One morning a patient of mine came to see me. She was depressed. Her close friend had suffered from stroke and she could see how devastated this was to her friend and her family. She went on to share some of the good times she had with her friend. She obviously was very disturbed- sad, worried and scared. She wanted to know what her risks of having a stroke were.

Well, this is something that we all need to think about. Lets talk about some stroke facts.

Stroke ranks as the third leading killer in the United States. A stroke can be devastating to individuals and their families, robbing them of their independence. It is the most common cause of adult disability. Each year more than 700,000 Americans have a stroke, with about 160,000 dying from stroke-related causes.

What is a stroke?
A stroke is sometimes called a "brain attack." Most often, stroke occurs when blood flow to the brain stops because a clot blocks it. The brain cells in the immediate area begin to die because they stop getting the oxygen and nutrients they need to function. 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. 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.

Risk factors: What increases the risk of stroke? 
While family history of stroke plays a role in your risk, there are many risk factors you can control.

Hypertension
Blockage in the Carotid arteries that are the main arteries in the neck that supply blood to the brain, is the major risk factor for ischemic stroke.
Approximately 60 percent of strokes in men and women and of all ages are attributed to hypertension. Hypertension, which promotes the formation of atherosclerotic lesions (blockage in the blood vessels) of the carotid arteries, is the single most important treatable risk factor for stroke. 

Smoking
There is a large body of evidence showing increased risk of stroke with smoking. Smoking has been correlated with increases in atherosclerotic disease in carotid arteries.

Diabetes
Patients with diabetes mellitus have about twice the risk of ischemic stroke when compared to the general population. Cholesterol abnormalities, dysfunction of lining of blood vessels, and platelet and coagulation abnormalities are among the risk factors that may promote the development of carotid atherosclerosis (blockage of the main arteries in the neck that supply the brain) in diabetics.

Alcohol intake
Alcohol affects the risk of stroke in contradictory directions depending upon level of consumption. Light drinking (one to two drinks per day) appears to reduce risk, while heavy drinking increases risk.

Obesity
Studies have found that both an increased BMI (body mass index) ( 27 kg/m2) and weight gain after age 18 years are associated with an increased risk of ischemic stroke. 

Dyslipidemia
Both low levels of HDL-cholesterol (good cholesterol) and a high total-to-HDL-cholesterol ratio are risk factors for the development of carotid atherosclerosis, but epidemiological studies have not found a consistent relationship between cholesterol and the incidence of stroke. Nevertheless, multiple trials have shown that use of statins (cholesterol lowering medications) will reduce the occurrence of first and recurrent strokes by 21 to 29 percent. 

Other conditions that increase the risk of stroke are heart condition known as atrial fibrillation (with irregular heart beats) and sickle cell disease.

Take steps to reduce your stroke risk
· Managing your high blood pressure is the most important thing you can do to avoid stroke. 
· If you smoke, quit. 
· If you have diabetes, learn how to manage it. As with high blood pressure, diabetes usually causes no symptoms but it increases the chance of stroke. 
· If you are overweight, start maintaining a healthy diet and exercising regularly. 
It is important to understand that Stroke is an Emergency.

New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital within 60 minutes after symptoms start to prevent disability. Knowing stroke symptoms, calling 911 immediately, and getting to a hospital are critical. 

Know the Signs. Act in Time

Stroke Symptoms
· 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

What should you do?
Every minute counts. The longer blood flow is cut off to the brain, the greater the damage. The most common kind of stroke, ischemic stroke, can be treated with a drug that dissolves clots blocking the blood flow. The window of opportunity to start treating stroke patients is three hours. But a person needs to be at the hospital within 60 minutes of having a stroke to be evaluated and receive treatment.
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. 

*Disclaimer: The contents are meant for informative, educational purposes only. Formal recommendations can only be made by physicians involved in your care. Please check with your physician before acting on any part of this article.