Stroke is the third leading cause of death and the leading cause of disability in the United States.
The most common causes of stroke are atherosclerosis in the blood vessels feeding the brain and several types of cardiac disease which allow clots to form within the chambers of the heart. When these clots form, they are then pumped by the heart to the brain where they block important blood vessels that feed the brain. The parts of the brain that are deprived of blood flow then die, often leaving the victim with permanent disability.
Outside of emergency treatment of a stroke within the very early hours following the onset of symptoms, treatment focuses on prevention. Since stroke often results in permanent disability, preventing the stroke from occurring at all is the best medicine.
There are well-known risk factors for stroke that are important to manage in adults. Factors that increase stroke risk include being over 65, being single, smoking or obese and having high blood pressure, heart disease or diabetes. The most important of these risk factors are age, high blood pressure, heart disease and diabetes. These risk factors are even more important in African-Americans and Latinos, both have a higher risk of stroke than Caucasians.
Recent studies have indicated that the best stroke prevention may begin in childhood. Given the current obesity epidemic among children, the incidence of high blood pressure and diabetes are rising in children. Thus, health programs targeting childhood obesity are important in stroke prevention.
Some studies indicate that prenatal factors can impact stroke risk. Low birth weight babies are known to have a higher risk of stroke. This may be related to the higher incidence of low birth weight babies born to economically disadvantaged mothers.
Children who grow up in middle and low socioeconomic environments have a 24 percent and 36 percent higher risk of stroke respectively than those children from high socioeconomic settings. This risk continues into adulthood and can be reduced by improving adult socioeconomic status.
In addition, lower socioeconomic status interacts with high blood pressure, heart disease and diabetes to make these risk factors even more potent in causing a stroke. Researchers do not know why poorer children have a higher risk of stroke. However, these findings reinforce the importance of lifelong stroke prevention.
Paula Gisler is director of Central Baptist Hospital Neuroscience Center.