domingo, 1 de junio de 2014

Stroke Awareness: Family History & Genomics

Genomics|Update|Current

Genomics & Health Impact Update

Stroke Awareness: Family History & Genomics

CDC information: National Stroke Awareness Month

CDC information: Stroke, family history and genomics

Am I at risk for a stroke?

Family history is a risk factor for stroke, from the National Stroke Association

Did you know? More than 720 genes have been reported in relation to risk and outcomes of stroke/ cerebrovascular accident, including 41 genomewide association studies?

Did you know? About 10% of children with sickle cell disease will have a symptomatic stroke? Learn about complications of sickle cell disease and how to prevent them

May is National Stroke Awareness Month

Every year, more than 795,000 people in the United States have a stroke. Although stroke is a leading cause of serious long-term disability, a quick response when the stroke occurs can help minimize brain damage and shorten the recovery period.

Take the time to learn the signs and symptoms of stroke during May, which is National Stroke Awareness Month. A 2005 CDC survey found that only 38% of people could correctly identify all 5 symptoms of stroke and knew to call 9-1-1 if they thought that someone was having a stroke.

The key to recognizing a stroke is knowing the following signs and remembering that they occur suddenly:

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

What to Do? Act FAST

If you think someone may be having a stroke, act FAST and do the following simple test:

F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T—Time: If you observe any of these signs, call 9-1-1 immediately.

Note the time when any symptoms first appear. Some treatments for stroke must be given within the first few hours after stroke. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room.

What Is Stroke?

Stroke is a leading cause of death in the United States, killing nearly 130,000 Americans each year—that's 1 of every 19 deaths. On average, an American dies from stroke every 4 minutes.

There are two types of stroke. The most common form is ischemic, in which the artery carrying oxygen-rich blood to the brain becomes blocked. The second is hemorrhagic, in which an artery in the brain leaks blood or ruptures (breaks open). Either type of stroke can cause brain cells to die quickly.

Medical personnel will try to open a blocked artery after an ischemic stroke by quickly dissolving or removing the blood clot. For hemorrhagic stroke, immediate surgery may be necessary to treat the bleeding or prevent re-bleeding, which leads to serious disability or death in 40% to 60% of hemorrhagic stroke cases.

What Is My Risk for Stroke?

The risk of having a first stroke is nearly twice as high for blacks as for whites, and blacks are more likely to die following a stroke than whites are. Hispanics' risk for stroke falls between that of whites and blacks.1 American Indians, Alaska Natives, and blacks are more likely to have had a stroke than are other groups.2

Sickle cell disease is a blood disorder associated with ischemic stroke that mainly affects black and Hispanic children. The disease causes some red blood cells to form an abnormal sickle shape. A stroke can happen if sickle cells get stuck in a blood vessel and block the flow of blood to the brain.

Although stroke risk increases with age, strokes can—and do—occur at any age, even in children and young adults. In 2009, 34% of people hospitalized for stroke were younger than 65 years.

Some of these risk factors for stroke cannot be controlled, such as your age or family history. But you can take steps to lower your risk by changing the factors you can control.

High blood pressure. High blood pressure is a major risk factor for stroke, and it is possible to have high blood pressure without knowing it. Nearly 8 of every 10 of people having their first stroke have high blood pressure. Lowering your blood pressure by making changes in lifestyle or using medication can reduce your risk for stroke. The Affordable Care Act ensures that many adult patients receive preventive services, including blood pressure screenings, at no cost.

High cholesterol. Extra cholesterol can build up in your arteries, including those of the brain. This build-up can lead to narrowing of the arteries, stroke, and other problems. A blood test can detect the amount of cholesterol and triglycerides (a related kind of fat) in your blood. If you have high cholesterol, your doctor may prescribe medications in addition to recommending lifestyle changes.

Heart disease. Common heart disorders can increase your risk for stroke. For example, irregular heartbeat (including atrial fibrillation which is thought to be the cause of 20% of strokes), heart valve defects, and enlarged heart chambers, can cause blood clots that may break loose and cause a stroke. Other heart conditions, such as coronary artery disease increases your risk for stroke because plaque builds up in the arteries and blocks the flow of oxygen-rich blood to the brain.

