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Heart Disease and  Stroke

Heart Disease and Stroke

It is interesting to note how heart disease and stroke are growing proportionally to the growth of overweight and obesity. The statistics and geography of the two seem to overlap. They are related. More overweight people and more obese people bring about more heart disease and stroke. Below you will discover how dangerous and preventable heart disease and stroke are. Also, the books offered here may help you avoid or overcome these problems.

 

 

Preventing Heart Disease and Stroke

Heart disease and stroke--the principal components of cardiovascular disease--are the first and third leading causes of death in the United States, accounting for more than 40% of all deaths.

  • About 950,000 Americans die of cardiovascular disease each year, which amounts to one death every 33 seconds.

  • Although heart disease and stroke are often thought to affect men and older people primarily, it is also a major killer of women and people in the prime of life.

  • Looking at only deaths due to heart disease or stroke, however, understates the health effects of these two conditions:

  • About 61 million Americans (almost one-fourth of the population) have some form of cardiovascular disease.

  • Coronary heart disease is a leading cause of premature, permanent disability among working adults.

  • Stroke alone accounts for the disability of more than 1 million Americans.

  • Almost 6 million hospitalizations each year are due to cardiovascular disease.

Costs

The economic effects of cardiovascular disease on the U.S. health care system grows larger as the population ages. In 2003, the cost of heart disease and stroke is projected to be $351 billion: $209 billion for health care expenditures and $142 billion for lost productivity from death and disability.

Rates of Death Due to Diseases of the Heart,* 1999

Rates of Death Due to Diseases of the Heart,* 1999. Click below for text description.

*Deaths per 100,000, age adjusted to 2000 total U.S. population.


CDC Goals 

  • To build a nationwide program to prevent heart disease and stroke.

  • To reduce disparities in cardiovascular health among high-risk populations.

  • To define geographic variations in the risk factors and the rates of illness and death associated with heart disease and stroke.

  • To promote secondary prevention of heart disease and stroke.

  • To increase research into heart failure and to develop interventions to prevent it.

  • To develop and assess new methods for preventing heart disease and stroke.

 

Effectiveness of Efforts

Thirty years of research shows that measures such as encouraging healthier lifestyles and increasing early detection and intervention can 1) prevent heart disease and stroke for those who are healthy and 2) improve the health of people who have experienced these conditions. For example, people who stop smoking reduce their risk for heart disease rapidly and substantially. Improved nutrition and increased physical activity help to lower high blood pressure.

Research done during the 1980s shows that community interventions that change our environment (places where we work, play, learn, or live) are particularly effective in reducing heart disease and stroke throughout the entire community. For example, when a work place adopts a no-smoking policy, all employees benefit whether they smoke or not.

 

Examples of CDC Activities

  • CDC was a leader in the development of Preventing Death and Disability from Cardiovascular Diseases: A State-Based Plan for Action. The purpose of this plan is to ensure that every state is part of a comprehensive national program to prevent heart disease and stroke, which includes targeting the risk factor that lead to these conditions.

  • Since 1998, CDC has funded state programs to prevent heart disease and stroke. At present, 28 states receive such funds.

Examples of State Activities

South Carolina: A 1-day workshop was set up to train teachers to help students avoid behaviors that put them at risk for heart disease and stroke later in their lives. In attendance were 93 teachers from 11 school districts. Evaluation of this program showed that 70% of the teachers incorporated the skills they learned into their daily lessons.

New York: The New York Healthy Heart Program developed a tool for assessing heart-healthy policies and environments and applied this tool at over 100 work sites. As a result of this assessment, work sites increased their support for heart health by 65%. These supports included more low-fat food choices, smoke-free workplace policies, physical activity breaks, and safer stairwells.

 

This page last reviewed August 10, 2004

United States Department of Health and Human Services
Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion

 


 

NINDS Stroke Information Page

Condensed from Stroke: Hope Through Research


Table of Contents

What is Stroke?
Is there any treatment?
What is the prognosis?
What research is being done?

Organizations
Related NINDS Publications and Information
Publicaciones en Espaņol
Additional resources from MEDLINEplus

What is Stroke?

A stroke happens when blood flow to the brain stops. There are two different kinds of stroke. The most common is an ischemic stroke, caused by a blood clot that blocks a blood vessel or artery in the brain. The other, less common, is a hemorrhagic stroke, caused when a blood vessel in the brain ruptures and spills blood into the surrounding tissue. Brain cells in the area begin to die, either because they stop getting the oxygen and nutrients they need to function, or they are killed by the rupture of the vessel and sudden spill of blood.

The symptoms of stroke happen immediately:

  • Numbness or weakness in the face, arms, or legs (especially on one side of the body)
  • Confusion, difficulty speaking or understanding speech
  • Vision disturbances in one or both eyes
  • Dizziness, trouble walking, loss of balance or coordination
  • Severe headache with no known cause

If you or someone else has these symptoms, seek immediate medical assistance. The longer blood flow is cut off to the brain, the greater the potential for permanent damage.

