glenn ellis

Glenn Ellis

*A stroke is serious – just like a heart attack. Yet, we don’t know as much about it enough as we should.

Each year in the United States, there are approximately 795,000 strokes. Five hundred thousand of these strokes are first occurrences, while the rest are repeat strokes. Stroke is the fourth leading cause of death in the country. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65 and the risk of having a stroke more than doubles each decade after the age of 55.

For African Americans, stroke is more common and more deadly – even in young and middle-aged adults – than for any ethnic or other racial group in the United States. In any given year, 100,000 African-Americans will have a stroke, and stroke is the third leading cause of death in the African-American community.

According to the National Stroke Association, stroke or heart disease will claim the lives of half of all African-American women. African-Americans have more severe strokes that are also more disabling.

Blood is circulating through your body all the time in tubes called arteries and veins. Usually, these blood vessels work fine and there’s no problem. That’s important because blood carries oxygen to all the cells in your body. And without oxygen, the cells would die.

A stroke can happen if something keeps the blood from flowing, as it should. A person might have a clogged blood vessel, so the blood can’t get through. Or a blood vessel may burst and a part of the brain is suddenly flooded with blood. Either way, with a stroke, brain cells die because they don’t get the oxygen they need.

There are two kinds of stroke. The most common kind of stroke, called ischemic stroke, is caused by a blood clot that blocks or plugs a blood vessel in the brain. The other kind of stroke, called hemorrhagic stroke, is caused by a blood vessel that breaks and bleeds into the brain.

On average, half the damage from a stroke happens within the first 90 minutes, 90 percent by three hours, and 99 percent by six hours. Yet the average person waits 22 hours to get help.

According to the National Institute of Neurological Diseases and Stroke (NINDS), the especially sensitive brain cells are gone within 10 to 15 minutes, but if the blood flow is only slowed down, not cut off completely, the less sensitive brain cells can ‘hold their breath’ for about three hours.

A University of Michigan study showed that a primary obstacle to care among African Americans was that they were less likely to arrive at the hospital in an ambulance than were whites. Only 20% to 25% of patients who are admitted to the hospital with a stroke arrive in the emergency department within 3 hours of the onset of symptoms.  Fewer than 9% of ischemic strokes receive treatment with tissue plasminogen activator (TPA), a blood thinner. This delay in evaluation in the emergency department was the documented reason why TPA was not administered to African Americans in the treatment of acute ischemic stroke.

Strokes caused by a blocked artery are more likely than those caused by a hemorrhage to leave a trickle of blood flowing to brain cells. That’s good news, because 70 percent of strokes in the U.S. are due to blocked arteries. These “ischemic” strokes usually occur when a blood clot gets stuck in an already-narrowed artery. That leaves time to dissolve the clot…but not much.

The best treatment for stroke is prevention. Some of the following risk factors are inherited, others are lifestyle-related and easier to change.

  • High blood pressure. This is risk factor number one for stroke, and up to 40 percent of African-Americans have the condition. “High blood pressure is more prevalent in African-Americans and not as well controlled, particularly where access to care is not great,” says Sacco.
  • Obesity. Nearly 63 percent of African-American men are overweight or obese, and that number jumps to just over 77 percent for women.
  • Diabetes. African-Americans are also more likely to have diabetes than Caucasians.
  • Tobacco use. Almost 28 percent of African-Americans use tobacco, one risk factor that can be reduced or eliminated by stopping the use of tobacco products or never starting in the first place.
  • Sickle cell anemia. The blood disease sickle cell anemia is a condition that primarily affects African-Americans. A stroke can occur if sickle- or abnormally-shaped blood cells create a blockage in a blood vessel.

If you smoke – quit. If you have high blood pressure, heart disease, diabetes, or high cholesterol, getting them under control – and keeping them under control – will greatly reduce your chances of having a stroke.

Stroke symptoms include:

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

Stroke damage in the brain can affect the entire body – resulting in mild to severe disabilities. These include paralysis, problems with thinking, problems with speaking, and emotional problems.

Because stroke injures the brain, you may not realize that you are having a stroke. The people around you might not know it either. Your family, friends, or neighbors may think you are confused. You may not be able to call 911 on your own. That’s why everyone should know the signs of stroke – and know how to act fast.

Don’t wait for the symptoms to improve or worsen. If you believe you are having a stroke – or someone you know is having a stroke – call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.

Remember, I’m not a doctor. I just sound like one.

Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.

Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. A health columnist and radio commentator who lectures, nationally and internationally on health related topics, Ellis is an active media contributor on Health Equity and Medical Ethics.

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