The Cooper Institute

Founded in 1970 by the "Father of Aerobics"
Kenneth H. Cooper MD, MPH


Stroke: A Frequently Preventable Cause of Disability and Death?

Posted in
Live well

Thursday, Feb 11, 2016

Stroke, which is also known as a cerebrovascular accident, is a form of cardiovascular disease that affects the arteries of the brain. A stroke occurs when an artery bringing oxygen and nutrients to the brain is blocked by plaque and blood clots (ischemic stroke), or when an artery in the brain bursts (hemorrhagic stroke). Approximately 795,000 strokes occur annually in the United States. Ischemic strokes account for about 87% of all strokes, while hemorrhagic strokes account for about 13%. In addition to being the leading cause of long-term disability, stroke also causes about 130,000 deaths annually in the U.S.1

Oftentimes, the person having the stroke is unaware of what is occurring. To compound this situation, many people are unaware of the warning signs of stroke, which is the major reason why only about 10% of all stroke victims obtain the best treatment available. It is not uncommon for several hours to elapse from the time the stroke occurs until the victim arrives in the emergency room. Half of all the damage caused by stroke occurs within the first 90 minutes, while 90% of the damage occurs during the first three hours. The warning signs of stroke include the following:

  • Sudden weakness or numbness of the face, arm, or leg on one side of the body
  • Sudden dimness or loss of vision, particularly in one eye
  • Loss of speech, trouble talking or understanding speech
  • Mental confusion; sudden loss of consciousness
  • Sudden severe headache with no known cause
  • Unexplained dizziness or sudden falls
Only 68% of the U.S. population is able to identify just one of these warning signs of stroke. Clearly, given the time parameters following a stroke noted above, the degree of disability and the number of deaths from stroke could be markedly reduced if the public was better able to recognize the warning signs and act (i.e., call 911) more quickly.

Can Strokes be Prevented?
Risk factors are behaviors or characteristics that increase the likelihood of disease. Some risk factors cannot be changed, while others can be changed by lifestyle modification or medication. Among the risk factors for stroke that cannot be changed are age, gender, family history of stroke, ethnicity, previous stroke, previous heart attack, and low birth weight. However, there are many risk factors for stroke that can be significantly improved by lifestyle modification or medication. These include:
  •  Hypertension
  •  Tobacco use
  •  Atrial fibrillation
  •  Obesity
  •  Presence of coronary heart disease
  •  Elevated LDL-cholesterol level
  •  Low HDL-cholesterol level
  •  Metabolic syndrome
  •  Diabetes
  •  Use of recreational drugs such as cocaine or amphetamines
  •  Carotid artery blockages
  •  Depression
  •  Chronic inflammation
  •  Sleep apnea
What About Exercise and Diet for Preventing Stroke?
In 2008, an important study utilizing Cooper Clinic patients was published in Stroke.2 After completing a medical exam including a maximal treadmill exercise test, a total of 46,405 apparently healthy men and 15,282 apparently healthy women were followed for an average of 17.5 and 16.3 years, respectively. A total of 692 strokes occurred among the men and 171 strokes occurred among the women. For both genders, the risk of stroke declined sharply across categories of cardiorespiratory fitness (CRF). For example, men who scored in the highest quartile of CRF were 40% less likely to experience stroke during the follow-up when compared to men in the lowest quartile. A very similar trend was seen in women.

From a dietary perspective, adherence to a Mediterranean-style diet high in olive oil, nuts, and other plant-based foods has been associated with a nearly 50% reduction in stroke risk when compared to a typical diet. Regular consumption of fatty fish is also associated with a significantly decreased risk of stroke; scientists speculate that omega-3 polyunsaturated fats that are found in fatty fish are responsible for this. Conversely, the Nurses’ Health Study showed that each 1 daily-serving-increase in sugar-sweetened soda was associated with a 13% increased risk of stroke.

So there you have it. Many strokes occur as a result of poor lifestyle, and are therefore, preventable. Furthermore, the number of stroke deaths and the degree of disability from non-fatal strokes could be greatly reduced if the public was more aware of the warning signs of stroke and summoned emergency help more quickly.

To learn more about nutrition, physical activity, healthy eating, and risk of chronic disease, take our Nutrition for Health and Fitness and/or Older Adults and Exercise course. You need not be a health and fitness professional to take these courses; the general public is always welcome to attend!

1. American Heart Association. (2015). Heart disease and stroke statistics-2015 update. Circulation. 131:e29-e322.
2. Hooker, S.P., et al. (2008). Cardiorespiratory fitness as a predictor of fatal and nonfatal stroke in asymptomatic women and men. Stroke. 39:2950-2957.