (atheroma), in the lining of blood vessels, so reducing flow of blood.
A blood clot may develop and restrict the flow further (see 'Facts About High Blood Pressure' section).
Two main medical conditions arise:
° Coronary Heart Attack - this occurs when blood supply to heart muscle is so inadequate that an area of muscle is damaged and functions poorly.
despite possible recovery, affected heart tissue may interfere with the heartdrate (see 'Reducing The Risk Of A Coronary' section).
° Angina - If the arteries are narrowed, the heart may not get enough blood and angina will result. This is why angina often occurs during exercise.
