One afternoon last summer, as Nancy Schwartz attempted to get up from her desk, she knew something was terribly wrong.
The 56-year-old financial advisor tried to pick up her phone, but her right hand couldn’t grab it. And she couldn’t speak. Frightened, she stumbled out to her intern, who called 911. Two hours later, after receiving drugs in the ER, she could speak again, but was completely dumbfounded. “I had a stroke?” she said to her doctor. “How could that be? There were no signs, no warnings.”
But the fact is, there were many warnings.
What many people do not realize is that the same lifestyle risks that lead to heart attacks also lead to strokes. Nancy had high blood pressure. She took medication for it, but her blood pressure still hovered around 140/90. She was also pre-diabetic. And she needed to lose about 25 pounds. She didn’t know it, but she was a prime candidate for both a heart attack and a stroke.
Bottom Line: A typical stroke, called an ischemic stroke, is basically a heart attack in the brain. To prevent ischemic strokes, you follow the same healthy lifestyle habits you would follow to prevent heart attacks.
During a stroke, every minute counts!
Acting F.A.S.T. can save lives. The most effective stroke treatments are only available if the stroke is treated within 3 hours of the first symptoms. If you think someone is having a stroke, do the following simple test:
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 phrase. Is speech slurred or strange?
Time: If you observe any of these signs, call 911 immediately.
About 9 out of 10 strokes in America are ischemic. Here’s what happens. Arteries leading to the brain become inflamed and diseased, just as arteries leading to the heart can. Both are largely the result of lifestyle-related insults, particularly the typical modern diet, high in salt, sugar, refined (white) grains, and fats, especially saturated and trans fats. Plaque builds, clogging the arteries. Then a plaque ruptures, triggering a massive blood clot that chokes off blood flow to the heart, causing a heart attack, or to the brain, causing a stroke.
Two million brain cells
During a stroke, two million brain cells die every minute. The result can be brain damage, paralysis or other forms of disability, or death. Of those who survive, research1 reports, more than one-third can no longer walk on their own. One-quarter end up in nursing homes. In fact, stroke is the #1 reason Americans enter nursing homes.
And many Americans are hit. Though recent data2 indicate that stroke rates are starting to decline, stroke is still the fourth leading cause of death in the U.S. About 800,000 Americans suffer a stroke each year. One American dies from a stroke every four minutes.3
Roughly 1 out of 10 strokes is hemorrhagic, which means a blood vessel near or in the brain bursts.
“I had a stroke. Now what?”
That’s why it’s so critical to treat the underlying causes of stroke, which include:
- High blood pressure (hypertension)
- Heart disease (coronary artery disease)
- Atrial fibrillation (fast, irregular heartbeat)
- High cholesterol levels
- Diabetes or pre-diabetes
- Excess weight
- Little or no exercise
- Too much alcohol
Some risk factors for stroke cannot be controlled, such as age (stroke risk doubles every decade after 55), family history of stroke, or having the genetic disorder sickle cell disease.
80% of strokes can be prevented
But you can take steps to greatly lower your risk by changing the factors you can control. In fact, the National Institute of Neurological Disorders and Strokes estimates that up to 80% of strokes can be prevented.5
Below are key recommendations from the Centers For Disease Control, the National Stroke Association, the Institute of Medicine, and the physicians and other faculty at the Pritikin Longevity Center in Miami, where thousands have come since 1975 to learn healthy living habits for prevention of heart attacks and strokes.
Lower your blood pressure
Hypertension, or high blood pressure, is the single most important risk factor for stroke. The higher your blood pressure, the greater your risk of not only stroke but also heart attacks, congestive heart failure, kidney disease, impotence, loss of mental function, and dementia.
What’s more, stroke risk starts to rise before the hypertension diagnosis of 140/90. In fact, research has found that about half of all blood-pressure-related strokes occur in people who are in the pre-hypertension range, which is 120/80 to 139/89.6
As blood pressure creeps up from optimal ranges (less than 115/75), damage increases.
