Stroke Risk in Black Americans: Expert Q&A

Stroke Risk in Black Americans: Expert Q&A

Types

A stroke can happen in two main ways: Something blocks the flow of blood, or something causes bleeding in the brain.

Ischemic stroke. In 8 out of 10 strokes, a blood vessel that takes blood to your brain gets plugged. It happens when fatty deposits in arteries break off and travel to the brain or when poor blood flow from an irregular heartbeat forms a blood clot.

Hemorrhagic stroke. It’s less common than an ischemic stroke but can be more serious. A blood vessel in your brain balloons up and bursts, or a weakened one leaks. Uncontrolled high blood pressure and taking too much blood thinner medicine can lead to this kind of stroke.

Some people have what’s called a transient ischemic attack (TIA). This “mini stroke” is due to a temporary blockage. It doesn’t cause permanent brain damage, but it raises your odds of having a full-scale stroke.

Stroke Risk in Black Americans: Expert Q&A

Causes

You can treat some conditions that make you more likely to have a stroke. Other things that put you at risk can’t be changed:

High blood pressure. Your doctor may call it hypertension. It’s the biggest cause of strokes. If your blood pressure is typically 130/80 or higher, your doctor will discuss treatments with you.

Tobacco. Smoking or chewing it raises your odds of a stroke. Nicotine makes your blood pressure go up. Cigarette smoke causes a fatty buildup in your main neck artery. It also thickens your blood and makes it more likely to clot. Even secondhand smoke can affect you.

Heart disease. This condition includes defective heart valves as well as atrial fibrillation, or irregular heartbeat, which causes a quarter of all strokes among the very elderly. You can also have clogged arteries from fatty deposits.

Diabetes. People who have it often have high blood pressure and are more likely to be overweight. Both raise the chance of a stroke. Diabetes damages your blood vessels, which makes a stroke more likely. If you have a stroke when your blood sugar levels are high, the injury to your brain is greater.

How Does a Stroke Occur?

There are two types of stroke.

• Ischemic stroke is similar to a heart attack, except it occurs in the blood vessels of the brain. Clots can form in the brain’s blood vessels, in blood vessels leading to the brain, or even in blood vessels elsewhere in the body and then travel to the brain. These clots block blood flow to the brain’s cells. Ischemic stroke can also occur when too much plaque (fatty deposits and cholesterol) clogs the brain’s blood vessels. About 80% of all strokes are ischemic.
• Hemorrhagic (heh-more-raj-ik) strokes occur when a blood vessel in the brain breaks or ruptures. The result is blood seeping into the brain tissue, causing damage to brain cells. The most common causes of hemorrhagic stroke are high blood pressure and brain aneurysms. An aneurysm is a weakness or thinness in the blood vessel wall.

What Are the Symptoms of Stroke?

The most common symptoms of a stroke are:

• Weakness or numbness of the face, arm, or leg on one side of the body
• Loss of vision or dimming (like a curtain falling) in one or both eyes
• Loss of speech, difficulty talking, or understanding what others are saying
• Sudden, severe headache with no known cause
• Loss of balance or unstable walking, usually combined with another symptom

What Should I Do If I Experience Stroke Symptoms?

Immediately call 911 if you or someone you know has symptoms of a stroke. Stroke is a medical emergency. Immediate treatment can save your life or increase your chances of a full recovery.

Is it Possible to Prevent a Stroke?

Up to 50% of all strokes are preventable. Many risk factors can be controlled before they cause problems.

Controllable Risk Factors for Stroke:

• High blood pressure
• Atrial fibrillation
• Uncontrolled diabetes
• High cholesterol
• Smoking
• Excessive alcohol intake
• Obesity
• Carotid or coronary artery disease

Uncontrollable Risk Factors for Stroke:

• Age (>65)
• Gender (Men have more strokes, but women have deadlier strokes)
• Race (African-Americans are at increased risk)
• Family history of stroke

These are called transient ischemic attacks (also called TIA or “mini-stroke”) and are short, brief episodes of the stroke symptoms listed above. Some people have no symptoms warning them prior to a stroke or symptoms are so mild they are not noticeable. Regular check-ups are important in catching problems before they become serious. Report any symptoms or risk factors to your doctor.

Warning Signs

Sometimes a stroke happens gradually, but you’re likely to have one or more sudden symptoms like these:

• Numbness or weakness in your face, arm, or leg, especially on one side
• Confusion or trouble understanding other people
• Difficulty speaking
• Trouble seeing with one or both eyes
• Problems walking or staying balanced or coordinated
• Dizziness
• Severe headache that comes on for no reason

If you have these symptoms, call 911 even if you’re not sure you’re having a stroke.

Be Prepared

Each year, about 795,000 people in the U.S. have a stroke. They can happen to anyone at any time. Planning for an emergency can make a big difference.

• Learn the warning signs of a stroke and let your family and friends know, too.
• If you have any medical conditions, wear a medical bracelet or other identification that lists them, your allergies, and any medication you take.
• Teach your children the FAST test, plus how to call 911, give your address, and describe what’s happening.

Detecting a Silent Stroke

If you have a silent stroke, you probably won’t know it unless you happen to have a brain scan and the damage shows up. You may have slight memory problems or a little difficulty getting around. A doctor may be able to see signs of silent strokes without testing.

Silent Strokes More Common Than You’d Expect

A study of middle-aged people with no apparent signs of stroke found that about 10% had brain damage from one.

The damage that happens is permanent, but therapy might help stimulate other parts of the brain so you regain abilities that may have weakened.

Prevent Strokes With Good Habits

Your chances of getting a stroke go up if you have high blood pressure, heart disease, vascular disease, diabetes, or irregular heartbeat due to a condition called atrial fibrillation.

• Keep tabs on your blood pressure, and get it under control if it’s too high.
• Check your cholesterol.
• Keep your blood sugar at the right levels.
• If you smoke, quit.
• Eat a healthy diet that includes plenty of fresh fruits, veggies, and whole grains. Cut back on saturated fats (found in red meat, for example), salt, and sugar.
• Get regular exercise.
• Keep to a healthy weight.