Strokes have become a public health issue given that it is one of the leading causes of death, alongside cardiovascular diseases and cancer. Moreover, it is the leading cause of permanent disability in adulthood, which is why identifying risk factors and early detection are crucial. (1)
There are different types of risk factors based on their degree of modifiability. We therefore have modifiable, partially modifiable, and non-modifiable factors. (2)
These include factors that when controlled or managed can modify the risk of suffering a stroke. Most notably, high blood pressure, diabetes mellitus, dyslipidemia tobacco use, obesity, physical inactivity and excessive alcohol and drug use. Let’s take an in-depth look at the most important ones:
- High blood pressure. This is the most important risk factor. It can be modified by leading a healthy lifestyle that lowers target numbers, below 140/90 mmHg.
- Diabetes mellitus. Diabetes increases vascular risk factors and, consequently, the possibility of suffering a stroke. Therefore, we can lower this risk by controlling blood sugar levels.
- Dyslipidemia. High levels of cholesterol in the blood are associated with greater vascular risk and, therefore, greater risk of suffering a stroke.
- Obesity. We can differentiate between two types of obesity: general obesity (measured by the mass body index) and abdominal obesity (measured by the waist-hip ratio). Both are associated with the presence of the main cardiovascular risk factors (high blood pressure, dyslipidemia, and diabetes).
- Tobacco use. There is a link between the habitual use of tobacco and the increased risk of cardiovascular diseases, which is why breaking this habit would be a good form of prevention.
- Alcohol. Although consuming alcohol is socially acceptable, excessive drinking can lead to a greater risk of cardiovascular diseases and stroke.
Potentially modifiable factors
These are factors related to different pathologies that can cause a stroke; however, when these diseases are treated, as is the case of different angiopathies, often related anticoagulation, it can lower the risk of suffering a stroke.
These include factors that are inherent to the person and that are unable to be modified, such as age, gender and race, but should nonetheless not be forgotten.
Therefore, to prevent a stroke, we must work on the modifiable risk factors though healthy habits, which include:
- Physical activity. At least 30 minutes of physical activity a day is linked to a lower risk of vascular incidents.
- Diet. Your diet is one of your biggest allies. Consuming more fruits and vegetables, incorporating fish into your diet, and lowering your intake of sweets and highly processed foods will help reduce total fat, improve cholesterol levels and control weight.
The most common symptoms for early detection
While it is true that there are several symptoms on a neurological level that can hinder an early diagnosis, there are a number of signs that can appear suddenly or progressively (over the course of several hours) that, when readily detected, can improve the outcome. One of the main objectives when caring for a patient that begins to show signs of a stroke is to ensure that the time between identifying symptoms and their arrival at the medical center is as short as possible.
Although the outcome will be primarily determined by the origin, severity, and location of the stroke, the time between onset and treatment will greatly influence the final outcome.
Here is a list of the most common symptoms: (3)
- Sudden paralysis in the face, arms or legs, with or without numbness.
- Sudden loss of speech or difficulty speaking or understanding.
- Loss of vision, which may occur in only one eye or cause the loss of half of your field of vision, on the right or left side.
- Sudden severe headache with no known cause.
- There may be isolated cases of altered sensations including numbness or tingling in the face, arm or leg on one side of the body.
- Any of the above symptoms, accompanied by others such as vertigo, loss of balance or a sudden unexplainable fall, required urgent care.
Knowing which risk factors can be modified in order to reduce incidents of stroke as well as the symptoms for early detection will help improve the numbers related to stroke incidents, prevalence and outcome. It’s a matter that involves everyone.
Raquel Valera is professor of Nursing in the Grado de Enfermería
(1) Sierra Martinez L, Casaval Camara ML, De la Hija Casaval M. “Ictus” (Stroke). In: Niño Martín V. Cuidados enfermeros al paciente crónico (Nursing care for chronic patients). Vol. I. Serie Cuidados Avanzados (Advanced Care Series). Madrid: Difusión Avances de Enfermería (DAE); 2019. p. 303-52 (Diffusion of Nursing Advances).
(2) Arribas Gutiérrez AR. “Paciente neurológico en atención primaria” (Neurological patients in primary care). In: Párraga Bermejo JL. Cuidados al paciente con alteraciones neurológicas (Care for patients with neurological alterations). Serie Cuidados Especializados (Specialized Care Series). Madrid: Difusión Avances de Enfermería (DAE); 2011. p. 354-372 (Diffusion of Nursing Advances).
(3) Cebada Sánchez S, Rovira Gil E. “Accidentes cerebrovasculares. Infecciones del sistema nervioso” (Cerebrovascular accidents. Infections of the nervous system). In: Rovira Gil E. Urgencias en enfermería (Nursing emergencies). Vol. II. Serie Cuidados Avanzados (Advanced Care Series). Madrid: Difusión Avances de Enfermería (DAE); 2020. p. 547-54 (Diffusion of Nursing Advances).