To keep your blood pressure low:
Cut salt (sodium-chloride) intake.
“Nearly everyone benefits from reduced sodium consumption,” states the Centers For Disease Control and Prevention. The Institute of Medicine, the scientific organization that sets the nation’s standards for recommended levels of nutrients and is comprised of the country’s leading researchers in health and nutrition, advises that adult Americans limit their consumption of sodium to 1,200 to 1,500 milligrams a day, depending on age.7
What is a “mini-stroke”?
A transient ischemic attack (TIA), often called a “mini-stroke,” occurs when blood flow is blocked to the brain, but only for a short time, usually no more than 5 minutes.
But a TIA is a warning sign of a future stroke. Call 911 immediately. More than a third of people who have a TIA suffer a major stroke within 1 year if they do not receive treatment and make healthy lifestyle changes.
Unfortunately, the average American adult now consumes about 4,000 milligrams of sodium daily.
The good news is that limiting sodium intake really works, especially for those most in need. Many studies have shown that the higher blood pressure is and the more sodium is restricted, the greater the fall in blood pressure.
At the Pritikin Longevity Center, where sodium intake is limited to 1,500 milligrams or fewer daily, published results have documented significant drops in blood pressure. In one analysis of 1,117 men and women with high blood pressure who came to Pritikin, systolic blood pressure (the top number) and diastolic pressure (the bottom number) each fell on average 9%, and within three weeks.8
Moreover, of those taking blood pressure drugs (598 people in total), 55% returned home medication-free. Many of the remaining 45% left Pritikin with their dosages substantially reduced.
Eat more potassium-rich foods.
Eating potassium-rich foods like potatoes, beans, yogurt, and many fruits and vegetables can help blunt some of the negative effects of sodium in the body. To help keep blood pressure in healthy ranges, the Institute of Medicine recommends at least 4,700 milligrams a day of potassium (from food, not supplements).
Sure, 4,700 milligrams sounds like a lot, but it’s surprisingly easy to meet. Healthy foods like the following (and there are many more among other varieties of fruits, vegetables, beans, and potatoes) can really ramp up your potassium intake:
Potassium (mg) Banana 422 Spinach (1 cup cooked) 839 Zucchini (1 cup cooked, sliced) 475 Mushrooms (1 cup, sliced, raw) 416 Baked Potato 926 White Beans (1 cup cooked) 829 Nonfat Yogurt (1 cup) 625 Salmon (4 ounces, cooked) 534 Total 5,066
Lose excess weight.
Being overweight puts a strain on the circulatory system. In addition to increasing your risk of blood pressure, excess body fat also makes it more likely you’ll develop high cholesterol, high blood sugar, and diabetes – all of which can increase the risk for stroke.
Regular exercise can help you maintain a healthy weight and lower your blood pressure. “It’s incredible how quickly people’s blood pressures fall here at Pritikin,” observes Jamie Costello, MSC, Pritikin’s Director of Exercise. “The Pritikin diet, low in salt and rich in fruits, vegetables, whole grains, and beans, really helps, but our fitness program plays a vital role, too.”
Stroke Recovery and Exercise
Studies have shown that regular exercise can significantly reduce the likelihood of another stroke.
“In fact, by day three, we need to keep a close watch on our guests’ blood pressures,” smiles physician and Medical Director Danine Fruge, MD. “Many people’s blood pressures have dropped so dramatically that we’re taking them off their medications or reducing their dosages so that their blood pressures don’t go too low.”
Drinking too much alcohol can raise your blood pressure. Pritikin recommendations, similar to those of many public health organizations, are not drinking or limiting intake to no more than 4 drinks weekly for women (not more than ½ to 1 drink per day) and no more than 7 drinks weekly for men (not more than 1 to 2 drinks per day).
“I had a stroke. Now what?”
