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Stroke (falij) and its prevention

“Doctor sahib , meray walid sahib ka falij behtar to ho jayega na!”

Pleas like these while being heart-wrenching, also raise many questions.Paucity of public health awareness websites add to the lack of knowledge which general public possess .The age old and time tested “prevention is better than cure” holds true for most general health conditions.

Stroke is unfortunately very prevalent in Pakistan owing to the stress, unhealthy lifestyle and poor dietary habits that plague our nation. Knowing what an actual diagnosis of “Stroke” entails and ways to prevent its occurrence can go a long way in reducing its impact. 

So what is a stroke (falij)? 

A Stroke occurs when blood stops going to a part of the brain. It can be referred to as “Brain Attack” much like the “heart attack” we all fear.

Broadly speaking, stroke can be divided into two types. The “ischemic” (occlusive) stroke occurs when the oxygen-rich blood supply to part of your brain is reduced and the “hemorrhagic” (bleeding) stroke occurs when there is bleeding in the brain.


After about 4 minutes without blood and oxygen, brain cells become damaged and may die. The body tries to restore blood and oxygen to the cells by enlarging other blood channels (arteries) near the affected area.

If blood supply isn’t restored, permanent damage usually ensues. The body parts controlled by those damaged cells stop functioning appropriately .

The degree of loss of function varies from mild to very severe and can be temporary or permanent.

Additionally, the location, extent and how quickly the blood supply was restored determine the eventual damage including life-threatehing complications.

No matter how big the initial disability is, getting urgent medical attention is of paramount importance.

Certain risk factors can increase your chances of having a stroke. If you have identified personal risk factors, work with your healthcare provider to reduce your personal risk.


Eating habits, physical activity, smoking and drinking are examples of lifestyle stroke risk factors. Lifestyle risk factors are habits or behaviors people choose to engage in. If changed, they can directly affect some medical risk factors by improving them.

1:Lose weight

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.We must aim to keep our body mass index (BMI) at 25 or less.

Tips to achieve it:

  • Limit or avoid saturated and trans fats.
  • Try to eat no more than 2,000 calories a day (For an average build person with reasonable physical activity level).
  • Increase the amount of exercise you do with such activities as walking, golfing, or playing cricket.

2:Exercise more

Exercise helps in losing weight and lowering blood pressure and sugar levels, but it also stands on its own as an independent stroke reducer. One study published in 2012 found that women who walked three hours a week were less likely to have a stroke than women who didn’t walk. We must aim to exercise at a moderate intensity at least five days a week.

Tips to achieve the target:

  • Do regular morning walks after breakfast.
  • Join a gym with friends.
  • Try taking stairs instead of an elevator when you can.
  • If you don’t have 30 consecutive minutes to exercise, break it up into 10- to 15-minute sessions a few times each day.

3 :Moderation of alcohol intake:

Although drinking can make you less likely to have a stroke, it’s benefits extend to a point. “Studies show that if you have about one drink per day, your risk may be lower,” according to Dr. Rost. (Harvard) “Once you start drinking more than two drinks per day, your risk goes up very sharply.”

How to achieve it:

  • Have one glass of alcohol a day.
  • Make red wine your first choice, because it contains resveratrol, which is thought to protect the heart and brain.
  • Watch your portion sizes. A standard-sized drink is a 5-ounce glass of wine, 12-ounce beer, or 1.5-ounce glass of hard liquor.
  • Your doctors can guide you through this treatment.

4: Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Your goal must be to quit smoking.


Things that can help:

  • Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.
  • Don’t give up. Most smokers take several tries to quit. See each failed attempt as bringing you one step closer to successfully beating the habit.



High blood pressure, atrial fibrillation (Afib), high cholesterol, diabetes and circulation problems are all or medical risk factors for stroke and can be controlled.  Learn more about identifying and treating these medical risk factors. 

 1:Lower blood pressure

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. “High blood pressure is the biggest contributor to the risk of stroke in both men and women.We must aim to maintain a blood pressure of less than 120 (top number) over less than 80 (bottom number).

Measures we can take:

  • Avoid high-cholesterol foods, such as burgers, cheese, and ice cream.
  • Get more exercise—at least 30 minutes of activity a day, and more, if possible.
  • Reduce the salt in your diet to no more than 1,500 milligrams a day (about a half teaspoon).
  • Eat 4 to 5 cups of fruits and vegetables every day, fish two to three times a week, and several daily servings of whole grains and low-fat dairy.
  • Quit smoking
  • Strictly adhere to blood pressure medicines (if prescribed).

2: Treat diabetes

Having high blood sugar over time damages blood vessels, making clots more likely to form inside them.

Keep your blood sugar under control can help you reduce the risk of a stroke.

How to improve Diabetic control:

  • Monitor your blood sugar as directed by your doctor.
  • Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

3:Take aspirin 75 mg once daily (if appropriate)

Aspirin is often hailed as a wonder drug, thanks to its ability to help stave off heart attacks and clot-caused strokes. But fewer than half of people who could benefit from a daily low-dose aspirin take it, while many others take it when they shouldn’t.

A landmark women health study found that women over age 65 who take a daily baby aspirin lower their stroke risk. Aspirin helps by preventing blood clots from forming.

How to achieve it:

  • First talk to your doctor to make sure aspirin is safe and appropriate for you to take.
  • If you have a bleeding disorder, you may need to reduce your dose to every other day or avoid this regimen altogether.

4:Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. Atrial fibrillation carries almost a fivefold risk of stroke.

How to treat it:

  • If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.
  • You may need to take blood thinners such as high-dose aspirin, warfarin or some of the newer agents (NOACs) to reduce your stroke risk from atrial fibrillation.

Having a stroke is a life altering experience. While the overall incidence, risk factors and outcomesfor stroke are different in women than in men, attention to risk reduction has the potential to reduce these disparities .Discuss prevention, recovery, and more with experts who understand and try to follow their advice.

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