“Experts say that fully 80% of all strokes are preventable. No kidding — 80%! “
HERE’S A NAME YOU DON’T HEAR EVERY DAY: Johann Jakob Wepfer. He was a Swiss pharmacologist and pathologist who lived from 1620 to 1695 — a remarkable life span for a person of that era. To put that in historical perspective, Dr. Wepfer died 75 years before Beethoven was even born.
He contributed many important things to the field of medicine. He was the first to warn us that arsenic and mercury and some other things that I can’t pronounce really aren’t good for us. But his most important contribution was his study of the vascular anatomy of the brain which led to our understanding of what causes stroke.
Some time around 400 B.C., Hippocrates, the father of western medicine and the man who gives his name to the Hippocratic Oath, first recognized stroke, which at that time was called apoplexy. Because doctors didn’t connect the condition with the brain, the cause of apoplexy remained a medical mystery for centuries.
It was not until the mid-1600s that Dr. Wepfer found that patients who died with apoplexy had bleeding in the brain. He also discovered that a blockage in one of the brain’s blood vessels could cause apoplexy, which eventually became known as stroke.
Today stroke is the Number 4 cause of death, and the leading cause of adult disability in the U.S. According to the National Stroke Association, each year in this country people suffer 795,000 strokes, 610,000 of which are first strokes. Stroke can happen to anyone at any time, regardless of race, sex or age.
The American Stroke Association says the chance of having a stroke approximately doubles for each decade of life after age 55. While stroke is common among the elderly, a lot of people under 65 also have strokes. My occasional coffee buddy John, who, back in the 90’s worked for a company across the street from my office in Palo Alto, had a crippling stroke at age 31, an event I’m sure he never anticipated.
Each year 55,000 more women than men suffer a stroke but experts say that is because women on average live about seven years longer than men, years during which they are more susceptible to stroke.
Strokes, sometimes called “brain attacks,” occur because of a sudden failure of the brain to receive the oxygen and nutrients it needs to thrive. This can happen for either of two reasons: a vessel leading to the brain is blocked or a vessel in the brain ruptures.
AT THIS POINT I’M TEMPTED to show how smart I am by defining the different kinds of strokes and proving that I can spell such exotic medical terms as ischemic and hemorrhagic. But a more productive approach would be to forget the lecture and instead say what we all can do to prevent stroke.
Here’s the really good news. Experts say that fully 80% of all strokes are preventable. No kidding — 80%! Think about that. If you buy a lottery ticket, your odds of winning the big one are as tiny as 1 in 127 million against you. But if you control your risk factors, the odds of avoiding a stroke are 8 to 10 in your favor. So why would you not do that?
Here are some risk factors you can control:
Blood Pressure. If your blood pressure is regularly about 120/80, it’s in great shape. If it’s regularly above 140/90, you’ve got a problem and should see your doctor to find out what to do about it. Diet, exercise and medication can help,
High Cholesterol. Every body needs cholesterol, but too much cholesterol in the bloodstream can clog arteries and lead to a stroke or heart attack. In addition to having an overall cholesterol reading of less that 200, you should have an HDL (good cholesterol) reading above 40, and an LDL (bad cholesterol) reading of less than 100. The best defense is a diet high in grains, fruits and vegetables, and low in saturated fat. In addition, your doctor can prescribe medications that can help lower your cholesterol.
Diabetes. If you’re a Type 2 diabetic keeping your blood glucose level in the low 100’s is essential. Weight loss alone can accomplish this in many people. Doctors can also prescribe medication.
Controllable lifestyle factors. Maintain an anti-stroke lifestyle: a heart-healthy diet, regular exercise, no smoking, little or no alcohol and using any medication your doctor prescribes.
While there are some risk factors you can’t control — age, gender, race, prior heart attack, and family history of stroke — there is much you can do to switch the odds in your favor.
Two million brain cells die every minute during stroke, increasing the risk of permanent brain damage, disability or death. If you can recognize the symptoms of stroke and act immediately, you may help to limit the disabilities the person will incur and you may even save that person’s life.
If you are in the presence of someone who is exhibiting symptoms of stroke, use the FAST method to do a layperson’s diagnosis.
Face. Ask the person to smile. Does one side of the face droop?
Arm. Ask the person to raise both arms. Does one arm drift downward?
Speech. Ask the person to repeat a simple sentence, such as, “Most grass is green.” Does the speech sound slurred or strange?
Time. If you observe any of these signs, it’s time to call 9-1-1 — immediately!
A FINAL FEW WORDS ABOUT JOHANN JAKOB WEPFER. Every year since 1990 stroke specialists have gathered for what is known as the European Stroke Conference. This year it was held in Venice and in previous years in London, Nice and elsewhere. In 2005 the conference began honoring one scientist annually with an award for, in the conference’s words, “outstanding scientific work in the field of cerebrovascular diseases and significant contributions to our knowledge about treatment of acute stroke.”
They named it the “Johann Jakob Wepfer Award” in recognition of the pioneering work Dr. Wepfer did more than 350 years ago. Dr. Wepfer’s name is not a household word, but among cerebrovascular scientists, he is revered as a giant.