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giatroi Prevention

Guidelines for prevention

    Please note the information provided is intended to support patients and is not a substitute for medical advice and treatment. We strongly recommend consultation with your doctor or health care professional, before using any information obtained from articles of this website.
    Find out what your blood pressure is
    Have your blood pressure checked at least once a year. If it is higher than normal, work with your doctor to keep it under control. Elevated blood pressure, or arterial hypertension, is a risk factor for stroke and other cardiovascular events. You can have your blood pressure checked at a medical office, at a pharmacy or at home with an automatic machine, called manometer.

    If your systolic blood pressure (the higher number) is persistently over 120 mmHg or your diastolic pressure (the lower number) is persistently over 80 mmHg, talk to your doctor.

    If your doctor believes you have hypertension, he/she may recommend certain changes in your lifestyle (diet, exercise) or medication. Medications for hypertension have been improved over the years. Once you and your doctor find the right medicine or combination of medicines for you, you will not have undesirable side effects and your activities will not be restricted.

    Find out if you have atrial fibrillation
    Atrial fibrillation (AF) is an irregular heartbeat, which changes the function of your heart and allows pooling of blood in the chambers of your heart. This blood which is not moving tends to clot. Your heartbeats may move this clot into the bloodstream and cause:

    • an ischaemic stroke (AF is associated with a 5-fold increase of the risk for such a stoke)
    • a problem in the circulation of the bowel
    • a problem in the circulation of an upper or power limb

    The doctor can often diagnose AF by examining your pulse. This will usually be confirmed or ruled out by suitable electrocardiography (recording of the electrical activity of your heart, commonly performed at a medical office of certain specialists).

    If you are found to have AF, your doctor may prescribe suitable medication to “thin” the blood in order that the risk for clot formation and embolization through the bloodstream is reduced. Commonly used medications in atrial fibrillation are anticoagulants (Sintrom and Panwarfin) or antiplatelets (Aspirin and Clopidogrel), while today novel oral anticoagulants (NOACs) have been introduced in clinical practice; such NOACs are the direct thrombin inhibitors (eg Pradaxa) and the direct inhibitors of activated factor X (eg Xarelto, Eliquis).

    If you smoke, quit

    Smoking increases significantly the risk for stroke, heart attack and leg amputation.

    Be cautious of passive smoking, which is harmful too.

    If you quit smoking today, the risk will immediately begin to drop.

    If you drink alcohol, do so in moderation
    There are studies showing that drinking up to two units of alcoholic drinks per day can reduce the risk for stroke or other vascular events by about half. More alcohol than this may increase that risk and also cause liver disease, accidents etc.

    If you drink, physicians recommend no more than two drinks a day, but, if you don’t drink, don’t start!

    Keep in mind that alcohol is a drug and may interact with other drugs. You need to know whether any of the drugs you are on could interact with alcohol.

    Find out if you have high cholesterol
    Learn what your cholesterol levels are. Cholesterol is a soft waxy lipid, or fat, which circulates in the blood and there is in all cells of the body. If your total cholesterol is over 200mg/dL or if your LDL cholesterol is over 130mg/dL , talk to your doctor. You may be at increased risk for stroke or other vascular events.

    LDL, or “bad”, cholesterol is the type of cholesterol that builds up in the wall of the arteries and forms the atheromatous plaque which may narrow the lumen of an artery and reduce or stop the blood flow in it. Having a high LDL cholesterol may be inherited or may be the result of your body’s chemistry. It may also be the result of a diet rich in saturated fats, lack of exercise or diabetes mellitus.

    HDL, or “good”, cholesterol sweeps blood and removes the plaque.

    Lowering your “bad” and increasing your “good” cholesterol may reduce your risk for vascular events (like stroke, heart attack, bad circulation in the legs).

    High bad clolesterol can be controlled in many people by healthy diet and exercise. Other people, however, will need cholesterol-lowering medications.

    If you have diabetes mellitus…
    Follow your doctor’s instructions carefully to control your diabetes mellitus.

    Diabetes can often be controlled through careful attention to what, when and how much you eat. Work with your doctor and your dietician to develop a healthy eating programme which suits your lifestyle. Your doctor can recommend lifestyle changes and prescribe medicines for diabetes control.

    The fact that you have diabetes increases the risk for stroke and other vascular events, however, controlling it may lower that risk. Special attention to the care of your feet is necessary, too.

    Increase exercise
    Include aerobic exercise in your daily activities. Brisk walking for 30 minutes a day may help your health in many ways, and reduce the risk for stroke or other vascular events. Try to walk with a friend, as this may help you make it a habit.

    If you are not keen on walking, try another type of physical activity which you may enjoy, such as cycling, swimming, jogging, dancing, tennis, golf or aerobic exercise.

    Put some time aside for yourself every day, so that you can exercise!

    Enjoy a diet low in salt and animal fat
    By reducing salt and animal fat in your diet, you may manage to reduce your blood pressure, and, most importantly, reduce the risk for stroke and other cardiovascular events.

    Try to have a balanced diet each day with plenty of fruits, vegetables, grains and a moderate amount of protein (meat, fish, eggs, milk, nuts, beans).

    Adding fibers (such as whole grain bread and cereal products, raw, unpeeled fruits and vegetables and dried beans) to the diet, can reduce cholesterol levels by 6-19%.

    Find out if you have circulation problems
    Fatty deposits (deposits of cholesterol and other materials in the wall of the arteries) may cause atherosclerosis, or hardening of the arteries, and narrow or completely block the arteries which carry oxygenated blood from the heart to the various parts of the body. Most commonly affected are the arteries to the heart itself, the brain and the legs, causing a heart attack, stroke or leg ischaemia, respectively.

    With regard to strokes, these may be caused by blockage in the arteries on each side of the neck, namely carotid and vertebral arteries. If carotid artery disease is left without treatment it can cause a stroke. Your doctor can organize a test to see if there is a problem with the circulation to your brain. Imaging of the arteries in the neck is usually performed with duplex ultrasonography or angiography (digital, MRA or CTA).

    To find out if you have heart artery disease, or coronary artery disease, your doctor may organize certain special tests.

    Circulation problems are usually treated with medications. If your doctor prescribes a medication like Aspirin, Iscover, Plavix, Sintrom, Panwarfin etc, do take it exactly as prescribed. Occasionally, an operation is required to correct the problem caused by a blocked artery.

    Symptoms of a stroke
    If you have symptoms of stroke, seek medical advice immediately.

    Symptoms of a stroke may be:

    • Sudden numbness or weakness of the face or a limb of one side of the body
    • Sudden trouble speaking or understanding
    • Sudden confusion
    • Sudden trouble seeing
    • Sudden loss of balance or coordination, dizziness
    • Sudden severe headache with no known cause

    If you have experienced any of these symptoms, you may have had a minor stroke or transient ischaemic attack (TIA). Talk to your doctor.

    If you think that someone is having a stroke, act fast (“F-A-S-T”) and do this simple test, as recommended by the National Stroke Association:

    Face – Ask the person to smile: Does one side of the face droop?

    Arms – Ask the person to raise both arms: Does one arm drift downward?

    Speech – Ask the person to repeat a simple sentence: Are the words slurred? Can he/she repeat the sentence correctly?

    Time – If the person shows any of these symptoms, time is important: Call 166 (if in Greece) or get to the hospital fast. Brain cells are dying!

     Last modified 12/12/2015