Controlling High Blood Pressure
Because outward symptoms of hypertension are rare, it's important to have blood pressure checked regularly. According to the sixth Report of the Joint National Committee on the Detection, Evaluation and Treatment of High Blood Pressure, people should have their blood pressure checked at least every two years (more often if there is a history of high pressure).
Doctors may choose to treat hypertension (blood pressure consistently more than 140/90 in one or more to the following ways:
A low-salt diet
Too much salt may contribute to high blood pressure and make it more difficult to control. Doctors may ask people with blood pressure to stop using table salt and to eat as many fresh foods as possible, since a lot of salt is "hidden" in processed or prepared foods. According to the National Heart, Lung and Blood Institute (NHLBl), if everyone in the United States ate 1 fewer teaspoon of salt each day, their collective blood pressures would drop enough to decrease the national stroke rate by 11 percent .
In addition to a low-salt diet, doctors may choose to lower blood pressure by having patients lose weight, stop smoking and exercise regularly. These life style modifications are often all that is needed to successfully control hypertension. For some patients, lifestyle modification will not adequately lower blood pressure, so their physicians might prescribe high blood pressure medication.
Controlling Heart Disease
Coronary Heart Disease and High Cholesterol
A doctor may choose to treat high cholesterol (more than 200 mg/dL) or prevent coronary heart disease by reducing cholesterol with one or more of the following methods:
According to the National Heart, Lung and Blood Institute (NHLBI), a diet with 30 percent or fewer total calories from fat and low in saturated fat is important for lowering cholesterol levels. This type of diet will likely include vegetables, lean meats such as chicken, fish, low-fat dairy products and a limited number of egg yolks. Adding fiber, such as whole grain bread, cereal products, raw unpeeled fruits and vegetables and dried beans, to the diet may also help reduce cholesterol levels by 6 to 19 percent. In addition to diet, doctors may encourage a change in cooking habits, with an emphasis on baking, broiling, steaming and grilling rather than frying.
According to the NHLBI, active people tend to have lower cholesterol levels. Regular exercise also seems to slow down or stop the clogging of blood vessels by fatty plaque deposits. Doctors may recommend a program of regular exercise to lower cholesterol. Aerobic exercise is best for lowering cholesterol because it strengthens the heart and lungs by maintaining an accelerated heart rate for an extended period of time. Walking, swimming and cycling are examples of aerobic exercise. For best results, exercise at an aerobic level at least three times a week for 20 to 30 minutes each time.
Atrial fibrillation is a very important controllable stroke risk factor. Some people with AF will experience heart palpitations --- often described as a "pounding,""racing" or "fluttering" heart beat. In other people, the only symptom of AF may be dizziness, faintness or light-headedness. Some may experience chest pains ranging from mild discomfort to severe pain. Others may experience no symptoms at all.
Self-test for irregular pulse
A recent nation wide study showed that 76 percent of the study participants could easily and quickly screen themselves to determine if they have an irregular pulse, a telltale sign of AF. In the study, trained instructors taught participants how to find their own pulse and then identify the difference between a regular heartbeat and an irregular one.
The National Stroke Association states that this new, simple self-screening technique can be conducted on anyone to determine an irregular pulse. To properly self-screen for an irregular pulse, place the first two fingers of the right hand on the left wrist, then take the pulse to feel for a regular or irregular heartbeat. A regular heartbeat is characterized by a series of even, continuous beats, whereas an irregular heartbeat often feels like an extra or missed heartbeat. Keeping time by tapping the foot, may be helpful.
This self-screening technique must be performed properly in order to obtain correct results and should not be considered a substitute for consulting with a physician. If you are having difficulty locating your pulse or performing the screening technique, you may want to discuss your concerns with a physician.
AF, like high blood pressure or high cholesterol, often has no outward symptoms. The only way to completely confirm its presence is to perform an electrocardiogram (ECG)
During an ECG, sensitive electrodes are placed on the chest. These electrodes pick up the electrical impulses generated by the body that cause the heart to beat. The impulses are sent to a T.V. screen or a piece of paper called an ECG strip. By examining the specific pattern of electrical impulses, a doctor can determine whether a patient has AF. Doctors may choose to treat this form of heart disease by prescribing medication or by an electrical shock to the chest to return the beating back to normal.
Once someone stops smoking, stroke risk drops significantly within two years. Within five years of quitting, the stroke risk may be the same as someone who's never smoked. Doctors can share information about quitting and prescribe medicine to help. It's especially advisable for women over 40 who smoke and also take high-estrogen birth-control pills to quit smoking. This combination of factors makes a woman 22 times more likely to have a stroke than the average person. However, most physicians no longer prescribe high-estrogen birth control pills to smokers.
Monitoring Alcohol Consumption
For most people, moderate drinking may help lower stroke risk. " Moderate" drinking means limiting intake of alcohol to no more than two drinks per day (one drink = 1.5 oz. of hard liquor; OR 4 oz. of wine; OR 12 oz. of beer). If you don't drink, don't start.
Doctors can recommend a sensible weight-loss and exercise program for people who are at increased stroke risk because they are over weight. With their doctors, over weight patients should set reasonable weight-loss and exercise goals. A common goal is to aim for losing one pound a week and exercising three times a week for 30 minutes at a time. Losing excess weight can also help control other stroke risk factors, such as high blood pressure, high cholesterol, heart disease and/or diabetes.
Risk Reduction through Medical Management
Your physician can talk with you about risk reduction through medical management. Medical management may include:
- Antihypertensive medications
- Cholesterol reducing medications
- Clot preventing medications
- Antiplatelet drugs
- Medical management may also include surgical interventions such as:
- Carotid endarterectomy
Team Effort Enhances Therapy
|Read how Charlie Sears' determination helped him recover from a stroke|