Dr. Sean Evans provides three tips to prevent a stroke.
The, certainly the most important three stroke tips for women are actually the same as the most important three stroke tips for anybody. It’s not smoking, it’s controlling blood pressure and controlling diabetes and so, I think the key thing is that the smoking is easy and obvious. People know that they are smoking; it’s making a decision, engaging for help, getting the resources they need to stop smoking.
The hypertension, the high blood pressure, and the diabetes, those are a little sneakier because they are things that often patients don’t have a lot of symptoms of, especially early on in the disease, and so those are good things to be talking about with your primary care doctor.
For women, especially younger women, often that’s actually their OB/GYN, and those are very reasonable topics to bring up, “Hey, are you screening me for diabetes? Are you screening me for hypertension? Are my stroke risk factors under good control?”
And if it’s something that the gynecologist feels comfortable with, they can do the primary screening and management, and if it’s something that’s gotten beyond their comfort zone, they can easily refer the woman on to a more qualified internist or to a neurologist with their special questions.
The important aspect of it is that better is always better, and so the problem is that sometimes people, they initially get a diagnosis of a stroke risk factor like hypertension, diabetes, and the initial response that they have with their doctor is good. They get some improvement and control; for example, their blood pressure goes from 150 down to 140, and sometimes the response is “That’s good enough.”
Well, what we really want to do with stroke prevention is it’s all about long-term numbers and long-term control, and so somebody who was at 150 with their blood pressure when they start, getting to 140 is a great first step, but where they want to go is to the lowest level of blood pressure that they can easily maintain and that they feel good on. And the current guidelines for blood pressure is about 120/70 providing the best protection against stroke, and so I am a big fan of making sure that patients and primary care doctors know that good isn’t good enough; we want the best possible care for that individual person.
About Dr. Evans, M.D.:
Dr. Evans joined the Neurosciences faculty in July 2005. Dr. Evans received a BS in Chemistry, Magna Cum Laude, from the University of Southern California, and a MD from UCSD. After a year of Internal Medicine training at Loma Linda Medical Center, he returned to UCSD for his residency in neurology. He has received several awards for academic excellence during his training and was the 25th Anniversary Scholar for the UCSD School of Medicine. He was named the valedictorian of UCSD’s National Center of Leadership in Academic Medicine’s class of 2006. He is a full-time clinical neurologist at the UCSD Neuroscience Center at Alvarado Hospital Medical Center.