Cleveland Clinic Expert Shares Six Simple Steps to Prevent Vast Majority of Strokes
December 5, 2023 – According to the World Stroke Organization (WSO), stroke is the leading cause of disability worldwide. The WSO says one in four people will have a stroke in their lifetimes, and each year over 12 million people worldwide have strokes. However, it adds that 90% of strokes are preventable by addressing a small number of risk factors that are responsible for most strokes. In The Bahamas, on average 224 people (or 9.56%) die annually from strokes.
Here, Andrew Russman, DO, Medical Director of Cleveland Clinic’s Comprehensive Stroke Center and a vascular neurology specialist, offers advice on how to reduce stroke risk by better managing existing health conditions and also through implementing lifestyle changes. “These tips are interrelated as most of the lifestyle changes mentioned also play a role in improving management of hypertension, high cholesterol and diabetes, which all increase stroke risk,” Dr. Russman points out.
- Reduce hypertension
Uncontrolled hypertension – that is, blood pressure that is consistently above 130/80 – is the single most important modifiable risk factor in stroke worldwide, says Dr. Russman.
Aside from medication, an important step in reducing blood pressure is to reduce salt intake, which Dr. Russman says is good advice even if you don’t have high blood pressure. “We recommend consuming no more than 2g of salt per day. I advise my patients to check food labels and nutritional websites for sodium levels as their intake is usually far higher than they realize,” he adds.
- Be wary of diabetes
It is important to be tested for diabetes, and if diagnosed, to manage the condition wells, says Dr. Russman. He explains that diabetes causes narrowing of small, medium and large blood vessels in the body, including vessels of the eyes, kidney, heart and brain. Owing to this, diabetes can contribute to a variety of vascular, cardiovascular and cerebrovascular problems including stroke. In addition, for patients who have survived a stroke, the risk of having a second is three times higher in those patients whose diabetes is not controlled.
Dr. Russman says that as part of their treatment plan, people with diabetes should have their condition monitored through HbA1C tests, which provide a three-month snapshot of their blood sugar control. “We recommend that these individuals aim for an HbA1C result of 7.0 or less. Taking prescribed medication correctly, watching their diet, exercising regularly, and following their healthcare provider’s recommendations will help them achieve this.”
- Address atrial fibrillation
The WSO says atrial fibrillation is associated with one in four strokes, and Dr. Russman says these strokes tend to be more severe and disabling than strokes associated with other risk factors.
“Atrial fibrillation is a heart rhythm condition characterized by very rapid heartbeats that don’t allow the top left chamber of the heart – the left atrium – to contract normally. Instead, it fibrillates and flutters so blood is not ejected normally from the chamber,” he says. “Anytime blood is stagnant for too long, it can form a blood clot that can travel elsewhere in the body. This clot could cause a stroke by blocking a blood vessel in the brain, depriving that part of the brain of the oxygen and nutrients it needs.”
Dr. Russman says atrial fibrillation is the most common acquired heart rhythm disorder in older adults, and its associated risk is strongly related to age. “The older you are, the more at risk you are of acquiring the condition, but also the higher the risk of stroke associated with the condition,” he says. “It is estimated that up to half of all patients with a heart rhythm condition are not aware of it. However, once diagnosed, atrial fibrillation can be treated with a blood-thinning medication. These do carry some risks, but the benefits far outweigh these in the vast majority of patients.”
- Manage cholesterol levels
In addition to reducing high levels of low-density lipoprotein (LDL) or ‘bad’ cholesterol through diet, for example, by avoiding saturated fat, individuals might be prescribed statin medications that reduce future risk of heart attacks and strokes. Dr. Russman says these medications, particularly rosuvastatin and atorvastatin, may benefit patients beyond simply reducing cholesterol levels in that they also appear to reduce inflammation and stabilize plaque build-up in blood vessels.
- Stop smoking
“Any type of smoking is associated with increased risk of cardiovascular disease and stroke, and is strongly associated with accelerated hardening of the arteries and narrowing of blood vessels in the brain, heart and elsewhere,” says Dr. Russman. “We therefore strongly recommend everyone completely stop any form of nicotine ingestion to significantly reduce their long-term risk for a multitude of diseases.”