Additional Lifestyle Steps For Preventing The Next One…
In addition to lowering your blood pressure by cutting down on salt, eating more potassium-rich foods, losing excess weight, exercising regularly, and limiting alcohol, the following guidelines can greatly help in keeping strokes – and heart attacks – at bay.
Lower LDL (bad) cholesterol. Prevent/control heart disease.
Cholesterol is a complex molecule found in our cell walls and several hormones. Our livers produce enough cholesterol for the body’s needs, but we often get more from the foods we eat, particularly saturated-fat-rich foods like meat and full-fat dairy foods. If we take in more cholesterol than we need, the extra cholesterol can build up in our arteries, leading to both heart attacks and strokes.
Medications like statins can help lower LDL cholesterol, but so can a healthy lifestyle. In research, for example, on more than 4,500 men and women who began the Pritikin Program, LDL cholesterol levels fell on average 23% within three weeks.9
Lower blood sugar (glucose). Prevent/control diabetes.
People who have type 2 diabetes are two to four times more likely to have a stroke compared to people without the disease. High blood sugar, in and of itself, increases the risk of stroke, but so do other health problems common among diabetics, including high blood pressure, excess weight, high LDL cholesterol, heart disease (coronary artery disease, or atherosclerosis) as well as atrial fibrillation (a type of irregular heart beat).
Once again, a healthy lifestyle can have major benefits in lowering blood sugar and curbing both type 2 diabetes (a fasting glucose of 126 mg/dL or higher) and pre-diabetes (a fasting glucose between 100 and 125 mg/dL).
And the sooner you get started, the better your results. A study10 published on type 2 diabetics coming to the Pritikin Center followed 243 people in the early stages of diabetes (not yet on medications). Within three weeks, their fasting glucose plummeted on average from 160 to 124.
Compared to nonsmokers, being a smoker doubles your risk for a stroke. It increases the amount of plaque build-up in the arteries. It also reduces oxygen amounts in the blood, which causes the heart to work harder and makes blood clots form more easily. If you don’t smoke, that’s wonderful, but also make sure that others around you don’t smoke.
Treat atrial fibrillation.
Having atrial fibrillation or AFib, an irregular heartbeat that leads to the formation of clots within the heart, increases the risk of stroke five-fold. Often, unfortunately, people don’t know they have AFib because many do not experience its symptoms, which are fluttering, racing, or pounding sensations in the chest.
To find out if you have AFib, make an appointment with your physician. Medications and/or the use of electrical stimulation can often restore normal heart rhythms.
“I had a stroke, and I’m doing really well.”
Since her stroke last summer, Nancy has worked hard to turn her life around. She got a lot of help from her 84-year-old-father, who had starting living Pritikin-style 30 years ago after having a heart attack. He’s never had another heart problem. And he’s in great shape, walking five miles daily.
“We often walk to farmers’ markets together,” smiles Nancy, who has shed 25 pounds, is off all blood pressure medications (“I don’t need them anymore”), and has blood sugar readings in the normal range.
“I honestly had no idea how much a healthy lifestyle could benefit my life. In our society, we’re so used to taking a pill for this problem and another pill for that problem, but all too often, we’ve still got the problems.
“That’s not the case with a healthy lifestyle like Pritikin. I’m free of high blood pressure. I’m free of diabetes. I’m thinner. And I’m much, much happier.”
1 Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation, 2013; 127 (1): e6.
2 JAMA, 2014; 312 (3): 259.
3 Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation, 2013; 127 (1): e6.
4 Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation, 2013; 127 (1): e6.
6 Neurology, 10.1212/WNL.0000000000000268. Published online before print March 12, 2014, doi: 10.1212/WNL.0000000000000268
7 National Research Council. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press, 2005.
8 Journal of Applied Physiology, 2005; 98: 3.
9 Archives of Internal Medicine, 1991; 151: 1,389.
10 Diabetes Care, 1994; 17: 1469.