Doctors diagnose stroke by performing a short neurological examination, as well as blood tests, CT scans, MRI scans, Doppler ultrasound, and arteriography, if needed.

Is there any treatment?

Ischemic strokes can be treated with a drug called t-PA that dissolves the clot or clots that are keeping blood from flowing to the brain. Because damaged brain cells can linger in a compromised but potentially viable state for several hours, the sooner treatment begins the better the chances of surviving without disabilities.

Stroke appears to run in some families who may either have a genetic mutation that predisposes them to stroke, or share a lifestyle that contributes to stroke risk factors. Other than genetic predisposition, additional risk factors for stroke are high blood pressure, heart disease, smoking, diabetes, and high cholesterol. Controlling these risk factors can decrease the likelihood of stroke.

What is the prognosis?

The effects of a stroke range from mild to severe depending on the type of stroke, area of the brain affected, and the extent of the damage. Those who have survived a stroke may experience paralysis, pain, or numbness, as well as problems with thinking and speaking, and emotional changes. Many individuals will require physical therapy to regain strength and mobility, and occupational therapy to relearn how to perform everyday activities, such as eating, dressing, using the bathroom, etc. Speech therapy is appropriate for those who have trouble reading, understanding speech, or forming language.

What research is being done?

NINDS-sponsored research investigates the full range of factors involved in stroke incidence, treatment, diagnosis, and prevention. Current programs are exploring the genetic origins of stroke predisposition, the prevalence of stroke among different racial and cultural groups in America, clinical applications of new therapies, and basic science studies to understand the biological mechanisms involved in the death or survival of brain cells during stroke.

For example, a recent clinical trial showed that aspirin is just as effective as a more expensive medication called warfarin for preventing additional strokes. Prior to this study, most clinicians believed that warfarin was a better blood thinner than aspirin, even though it was more expensive, required monthly blood tests for proper monitoring, and had a greater risk of side effects. The findings from this trial demonstrated that aspirin was not only cheaper and safer than warfarin for preventing stroke, it was just as effective.

Another study used a vaccine that interferes with inflammation inside blood vessels to reduce the frequency and severity of strokes in animal subjects that had high blood pressure and a genetic predisposition to stroke. Researchers are hopeful that the vaccine will work in humans, and could be used to prevent many of the strokes that occur each year in individuals with high risk factors.

Researchers are also looking at how chemicals present in the brain can be used to heal damaged brain cells after a stroke occurs. The findings from a study that used one of these natural chemicals in animal models showed that it could improve motor skills after a stroke by stimulating undamaged nerve fibers to grow new connections in the brain and spinal cord.

View a list of studies currently seeking patients.

 

Organizations

American Stroke Association: A Division of American Heart Association
7272 Greenville Avenue
Dallas, TX   75231-4596
strokeassociation@heart.org
http://www.strokeassociation.org/
Tel: 1-888-4STROKE (478-7653)
Fax: 214-706-5231

Brain Aneurysm Foundation
12 Clarendon Street
Boston, MA   02116
information@bafound.org
http://www.bafound.org/
Tel: 617-723-3870
Fax: 617-723-8672

National Stroke Association
9707 East Easter Lane
Englewood, CO   80112-3747
info@stroke.org
http://www.stroke.org/
Tel: 303-649-9299 800-STROKES (787-6537)
Fax: 303-649-1328

Stroke Clubs International
805 12th Street
Galveston, TX   77550
strokeclubs@earthlink.net
Tel: 409-762-1022

National Aphasia Association
29 John Street
Suite 1103
New York, NY   10038
naa@aphasia.org
http://www.aphasia.org/
Tel: 212-267-2814 800-922-4NAA (4622)
Fax: 212-267-2812

Children’s Hemiplegia and Stroke Assocn. (CHASA)
4101 West Green Oaks Blvd., Ste. 305
PMB 149
Arlington, TX   76016
info437@chasa.org
http://www.chasa.org/
Tel: 817-492-4325

Hazel K. Goddess Fund for Stroke Research in Women
785 Park Avenue
New York, NY   10021-3552
courtneymartin@thegoddessfund.org
http://www.thegoddessfund.org/
Tel: 212-734-8067
Fax: 212-288-2160

American Health Assistance Foundation
22512 Gateway Center Drive
Clarksburg, MD   20871
info@ahaf.org
http://www.ahaf.org/
Tel: 301-948-3244 800-437-AHAF (2423)
Fax: 301-258-9454

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892

NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

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Last updated December 13, 2004
http://www.ninds.nih.gov/disorders/stroke/stroke.htm

 

 


 

 

Brain Basics: Preventing Stroke

Introduction

If you're like most Americans, you plan for your future. When you take a job, you examine its benefit plan. When you buy a home, you consider its location and condition so that your investment is safe. Today, more and more Americans are protecting their most important asset--their health. Are you?

