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MAY 2012
Already a subscriber? Login for complete instant access. A difference of 10 or more points could signal peripheral artery disease. Roll up both sleeves the next time you check your blood pressure at home or have it measured by a health care provider. Why? A recent analysis of 20 different studies in which blood pressure was measured in both arms came to two noteworthy conclusions. First, people with arm-to-arm pressure differences of 15 points or more were twice as likely to have peripheral artery disease (PAD) compared with those who had similar readings in both arms. PAD occurs when vessels of the arms, legs, or other body parts beyond the heart and brain become clogged, usually from atherosclerosis, the buildup of fatty plaque that is also behind most heart attacks and strokes. Second, arm-to-arm pressure differences of 10 to 15 points or more also boosted the chances of having a stroke or dying from cardiovascular disease (The Lancet, published online Jan. 30, 2012).
Avoid caffeine, alcohol, and nicotine for 30 minutes before you take the reading.
Sit quietly for a few minutes with your feet on the floor before inflating the cuff. Rest your arm so your elbow is level with your heart, and wrap the cuff over the bare skin of your upper arm. Take two readings. If they're close, average them. If not, take a third reading and average the three. Repeat the procedure in the other arm
As seen on this MRI, a silent stroke involves small spots of damage to areas of the brain that are not directly associated with functions such as vision or speech. Yet researchers are finding these strokes can have an impact on memory.
Though a woman may not notice any immediate effects, a silent stroke could interrupt the flow of information in her brain needed for memory, especially if several of these strokes occur over time (which is the most common scenario). In a study published in the January 3 issue of the journal Neurology, researchers looked at more than 650 people without a history of dementia. Using MRI scans, the study authors tracked interruptions in blood supply to the participants' brains. More than 170 of the participants were found to have small areas of dead tissue from a lack of blood supply (called infarcts) in the brain, even though only 66 of them reported having had symptoms of a stroke. People with these brain infarcts had difficulties with memory and mental processes (cognition). The memory issues occurred independent of any shrinkage of the hippocampus (the part of the brain responsible for memory)which is typically seen with Alzheimer's and other forms of age-related memory loss. Researchers say that over time, the damage from silent strokes can accumulate, leading to more and more memory problems. "The more brain damage or injury that you have due to these silent strokes, the more difficult it is for the brain to function normally," Dr. Furie says.
During a regular ischemic stroke, a clot interrupts the flow of blood to part of the brain. Without oxygen-rich blood, that part of the brain dies, taking with it functions such as speech and movement.
High blood pressure High cholesterol Atherosclerosis Smoking High LDL ("bad") cholesterol Diabetes Obesity Sedentary lifestyle Atrial fibrillation
To lower your stroke risk, your doctor may recommend lifestyle changes (see box), or prescribe medicine to prevent a stroke, such as a drug that prevents blood clots from forming (such as Coumadin, aspirin, or others) or a cholesterol-lowering statin drug. If you're experiencing signs of memory loss, don't dismiss them as a normal part of aging. See your doctor for testing. It's also important to let your doctor know if you have a family history of memory loss and stroke. Because they live longer, women are more vulnerable to stroke, "so it is very important that they be aware that they're at risk, and make sure they've had an evaluation for vascular risk factors and cerebrovascular disease," Dr. Furie advises. "Women need to be very proactive about making sure that's addressed in the course of their routine medical exams."
Control your blood pressure by getting it checked regularly and taking blood pressure
medicine, if you need it. Limit salt to less than 1 teaspoon per day and follow the DASH eating plan, which has been shown to lower blood pressure about as much as medication in some people. (To learn more about this diet, visit: www.dashdiet.org/) Aim to keep your total cholesterol levels below 200 mg/dL, and your LDL cholesterol below 100 mg/dL. To help lower your cholesterol, lose weight if you're overweight, consume less than 200 milligrams of cholesterol daily, and increase the fiber in your diet (20 to 30 grams of fiber each day is ideal). Quit smoking. Smoking more than doubles your risk of a stroke. Talk to your doctor about nicotine-replacement products such as patches and gums, and medicines to help you quit. Watch your weight. Aim for a body mass index between 19 and 25 (calculate your BMI atwww.nhlbisupport.com/bmi). Eat at least 1.5 cups of fruit and 2.5 cups of vegetables a day and cut back on foods like red meat and sweets to keep your weight within a healthy range. Play tennis, swim, ride a bike, or take a brisk walk for 30 minutes a day, at least five days a week. A 2011 study in the journal Neurology found that getting regular, moderate to intense exercise can cut your risk of a silent stroke by 40 percent.