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Heart Health Supports Brain Health: Self-Management to Prevent Stroke

Categories: ACBIS Insider

By Riqiea Kitchens PhD, OTR, BCPR, CSRS, Amber Armstead DrPH, OTR, BCPR, Chih-Ying Li, PhD, OTR, Monique Pappadis, PhD, MEd, FACRM

We just celebrated National Stroke Awareness Month in May. Having a stroke is a life-changing event that affects almost 800,000 people in the United States (US) each year.

Strokes happen when blood vessels are blocked or burst in the brain. Strokes can affect a person’s ability to think, move, speak, and feel. Fortunately, most strokes can be prevented. Health conditions including high blood pressure, high cholesterol, or diabetes can increase a person’s risk for having a stroke. High blood pressure occurs when there is increased pressure in the arteries. A blood pressure reading has a top (systolic) number and bottom (diastolic) number. A normal blood pressure reading is 120/80 mm Hg or lower. Blood pressure is considered high if the top number is 140 mmHg or higher, or the bottom number is 90 mmHg or higher. Over time, high blood pressure can cause damage to the arteries and can lead to stroke or heart attack. In this article, we will briefly discuss critical components relevant to brain and heart health and the importance to monitor those factors.

Cholesterol is a fatty substance that the body needs to function properly. However, too much cholesterol in the body can cause buildup in the arteries making arteries narrow or stiff and harder for blood to flow. High cholesterol can lead to stroke or disease of the blood vessels. Total cholesterol (TC) is measured by a blood test that examines two numbers: the high-density lipoprotein (HDL) ‘good’ cholesterol and low-density lipoprotein (LDL) ‘bad’ cholesterol. Normal total cholesterol is less than 200 mg/dL. Cholesterol is considered high when it is above 240 mg/dL. The relationship between cholesterol levels and risk of stroke is complex. High levels of TC and LDL are both associated with increased incidence of having an ischemic stroke, while low levels of TC and LDL are associated with increased risk of hemorrhagic stroke (Hackam & Hegele, 2019). The levels of TC and LDL are expected to be maintained at the acceptable ranges to stabilize brain health.

Diabetes is a condition that affects how the body uses food for energy. In a healthy body, food is broken down and the sugar (glucose) from the food is used for energy. When individuals have diabetes, their bodies have difficulty converting the glucose into energy, which causes an increase of glucose in the body. This can lead to damage to the heart, blood vessels, nerves, and kidneys over time. There are three types of diabetes: type 1, type 2, and gestational diabetes (diabetes while pregnant). Type 2 diabetes is the most common. A blood test can measure the amount of glucose in the blood to detect diabetes. The glycated hemoglobin A1C test is one way to measure diabetes. A normal A1C reading is below 5.7%. A person is considered prediabetic is their A1C level is between 5.7% and 6.4%. A person is diagnosed with diabetes when the A1C reading is 6.5% or higher. A1C levels may vary by race/ethnicity (ADA Professional Practice Committee, 2022), which is an important consideration for diabetes screening and management.

Each of these risk factors can be managed if a person knows how to do so. The ability for a person to manage their health conditions is called self-management. There are several ways a person can self-manage those risk factors. Eating a balanced diet that is plentiful in fruits, vegetables, poultry, fish, and whole grains, and low in fat and low sodium is important to help maintain a healthy weight. Additionally, engaging in at least 30 minutes of exercise at least five days per week can help a person maintain a healthy blood pressure and healthy weight. A person may need to take medication to help them manage their conditions. It is important to take medications regularly, measure blood pressure routinely, and talk with their health providers to remain informed about their health. When a person can self-manage their risk factors properly, they are more likely to take steps to become or remain brain and heart healthy and lower their risk of stroke.

References

  1. American Diabetes Association. (n.d.). Understanding A1c Diagnosis. https://diabetes.org/diabetes/a1c/diagnosis
  2. American Diabetes Association Professional Practice Committee. 2. Classification and diagnosis of diabetes: Standards of Medical Care in Diabetes—2022. Diabetes Care 2022;45(Suppl. 1):S17–S38
  3. Centers for Disease Control and Prevention. (2021, May 18). High blood pressure symptoms and causes. Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/about.htm#:~:text=High%20blood%20pressure%2C%20also%20called,blood%20pressure%20(or%20hypertension).
  4. Chen, R., Ovbiagele, B., & Feng, W. (2016). Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. The American journal of the medical sciences, 351(4), 380–386. https://doi.org/10.1016/j.amjms.2016.01.011
  5. Hackam, D. G., & Hegele, R. A. (2019). Cholesterol lowering and prevention of stroke: An overview. Stroke, 50(2), 537-541.