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Can Aspirin Help
If My Mother Died of a Stroke at Age 63?

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

This article originally appeared on page 13 in the February 14-15, 2004 issue of
The Mississauga News under the feature: Health & Wellness, Doctor's Corner.

There are two basic types of stroke. Hemorrhagic stroke causes brain death when a blood vessel bursts and no longer supplies a portion of the brain. Ischemic stroke is the result of a small clot which lodges in a vessel and prevents the flow of oxygen rich blood to an area of the brain. These should be differentiated from a TIA (transient ischemic attack) which essentially is a mini or warning stroke. TIAs have many stroke features which resolve within a short period of time.

A complete assessment of all your risk factors and your health should be done to determine which strategy could help reduce your chances of getting a stroke. Some risk factors are open to change while others are not. We tend to use various scales to come up with a relative risk number. This is simply a probability, because in life nothing is for certain. Age is one factor. 70% of strokes occur after age 65. Men are at greater risk, but the risk for women increases after menopause. Certain ethnic groups are also more prone to strokes. Having a family history of strokes is another risk factor. It also follows that having one stroke puts you at higher risk for another one. Similarly, other health problems such as diabetes put you at higher risk. People with heart problems such as atrial fibrillation are at increased risk of debris or thrombus being liberated from corroded valves and traveling to the brain. Yet others have clotting problems which should be identified and controlled.

There are also risk factors which you can modify. Hypertension is one example. Two-thirds of strokes occur in hypertensive individuals. Controlling your blood pressure lowers your risk. Smoking is a major modifiable risk factor. The evil weed increases your chances by 40-60%. Combine smoking with the birth control pill and it gets worse. Excessive alcohol consumption, defined as more than two drinks daily, can cause weight gain, hypertension, and cholesterol elevation all leading to elevation of your stroke risk. Elevated blood lipids and cholesterol harden the arteries by forming plaques on the inner surfaces. Fragments of these plaques can break off and cause ischemic strokes. Some street drugs such as cocaine and speed can cause strokes as can some herbs and over the counter cold medications. Lack of regular exercise may also double your risk. Long plane rides in cramped quarters and neck manipulations have now entered the risk factor debate arena. These are all things that can be changed before you need to start thinking about taking medication.

My advice is to get your health checked out and discuss the potential benefits of aspirin with your doctor. In the meantime, learn to recognize the early signs of stroke. They can be confusing and often not clear-cut. Things happen suddenly: loss of speech, sever headache, vision changes, dizziness, numbness, tingling or loss of use of an arm or leg. There may be an inability to understand people, confusion or change in consciousness. The key is quick action. In the short span of my career, I have seen almost miracle like cures in some cases where the conditions were right. Trillium Health Centre was the first local institution to start using clot-busting drugs in ischemic stroke victims to produce complete resolution in some people. But success lies in early recognition and seeking help within the first few hours before the brain is irreversibly damaged.


Related resources:

Know Stroke. Know the Signs. Act in Time. - from National Institute of Neurological Disorders and Stroke.

Stroke.

Stroke Warning Signs.

Stroke Risk Factors.

Types of Strokes from Texas Heart Institute.

Stroke (Hemorrhagic).

Hemorrhagic Stroke from Merck.

Stroke (Ischemic, Thrombotic, Embolic, and Transient Ischemic Attack) from Life Extension Foundation.

Transient Ischemic Attack from MedlinePlus.

Aspirin and stroke from Bandolier, an independent journal about evidence-based healthcare in UK.

Aspirin to prevent heart attack and stroke: what's the right dose? By James Dalen, University of Arizona, Tucson.

Low doses of aspirin may help some prevent stroke from CNN.com.

Aspirin to Prevent Blood Clots from Clinical Guidance, PRODIGY, UK.

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