- Adopt a healthy lifestyle
Dr. Russman recommends following an eating plan that is low in saturated fats and sodium, and to avoid alcohol and excessive caffeine consumption. Regular physical activity is also important as it can reduce the risk of stroke directly, but also indirectly as it helps to lower high blood pressure and blood sugar levels. Exercise can also help to reduce stress, as can other activities such as meditation or deep breathing, which is important as stress causes the body to release chemicals that can increase blood pressure, affect hormones and raise blood sugar levels, says Dr. Russman.
Irish Humanitarian Organization in Haiti – Address Hunger Crisis and More
#Haiti#Crisis#ConcernWorldwide, February 2oth, 2024 – Seeing that Haiti’s humanitarian crisis worsens day by day with too many Haitians, hundreds of thousands, edging the line to severe deprivation of food, Ireland’s largest aid and humanitarian agency Concern Worldwide is addressing major food insecurity.
The organization in a release said “ “We are providing food assistance, via electronic vouchers to help families purchase food from local vendors so that they can feed their families and prevent malnutrition in children as the situation worsens.”
They are also working to provide Haitians with clean water and sanitation as the waterborne disease Cholera continues to threaten lives, killing more than 1,150 people in 2023.
And, they provide referrals for cases of sexual and gender based violence in Port au Prince.
Concern is supported by funding from USAID, receiving €2.1 million (euros) to help over 30 thousand people in the hunger crisis as well as €1 million (euros) yearly from the Irish Government for its work in Haiti.
How to protect against HIV
#TurksandCaicos, February 15, 2024 – HIV/AIDS has killed more than 40 million people globally since it first appeared in the human population in 1959 according to the World Health Organization WHO and even though there are effective treatments there is no cure making prevention practices a top priority for vulnerable groups.
In recent months claims have emerged of rising cases locally creating concern in some Turks and Caicos residents. The Ministry of Health has remained silent on the issue and has not published relevant statistics despite repeated queries from Magnetic Media.
Given the continued presence of the virus, individuals are still at risk from infection. In fact the WHO says in 2022, when 630,000 people died from HIV-related causes and 1.3 million people acquired HIV.
Human immunodeficiency virus (HIV) is the virus behind AIDS, the most advanced form of HIV.
The virus spreads through the body fluids of an infected person, including blood, breast milk, semen and vaginal fluids. It is not spread by kisses, hugs or sharing food.
With this in mind there are several steps that residents can take to protect themselves including
- Using condoms during sex
- Limiting sexual partners
- Being tested regularly
- avoiding sharing needles, syringes and other injecting equipment
- Using personal protective gear when dealing with bodily fluids
Vulnerable populations can be administered Pre Exposure Prophylaxis which work to prevent infection and Post Exposure Prophylaxis which can prevent the virus from taking hold.
An HIV diagnosis is not a death sentence. In 2024 HIV can be treated and prevented with antiretroviral therapy (ART). These drugs strengthen the immune system which HIV weakens significantly.
Still the WHO encourages residents to take preventative action.
CARPHA: Take Action to Avoid the Harmful Effects of Saharan Dust
February 16, 2024 – The Caribbean Public Health Agency (CARPHA) is urging persons to protect themselves against adverse health effects of a Saharan dust plume, which has covered many parts of the Caribbean.
The Caribbean Institute for Meteorology and Hydrology (CIMH) in a Dust Bulletin dated February 9th, 2024 stated, “it is highly likely that particulate matter levels will be above the 24-hour outdoor air quality guidelines” as established by the World Health Organization (WHO).
Dr Joy St John, Executive Director, CARPHA, explained “Saharan dust worsens air quality and increases the levels of particulate matter in the air. This can be hazardous, especially to small children, older adults and people with underlying lung conditions and chronic cardiopulmonary diseases”. Dr St John added, “Saharan dust can also worsen the health symptoms of those who suffer from asthma, allergies and chronic obstructive pulmonary disease (COPD)”.
In light of the poor air quality levels, CARPHA is encouraging persons to take steps to avoid the harmful effects of Saharan dust. These include:
- Stay indoors as much as possible and when outdoors, wear a dust mask (eg. KN95)
- Utilise a HEPA filter indoors to purify air in individual rooms
- Persons who use medications for pulmonary conditions should carry them at all times and use as prescribed
- At the first sign of difficulty while breathing, seek professional medical advice immediately
- For less severe symptoms, standard allergy medications such as antihistamines and steroid nasal sprays may alleviate symptoms
For more information, please see excerpts from the attached CIMH Dust Bulletin.
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