By Megan Sessums, Pharmacist Resident, BHMC-Little Rock
Did you know that heart disease and stroke are the No. 1 and No. 3 causes of death in Arkansas, respectively? In fact, the stroke death rate in Arkansas is the highest in the United States.
In an effort to increase awareness of stroke warning signs, the American Heart Association and the American Stroke Association has deemed May as American Stroke Month. The following information is an overview of the threat of stroke and how to prevent and treat it.
What is a stroke?
A stroke occurs when a vessel in the brain ruptures (hemorrhagic stroke) or is blocked by a blood clot (ischemic stroke). Ischemic strokes account for about 87 percent of all strokes and occurs when a blood vessel carrying blood to the brain is blocked by a blood clot. This causes blood to not reach the brain and ultimately tissue death. High blood pressure is the most important risk factor for this type of stroke.
You may have also heard the term mini-stroke. This is known as a transient ischemic attack (TIA) and happens when blood flow to the brain is stopped for a short period of time. Symptoms of a TIA can mimic stroke symptoms but usually disappear within 24 hours. While TIAs usually cause no permanent damage, they should not be ignored as they may be warning signs for a future stroke.
What are the warning signs?
By learning the warning signs, you can help save a life. An easy way to remember the sudden signs of stroke is through the acronym F.A.S.T.
F –– Facial drooping
Ask the person to smile. Does one side of the face droop?
A –– Arm weakness
Ask the person to raise both arms. Does one arm drift downward?
S –– Speech difficulty
Ask the person to repeat a simple phrase. Is their speech slurred?
T –– Time
If you observe any of the above signs, call 911 immediately!
For each minute a stroke goes untreated, you or your loved one will lose about 1.9 million brain cells. This can lead to impaired memory, speech, and even movement.
It is important to recognize common stroke symptoms in order to act FAST. These symptoms include sudden numbness of the face, arms, or legs; sudden confusion or trouble speaking; sudden trouble seeing; sudden dizziness or trouble walking; or sudden severe headache with no known cause.
What are risk factors for stroke?
Certain risk factors such as high blood pressure, smoking, high cholesterol, atrial fibrillation (a. fib), and physical inactivity can increase your chances of having a stroke. Advanced age, family history of stroke, and gender can also put individuals at risk for stroke, but these risks can’t be controlled. For each decade after age 55, the chance of stroke approximately doubles. Women also experience more strokes than men. In fact, strokes take twice as many lives of women as breast cancer does each year.
How is a stroke treated?
Stroke medical treatments work to either open the blockage or treat the rupture. The only FDA-approved medication for treatment of ischemic strokes is tissue plasminogen activator (also known as tPA , Alteplase, or Activase). This medication is given intravenously and works by dissolving the clot and improving blood flow to the part of the brain affected. If administered within 3 to 4.5 hours of symptom onset, tPA may improve the chances of recovering from a stroke. This is why it is important to identify a stroke FAST and seek medical care immediately.
How to prevent stroke?
On the bright side, 80 percent of strokes can be prevented! Controlling modifiable risk factors is the key to avoiding a stroke. In general, this can be done by incorporating a healthy diet and exercise into your daily routine. Medication compliance for those individuals with high blood pressure, high cholesterol, and atrial fibrillation can also help to reduce the risk of stroke.
For those individuals who have had a stroke, medications can be used to prevent any recurrent strokes in the future.
Antiplatelet agents such as aspirin, clopidogrel (Plavix), prasugrel (Effient), and ticagrelor (Brilinta) prevent platelets from sticking together and forming blood clots.
Anticoagulants such as warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban (Xarelto), and apixaban (Eliquis), are commonly prescribed to prevent stroke in patients with atrial fibrillation. These medications work by keeping the blood from clotting.
Medications to control high cholesterol are very important for those individuals who have experienced a TIA or ischemic stroke. Statins are recommended to reduce the risk of stroke in individuals with elevated total cholesterol or low-density lipoprotein (LDL).
Examples of statins include, atorvastatin (Lipitor), lovastatin (Mevacor), pitavastatin (Livalo), pravastatin (Pravachol), rosuvastatin (Crestor), and simvastatin (Zocor).
Studies have shown that individuals who take statins are 35 percent less likely to have a second stroke and 57 percent less likely to die.
Medications to control high blood pressure and atrial fibrillation are also very important among those patients who are at high risk for a stroke. Antihypertensives, or blood pressure medications, in general work to lower the blood pressure by opening the blood vessels, reducing the force of heart beats, or decreasing excess fluid and salt in the body, making it easier for the heart to pump.
I challenge each of you to take the opportunity to educate your friends, family, co-workers, and community about stroke and acting FAST to save a life.