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Stroke prevention discussed at ERHC forum

May 21, 2012

Photo by Colin Deppen – Julia Wonderling, M.D., spoke at a recent stroke prevention seminar held at the Education Center at Elk Regional Health Center during which she discussed the risk factors, contributing factors, and symptoms associated with strokes.

ST. MARYS - With May marking National Stroke Awareness Month, a recent seminar was held at the Education Center at Elk Regional Health Center in an attempt to raise awareness surrounding the risk factors, contributing factors, and symptoms associated with strokes.
Guest speaker Julia Wonderling M.D., an Emergency Department doctor with Elk Regional for five years, identified strokes as the fourth leading cause of death in the U.S. and one of the most common causes of nursing home placement; following a stroke, many people can no longer perform Activities of Daily Living (ADLs) in caring for themselves.
Wonderling said an estimated 700,000 individuals annually will experience their first stroke, with 20 percent of those being fatal within the first year. Thirty-one percent of people who have a stroke will no longer be able to perform perform ADLs, and 71 percent will not be unable to remain in the workforce.
Wonderling explained that a stroke (cerebrovascular accident or CVA) is the cessation of blood flow to a part of the brain.
"You have to kind of think of that as a 'brain attack.' When you think about a heart attack is when your heart isn't getting the blood it needs, the oxygen it needs. A brain attack, a stroke is the same thing-- just a different blockage," Wonderling said.
Wonderling said there are two primary types of strokes: ischemic and hemorrhagic. Ischemic strokes result from a blockage in the brain and hemorrhagic strokes result from bleeding in the brain.
Wonderling said that strokes are increasing, with projections claiming that by the year 2050 the number annually will have risen from 700,000 to over one million.
In an attempt to lessen the extent of the projected increase, medical professionals like Wonderling are hoping to increase recognition of both uncontrollable and controllable risk factors.
Wonderling identified uncontrollable risk factors as age, gender, race, and family history.
Males, African-Americans, or those with a family history of stroke or transient ischemic attack (TIA, also referred to as a mini-stroke) are at higher risk of stroke themselves. Those who have already experienced a TIA or stroke have a 40 percent greater chance of experiencing an additional, and usually much more serious, stroke. Wonderling also said that pre-existing conditions, including Fibromuscular Dysplasia and Patent Foramen Ovale (PFO) also increase the likelihood of a stroke.
As for controllable risks, Wonderling said these include hypertension, smoking, alcohol consumption, and diet.
"Know your risk factors and pay special attention to the ones you have control over," Wonderling said.
Wonderling said alcohol consumption in moderation equates to no more than one alcoholic drink a day most days a week for women and one and a half drinks for men.
"Anything more than that actually puts you at a higher risk for stroke, among many other diseases," Wonderling said.
Wonderling said that elevated cholesterol levels, while building up plaques in the heart, also build up plaques in the brain and increase the risk of stroke. She identified ideal total cholesterol as under 200 and LDL under 130, while acknowledging certain physicians may set different targets for different individuals.
Wonderling said while there is a high rate of stroke in Elk County, the same holds true for the rest of the country and in developing nations, noting a direct corollary to increases in the obesity rate.
"There is a lot in this area, but there is a lot everywhere-- especially in the more developed nations, our lifestyle contributes a lot to that. The obesity rate is up significantly and a lot of the modifiable risk factors are directly related to obesity," Wonderling said.

Pick up a copy of the Tuesday, May 22, 2012 edition of The Ridgway Record for more.

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