So many people seem to be having strokes, and I worry because my wife has had several transient ischemic attacks—which they say may predict a stroke. What should we do?
Astroke is where an interruption of the blood supply to the brain results in damage that can be permanent, even lethal.
Most strokes occur in people with hypertension and a family history of stroke. Other types of stroke may involve a thrombosis, or embolism (a clot migrating to the brain). A hemorrhagic stroke occurs when a blood vessel bursts and bleeding into the brain causes damage. A person with symptoms suggesting a stroke should receive immediate medical attention, as the diagnosis may permit emergency measures that can reduce the severity of the stroke.
Prevention, where possible, would be much better.
For Adventists, among whose ranks are found many who disdain medications, we need to recognize that careful studies have shown that the use of antihypertensive medications reduces the risk of stroke by 22 percent. The use of angiotensin-converting enzyme (ACE) inhibitors appears to have an added and independent benefit. We stress this point not because it’s the primary recommendation we wish to make, but because it can be a major sticking point for some and not using physician-prescribed medications can have devastating consequences.
Obviously, the benefits of exercise and a diet low in fat and sodium play an enormous role. Avoidance of tobacco and alcohol lowers the risk of stroke. While medication may lower one’s risk of stroke by 22 percent, an unhealthful lifestyle raises the risk twofold. Those eating five servings of fruits and vegetables daily, exercising regularly, avoiding tobacco, and limiting alcohol had less than half the number of strokes than the control group.
It’s important to have regular medical checkups. One of our family members had atrial fibrillation before the days when anticoagulation was recommended, and she suffered a stroke with a consequent 14 years of paralysis. Prevention is key, but good medical surveillance can detect medical problems that need management. Many strokes can be prevented by astute recognition of the danger signals.
I have high triglyceride levels and my doctor is concerned. What lifestyle measures should I adopt?
First, we would reemphasize the importance of following your doctor’s advice. She or he knows you as an individual; we’re talking to lifestyle in general here in these columns.
Elevated triglycerides may actually reflect an inherited condition and can be modified by specific medications. But in Western society today, the prevalence of high triglycerides can involve a third of the population.
High triglycerides may play a role in several conditions including heart disease, the metabolic syndrome, and pancreatitis.
Triglycerides are a form of fat, and high levels are seen in the obese, the inactive, smokers, heavy alcohol consumers, and persons consuming a high carbohydrate intake. The epidemic consumption of giant-size soda drinks in some world regions such as the United States is likely a significant factor, as this is a serious factor in obesity.
Triglyceride levels should be less than 150 mg./dL. to be normal. Borderline high levels run between 150 and 199, high 200-499, and very high above 500 mg./dL.
Weight control, exercise, and a heart-healthy diet (vegetarian) will prove helpful. Alcohol is harmful to triglyceride levels.
The danger of triglyceride elevation is an increased risk of heart attack and acceleration of arteriosclerotic change in blood vessels. It’s important to know your numbers and keep triglycerides within the normal range.
Allan R. Handysides, M.B., Ch.B., FRCPC, FRCSC, FACOG,