Stroke ranks as the third leading killer in the United States. A stroke can be devastating to individuals and their families, robbing them of their independence. It is the most common cause of adult disability. Each year more than 700,000 Americans have a stroke, with about 160,000 dying from stroke-related causes. Officials at the National Institute of Neurological Disorders and Stroke (NINDS) are committed to reducing that burden through biomedical research.


What is a Stroke?

A stroke, or "brain attack," occurs when blood circulation to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two broad categories of stroke: those caused by a blockage of blood flow and those caused by bleeding. While not usually fatal, a blockage of a blood vessel in the brain or neck, called an ischemic stroke, is the most frequent cause of stroke and is responsible for about 80 percent of strokes. These blockages stem from three conditions: the formation of a clot within a blood vessel of the brain or neck, called thrombosis; the movement of a clot from another part of the body such as the heart to the neck or brain, called embolism; or a severe narrowing of an artery in or leading to the brain, called stenosis. Bleeding into the brain or the spaces surrounding the brain causes the second type of stroke, called hemorrhagic stroke.

Two key steps you can take will lower your risk of death or disability from stroke: know stroke’s warning signs and control stroke’s risk factors. Scientific research conducted by the NINDS has identified warning signs and a large number of risk factors.


What are Warning Signs of a Stroke?

Warning signs are clues your body sends that your brain is not receiving enough oxygen. If you observe one or more of these signs of a stroke or "brain attack," don't wait, call a doctor or 911 right away!

  • Sudden numbness or weakness of face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Sometimes the warning signs may last only a few moments and then disappear. These brief episodes, known as transient ischemic attacks or TIAs, are sometimes called "mini-strokes." Although brief, they identify an underlying serious condition that isn't going away without medical help. Unfortunately, since they clear up, many people ignore them. Don't. Heeding them can save your life.


What are Risk Factors for a Stroke?

A risk factor is a condition or behavior that occurs more frequently in those who have, or are at greater risk of getting, a disease than in those who don't. Having a risk factor for stroke doesn't mean you'll have a stroke. On the other hand, not having a risk factor doesn't mean you'll avoid a stroke. But your risk of stroke grows as the number and severity of risk factors increases.

Stroke occurs in all age groups, in both sexes, and in all races in every country. It can even occur before birth, when the fetus is still in the womb. In African-Americans, stroke is more common and more deadly--even in young and middle-aged adults--than for any ethnic or other racial group in the United States. Scientists have found more and more severe risk factors in some minority groups and continue to look for patterns of stroke in these groups.


What Are the Treatable Risk Factors?

Some of the most important treatable risk factors for stroke are:

High blood pressure. Also called hypertension, this is by far the most potent risk factor for stroke. If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Some ways that work: Maintain proper weight. Avoid drugs known to raise blood pressure. Cut down on salt. Eat fruits and vegetables to increase potassium in your diet. Exercise more. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.

Cigarette smoking. Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure; carbon monoxide reduces the amount of oxygen your blood can carry to the brain; and cigarette smoke makes your blood thicker and more likely to clot. Your doctor can recommend programs and medications that may help you quit smoking. By quitting, at any age, you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.

Heart disease. Common heart disorders such as coronary artery disease, valve defects, irregular heart beat, and enlargement of one of the heart’s chambers can result in blood clots that may break loose and block vessels in or leading to the brain. The most common blood vessel disease, caused by the buildup of fatty deposits in the arteries, is called atherosclerosis. Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you and your doctor should make a decision about aspirin therapy. A doctor can evaluate your risk factors and help you decide if you will benefit from aspirin or other blood-thinning therapy.

Warning signs or history of stroke. If you experience a TIA, get help at once. Many communities encourage those with stroke’s warning signs to dial 911 for emergency medical assistance. If you have had a stroke in the past, it’s important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by drawing on body systems that now do double duty. That means a second stroke can be twice as bad.

Diabetes. You may think this disorder affects only the body’s ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain. Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Treating diabetes can delay the onset of complications that increase the risk of stroke.


Do You Know Your Stroke Risk?

Some of the most important risk factors for stroke can be determined during a physical exam at your doctor’s office. If you are over 55 years old, a worksheet in a pamphlet available from the NINDS can help you estimate your risk of stroke and show the benefit of risk-factor control.

The worksheet was developed from NINDS-supported work in the well-known Framingham Study. Working with your doctor, you can develop a strategy to lower your risk to average or even below average for your age.

Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.

Americans have shown that stroke is preventable and treatable. In recent years, a better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half.

Scientists at the NINDS predict that, with continued attention to reducing the risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes.


More information on stroke

Prepared by:
Office of Communications and Public Liaison
National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892


NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Last updated
NINDS health-related material is provided for information purposes only and does not necessarily represent endorsement by or an official position of the National Institute of Neurological Disorders and Stroke or any other Federal agency. Advice on the treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

All NINDS-prepared information is in the public domain and may be freely copied. Credit to the NINDS or the NIH is appreciated.

Last updated September 30, 2004
http://www.ninds.nih.gov/disorders/stroke/preventing_stroke.htm

 

 

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