1. Stroke Prevention
By Kim Dutfield ,RN
January 2015

3. Stroke Impact
Stroke is widespread
►More than 62,000 admissions to emergency departments
for stroke, including transient ischemic attack (TIA), each
year in Canada
►Leading cause of disability
►Third leading cause of death in Canada
►Each year more than 13,000 Canadians die from stroke
►Women more likely to die when they have a stroke
► 1 in 5 for women, vs. 1 in 6 for men
HSF Stroke Report 2014; WSO 2014

4. Signs and Symptoms of Stroke
 Sudden Weakness,
numbness or
tingling in the face,
arm, or leg
 Sudden trouble
speaking or
understanding
 Sudden vision
changes
 Sudden
Headache
 Sudden loss of
balance

5. Shift from “Five” to FAST
Late 1990’s 2014

6. F
A
S
T
Think FAST

7. “Time Is Brain”
“Canadians need to understand
that the clock starts ticking at the
first signs of a stroke. And every
second of delay leads to more
brain cell death, and greater risk
of death or disability” –
Dr. Michael Hill

8.  Age(most strokes occur after 65)
 Gender (women have lower risk before menopause
than men. But more women die of stroke)
 Ethnicity(increased risk for persons of Aboriginal,
African, or South Asian descent because of higher
rates of high blood pressure and diabetes)
 Family history( if parent or sibling had a stroke before
65)
 Prior stroke or TIA
Risk Factors You Can’t Control

9.  Hypertension
 High blood cholesterol
 Diabetes
 Smoking
 Being overweight
 Physical inactivity
 Excessive alcohol consumption
 Stress (not managing stress), Depression
 Sleep apnea
 Women on birth control and HRT
Risk Factors You Can Control

10. Hypertension
 THE greatest risk factor for stroke
 Single most modifiable risk factor for stroke.
 Target B/P - <140/90
 Diabetics or Kidney disease- < 130/80
 KNOW YOUR BLOOD PRESSURE

11. Lipid Management
 Patients who have had a stroke or
TIA should have their lipid levels
assessed.
 A statin should be prescribed for
primary prevention of
cardiovascular events, including
stroke, to most patients with high
risk
 Achieve LDL of less than
2.0 mmol/l

12. Atrial Fibrillation

13. Alcohol Management
Alcohol reduction reduces
stroke risk!
Recommendations:
* Men: up to 2 drinks, per day
*Women: up to 1 drink, per day
1 drink = 1.5 oz. of spirits,
12 oz. of beer, 5 oz. of wine

14. Thinking About Quitting?

15. Within 20 minutes of quitting…
20 Minutes After Quitting
 Your heart rate drops
12 Hours After Quitting
 Carbon monoxide level in blood drops to normal
2 Weeks to 3 Months After Quitting
 Your heart attack risk begins to drop
 Your lung function begins to improve

16. 1 to 9 Months After Quitting
 Your coughing and shortness of breath
decrease.
1 Year After Quitting
 Your added risk of coronary heart disease is half
that of a smoker’s.
5 Years After Quitting
 Your stroke risk is reduced to that of a non-
smoker’s 5-15 years after quitting.

17. 10 Years After Quitting
 Your lung cancer death rate is about half that
of a smoker’s
 Your risk of cancers of the mouth, throat,
esophagus, bladder, kidney, and pancreas
decreases
15 Years After Quitting
 Your risk of coronary heart disease is back to
that of a non-smoker’s

18. To help reduce your risk for stroke,
the recommendations for physical
activity are simple:
*Accumulate a minimum of 150
minutes (2 ½ hrs)
of moderate to vigorous exercise
per week
*May do in segments of 10 minutes
Activity & Lifestyle

19.  Keeping your blood sugar in a healthy range will help to reduce
the damage to your blood vessels that leads to “hardening of
the arteries” (atherosclerosis).
 This can be achieved through: diet, exercise and possibly
medication and regular monitoring of sugar levels.
 Report to your doctor when blood sugars are often outside the
4-7 range. You may need another visit with the Diabetes
Educator.
 Good news! Well managed diabetes will also help to reduce
your risk of developing high blood pressure or heart disease or
having a stroke.
Diabetes Management

20. Sleep Apnea
Recommend screening for sleep apnea if
experiencing:
*Frequent waking &/or snoring, especially
if pauses are heard
*Broken sleep, wake with snort/gasp
*Poor concentration, sleepy in day
*BP, arrythmia hard to control
*More likely if overweight, short/wide
neck, 1 in 4 men, 1 in 10 women, age >50
*Untreated sleep apnea can mean a
significant increase in your stroke risk!

21. Body Weight
Waist Circumference

22. Stress. What is it?

23. Bad Stress

24. How do you cope with stress?
 Just say NO
 Get help when needed
 Relaxation techniques
 Exercise
 Time management
 Watch your diet-alcohol,
caffeine, sugar, fats &
tobacco
 Sleep and rest
 Talk with others
 Volunteer
 Have fun!! Laugh!!
 Be with people you enjoy!!
 Don’t try and be perfect
 Work off your anger
 Tackle one thing at a time-Don’t
try and do too much at once
 Ease up on criticism of others
 Give in occasionally-avoid quarrels
whenever possible
 Explore your spirituality

25. Know your risks and see your
doctor to help reduce them.
Be Good to Yourself
and your Farm!