Diabetes. Diabetes mellitus increases ischemic stroke incidence at all ages, but those with diabetes tend to experience stroke at a younger age than those without diabetes. Talk with your health care team about ways to manage diabetes and control other risk factors.

Smoking. Current smokers have 2 to 4 times the risk of stroke that nonsmokers or those who have quit for more than 10 years have. Exposure to secondhand smoke also is a risk factor for stroke. Quitting smoking has been shown to reduce stroke risk across sex, race, and age groups.

Tips for Preventing Stroke

Eat a healthy diet. Be sure to include plenty of fresh fruits and vegetables. Eating foods low in saturated fat and cholesterol and high in fiber can help prevent high blood cholesterol. Limiting sodium in your diet can lower your blood pressure. For more information, visit CDC's Consume Less Sodium Web site.

Maintain a healthy weight. Being overweight or obese can increase your risk for stroke. To determine whether your weight is in a healthy range, doctors often calculate a number called the body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC's Healthy Weight Web site.

Be physically active. Physical activity can help you maintain a healthy weight and lower your cholesterol and blood pressure. The Surgeon General recommends that adults engage in moderate-intensity exercise for at least 30 minutes on most days of the week. Visit CDC's Physical Activity Web sitefor more information on being active.

Don't smoke. If you don't smoke, don't start. If you do smoke, quitting will lower your risk. Your doctor can suggest ways to help you quit. CDC's Office on Smoking and Health Web site has information on stopping smoking.

Limit alcohol use. Avoid drinking too much alcohol, which causes high blood pressure. For women, that means no more than one drink per day; for men, no more than two drinks per day. For more information, visit CDC's Alcohol and Public Health Web site.

Talk with your health care team. You and your doctor, nurse, pharmacist, and other health care professionals can work together to prevent or treat the medical conditions that lead to heart disease and stroke. Discuss your treatment plan regularly and bring a list of questions to your appointments.

Stroke: A Public Health Priority

Stroke is a major public health priority in the United States. In 2011, the federal government and private organizations launched Million Hearts®, a national initiative to prevent 1 million heart attacks and strokes by 2017. In addition to offering resources for consumers and health care professionals, the initiative produced a series of videos with heart attack and stroke survivors. In one video, José shares his story of the long road to recovery after a stroke. In another, Dr. Amie Hsia discusses knowing your risk factors for stroke.

The Paul Coverdell National Acute Stroke Registry was established to ensure that all Americans receive the highest quality of acute stroke care currently available. The program also aims to reduce the number of untimely deaths attributable to stroke, prevent stroke-related disability, and keep stroke patients from suffering recurrent strokes.

CDC has provided funding and technical assistance to 11 states to develop systems to collect data on patients experiencing an acute stroke, help analyze these data, and use those results to guide quality improvement interventions for acute stroke care. Funded states are working to improve the care given to patients experiencing a stroke from the onset of stroke symptoms to recovery and rehabilitation.
Another national initiative, Healthy People 2020 , has established goals regarding stroke prevention and treatment for the nation, including an objective to increase the number of adults who are aware of the early warning signs of a stroke and the importance of obtaining rapid emergency care by calling 9-1-1.

If you have risk factors for stroke, share this information with family and friends who can help in the event of an emergency. And take steps to lower your risk. Be aware, and take that first step today.

References

CDC. Awareness of stroke warning symptoms—13 states and the District of Columbia, 2005–2008. MMWR. 2008;57:481-5.

National Institute of Neurological Disorders and Stroke. Brain Basics: Preventing Stroke Web site[255 KB]. Accessed May 7, 2014.

Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, et al. Heart disease and stroke statistics—2014 update: a report from the American Heart Association. Circulation. 2014;128: e28-292.
CDC. Prevalence of stroke—United States, 2006–2010. MMWR. 2012;61:379-82.