I was asked to give a talk last year on stroke prevention to physicians and nurses. I started out my talk by asking the audience several questions. The first was, “If you had a stroke, how many of you would want to be on a treatment program to prevent a second one?” Of course, every hand shot up. The second question was, “If you haven't had a stroke, how many of you would want to be on a treatment program to prevent a stroke in the first place?” Every hand went up again.
Next I asked, “How many of you do all of these things now: exercise at least 150 minutes every week; maintain a healthy diet and weight; don't smoke; limit alcohol intake; and maintain normal blood pressure, blood sugar, cholesterol, and lipid levels?” This time, several hands were raised.
The final question was, “How many of you would be willing to do all of these things if it meant that it would prevent you from having a stroke in the future?” Very few hands went up, and people looked a bit embarrassed.
Why do so few physicians and nurses do all the things we know will help prevent stroke? We understand as well as anyone the importance of controlling all of these risk factors to lower stroke risk. The reason is that doing all these things is really difficult!
In this issue of Neurology Now, we introduce a new department called “The Healthy Brain” (page 38). In it, we will provide the best information about proactively keeping our brains healthy. Not all neurologic conditions can be prevented, but being in the best possible health overall makes it easier to deal with and recover from any health problem.
The first question I asked my audience was really about treatment to prevent a health problem from recurring. This is called secondary prevention. Prevention of a second stroke is something that everyone can agree is important. In fact, it is often easier for people to make lifestyle changes—such as exercising, losing weight, stopping smoking, and paying more attention to blood pressure, blood sugar, and cholesterol—after they have experienced a life-changing illness.
But we also know that making these changes before a stroke (called primary prevention) is really the better way to go. What's more, implementing these lifestyle changes not only prevents stroke. Our first story in this new department describes how controlling blood pressure, for example, may help prevent dementia as well (not to mention prevent heart attacks, kidney disease, diabetes, and many other health problems).
I would encourage all of you to go to the American Heart Association website (heart.org ) and look at their program, Life's Simple Seven. You can see how your lifestyle impacts your risk for stroke, heart attack, and other conditions—and what you can do to make changes to live a healthier life. A healthy lifestyle doesn't guarantee a life free from health problems, and I freely admit that I find it very difficult to follow the Life's Simple Seven program every single day. Many days, I don't succeed. But as a neurologist, I see the terrible consequences of stroke and dementia all the time, which motivates me to keep on trying.
Please let us know what you are doing to keep you brain healthy, and whether this new department helps you in your efforts. Email us at neurologynow@lwwny .
Take good care,
Robin L. Brey, M.D.