Stress

• Complicated grief
• Relaxation techniques: Breath control helps quell errant stress response
• Anger: Heartbreaking at any age
• What to do about excessive sweating?
• Post-traumatic stress disorder
• Stress tests for the heart: What happens after exercise just as important as what happens during
• Dealing with grief and bereavement
• New guidelines for stroke prevention

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New guidelines for stroke prevention

With more than 700,000 Americans having strokes each year, doctors and patients need to focus on stroke prevention. In light of this, the American Heart Association (AHA) has issued a statement that details how to identify and modify risk factors. Here are the AHA's tips, along with other general guidelines for lowering stroke risk:

Blood pressure. You should get your blood pressure checked at least every two years because many people with high blood pressure don't even know they have it (130–139 mm Hg systolic pressure over 85–89 diastolic pressure is considered high-normal, while anything above 140 over 90 is considered high). If you have high blood pressure, the following lifestyle changes can help lower it:

• Eat more fruits and vegetables. Potassium-rich foods like bananas and oranges may be especially good.
• Pass on salt. Salt makes the body hold onto water, and the heart has to work harder to pump the extra fluid.
• Lose weight. The heavier you are, the harder your heart has to work to pump blood to all parts of your body.
• Exercise. Even if you don't need to lose weight, exercise can reduce high blood pressure and may even prevent it.
• Limit your alcohol. Having more than two alcoholic drinks a day significantly increases your risk of high blood pressure.
• Quit smoking. Smoking increases your risk of heart attack, as well as many other diseases. And if you live with a smoker, make sure he or she quenches his cravings outside. Exposure to secondhand smoke can double your risk of stroke.
• Learn to relax. Various kinds of behavioral therapy, like biofeedback, yoga, and tai chi may lower blood pressure.

These lifestyle changes can also help with other causes of stroke, like
atherosclerosis (hardening of the arteries) and high cholesterol. If the changes don't lower your blood pressure, your doctor may prescribe a medication such as a diuretic or beta blocker.

Other conditions. The AHA recommends that patients with diabetes and children with sickle cell disease closely monitor their blood pressure with screenings every six months.

Non-modifiable risk factors. Black, Hispanic, Chinese, and Japanese people are at increased risk for stroke compared to whites. Men and postmenopausal women are also at higher risks than others. If one of your parents had a stroke, you are at greater risk as well, either because of genetics or shared lifestyle traits.

While you can't do anything about non-modifiable risk factors it's helpful to know if you fall into a high-risk group so you can carefully monitor controllable factors.

July 2002 Update

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