By Constance Sommer, Sept 2022, AARP
Genetics working against you? Certain lifestyle changes may still make a stroke less likely, research finds. Even if genetics put you at risk for a stroke, you can greatly lower your chances of experiencing one by maintaining a few healthy lifestyle choices. That’s the finding of a recent study published in the Journal of the American Heart Association.
People who have maintained good cardiovascular health “could potentially slash that risk [of stroke] by a significant amount,” says Myriam Fornage, an author on the paper and a professor at the Center for Human Genetics at the University of Texas Health Science Center in Houston.
Specifically, the study looked at the effect of following Life’s Simple 7, the American Heart Association’s (AHA) prescription for heart health.
1. Stop smoking
2. Eat better
3. Get active
4. Lose weight
5. Manage blood pressure
6. Control cholesterol
(Note: The AHA recently updated this list, adding sleep as an eighth essential component of heart health.)
The study, published July 20, followed 11,568 people, starting when they were 45 years old (and free of stroke), for about 28 years. Just over half of the participants (56 percent) were women and just under a quarter (23 percent) were Black.
The researchers found that study participants with a genetic risk of stroke who did not follow the Life’s Simple 7 behaviors were most likely to experience a stroke.
But among all genetic risk profiles — low and high — those who followed Life’s Simple 7 had a 30 to 43 percent lower risk of stroke than those who did not adhere to the behaviors. That corresponds to nearly six additional years lived free of stroke.
“This study shows that you could do an amazing amount of risk reduction by living a healthy lifestyle, regardless of your genetic status,” says Cheryl Bushnell, M.D., a neurologist at the Wake Forest University School of Medicine, who was not involved in the study. “That’s really the bottom line.”
Lowering your risk for stroke can have additional health benefits too, research shows. For example, it can help protect your brain, since stroke is one of the strongest known risk factors for dementia, according to a report from AARP’s Global Council on Brain Health.
“When you adopt these healthy cardiovascular behaviors,” Fornage says, “you essentially maintain your brain health and do good for your heart as well.”
Nationwide about 10 percent of the 50-plus population, or 7.6 million people, have suffered a stroke at some point in their lives, Bushnell says, citing statistics from the AHA’s annual Heart Disease and Stroke Statistics report. But the risk, she notes, increases “dramatically” with age: 2.5 percent of adults ages 40 to 59 have suffered a stroke, versus 6 percent of those ages 60 to 79 and 13 percent of those over age 80.
As for how many people are genetically at risk for stroke, “that’s a difficult thing to answer,” Bushnell says, adding that researchers have identified 32 distinct genes associated with stroke.
“The interesting thing, though, is that most of them are linked in some way to other factors, like blood pressure or cholesterol,” she says. In other words, lifestyle plays a role in triggering stroke, even for those with a genetic predisposition.
The damaging effects of stroke
However a stroke occurs, it can have dramatic consequences. “It’s often long-term disability, but it can be death,” Fornage says.
In fact, stroke is the leading cause of long-term disability in the United States, according to the Centers for Disease Control and Prevention. What goes wrong depends on the type of stroke and the part of the brain that’s affected, Bushnell says.
Sometimes stroke attacks vision or leaves a person with tingling or weakness. Some people, after a stroke, have difficulty swallowing, or get a frozen shoulder, or stiffness and spasms in a weak limb. “It’s not something that anybody wants to have to deal with long-term,” she adds.
And that first stroke can cause more complications, because now the person is often moving less, which can lead to infection, heart disease and more blood clots. “Having a stroke is a life-changing event,” Bushnell says.
The severity of the disability caused by the stroke depends on a few factors.
• How bad the stroke was when it hit
• When the stroke first started
• The age of the person when they had the stroke
• Whether a stroke patient received proper treatment and, if so, how quickly
For instance, Bushnell says, a patient could suffer a very severe stroke, causing paralysis on one side of the body. But if they or someone who’s with them catches it early and gets them to the hospital on time, and if the blood clot is in an area where a surgeon can remove it, sometimes “it’s almost miraculous,” she says. “They get the blood flow back, and within a day or two they’re moving their arm and speaking again.”
To Spot Signs of Stroke, Remember B.E.F.A.S.T.
Because time is of the essence, people should know how to spot strokes when they’re happening, Bushnell says. She likes the acronym BE FAST.
B is for balance: Watch out if you’re suddenly struggling with your balance, she says.
E is for eyes: Seeing double, blurred vision or losing sight in one or both eyes without pain could be a sign of stroke, according to Duke University Health.
F is for face: If a person’s face is drooping or numb, that could indicate stroke. Duke’s advice: Ask the person to smile.
A is for arms: Does an arm feel numb? Ask the person to raise an arm and see if it drifts downward, advises Northwestern University Medicine.
S is for speech: Slurred speech, difficulty getting out words or not understanding what others are saying could be signs of stroke, Bushnell says.
T is for time: If someone has these symptoms, it’s time to call 911. Also, note the time it occurred, because that will help emergency medical personnel know what treatment is appropriate for the patient, Bushnell says.
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