Change of heart
According to a disturbing new report from the Yale School of Medicine, our chances of suffering a stroke following a heart attack are much higher than doctors ever knew before – especially for patients 75 or older. In addition to age, the Yale scientists identified several other risk factors that can increase your chances of suffering a stroke – whether you’ve recently suffered a heart attack or not.
Are you at risk?
In this study, published in the journal Circulation, scientists analyzed stroke incidence among 111,023 Medicare patients. Their average age was 76, and all had suffered a heart attack in the last six months. The researchers found 2.5 percent of them had suffered a stroke within those six months – a much higher incidence rate than they expected. Not surprisingly, those with generally accepted stroke risk factors like hypertension, diabetes, and peripheral vascular disease were at even greater danger for a post-heart-attack stroke. Yet the researchers also noted an association with other, less recognized stroke risk factors, stating that “women, [black] patients, and patients with any frailty are at increased risk for a stroke after a heart attack.” (For this study, frailty was measured as experiencing dementia, incontinence, or the inability to walk alone.)
Overall, the study produced two important findings; as the authors wrote: “The incidence of stroke after MI (myocardial infarction) in older patients is higher than previously estimated, and the risk of stroke after MI increases proportionally with the number of identified risk factors present.”
Now this may not be earth-shattering news, but it is important. To put this information to work for you, you need to know what to look for – and what you can do about it. Unfortunately, other than a passing reference to daily aspirin therapy after discharge, this study doesn’t provide a whole lot of useful information on prevention.
Know the warning signs – and what you can do to protect yourself
But as we often say at HSI, knowledge is one of the best means of prevention. If you or someone you love has recently had a heart attack – especially if you or your loved one is over the age of 75 or is in one of the other high risk groups – learn these warning signs of stroke and be prepared to act immediately if any of them appear suddenly:
weakness or numbness of face, arm or leg, especially on one side of the body
- confusion, trouble speaking or understanding
- trouble seeing in one or both eyes
- trouble walking, dizziness, loss of balance or coordination
- severe headache with no known cause
If you notice any of these signs, call for help immediately. Some stroke procedures, such as the drug treatment called “clot-busting” (tissue plasminogen activator, or tPA), can only be performed within the first hours after a stroke. In the event of a transient ischemic attack (TIA), or “mini stroke,” the symptoms will pass quickly. But more than one-third of those who suffer a TIA will later have a stroke. If you or a family member is in one of the high risk groups for stroke, don’t take any chances: always seek prompt medical attention after observing ANY of the warning signs.
If you’ve recently had a heart attack, be sure to talk to your doctor about these new findings. And make stroke awareness part of your overall heart health regimen. At HSI, we’ve written many times about ways to improve your cardiovascular health and reduce your risk of heart attack AND stroke. To review past recommendations featured in the Members Alert and in e-Alerts, you can search by condition on our website at www.hsionline.com.
To Your Good Health,
Jenny Thompson
Health Sciences Institute
Sources:
Circulation 2002;105:1082-1087
American Heart Association (www.americanheart.org)
American Stroke Association (www.strokeassociation.org)
InteliHealth: (www.intelihealth.com)
Copyright 1997-2002 by Institute of Health Sciences, L.L.C.
