Neurology and Men's Health: Stroke

By William Alexander

Our third entry in our “Neurology and Men’s Health” series focuses on the leading neurological killer of men and women alike--stroke. Every year, more than 55,000 men die from stroke, and thousands of others experience permanent disability. In this interview Stroke Fellow Aaron Loochtan, DO, discusses stroke’s impact on men, including its among younger men, how men and women can reduce their risk of stroke while improving their health, and how recognizing a stroke quickly can save nearly 2 million brain cells a minute.

How much of a health concern is stroke for men?
Stroke remains a leading cause of disability and death for men and women. For men it is the fifth-leading cause of death. It is a major health concern because the most common causes of stroke (diabetes, hypertension, tobacco abuse, hyperlipidemia, etc.) are common in both men and women. However, men may be less prone to seek healthcare advice regularly as compared to women.

Are there any ways in which symptoms, progression, or recovery from stroke differs for men compared to women?
Symptoms and progression are for the most part similar between men and women. However, there is recent evidence that women actually may have a worse recovery as compared to men after stroke. Additionally, stroke is more common in men for most age groups but after age 85 stroke is much more common in women. Recovery in this age group may be more limited by some factors more common to women such as osteoporosis.  

What men are most at risk for stroke?
Hispanic men and African American males are at a higher risk of stroke and death from stroke than Caucasian males. All men with uncontrolled risk factors are at a higher risk for stroke than their healthy counterparts. The modifiable risk factors such as tobacco, cocaine and excess alcohol definitely put men who use these substances at higher risk. The other risk factors such as high blood pressure, high cholesterol and diabetes increase ones risk. Lastly, men with atrial fibrillation and heart failure are at a higher risk for stroke.

Strokes are also becoming increasingly common for younger men. What are the reasons for this increase, and what can be done about it?
Again, risk factor modification is key. A lot of our younger male patients have strokes secondary to uncontrolled risk factors. We are seeing heavier patients or younger patients with diabetes, hypertension and hyperlipidemia. A sedentary lifestyle, poor diet and lack of exercise makes all of these things worse and hence leads to stroke and cardiovascular disease at a younger age.
Education about proper diet, nutrition and the importance of regular exercise is a start. Also, education about the importance of regularly seeking health care would also be beneficial. Other young men suffer from stroke due to extra-cranial cervical artery dissections. One particular group at risk is men who participate in activities that put excess tension/extension on the vasculature of their neck (ie extreme sports, weight lifting, etc). Education about the risk of these injuries may help prevent this rare cause of stroke. Lastly, young men with sickle cell disease are at a higher risk of stroke.

What are some things that men (and women) can do to reduce their risk of stroke or protect their health?
Diet, exercise, see a physician regularly and abstain from smoking. We often recommend diets high in vegetables and fruits with low fats and lean protein. Stress relief is also important whether it be via exercise, relaxation techniques or other modalities. Acute stress can cause acute changes in blood pressure which can increase one’s risk for stroke. Lastly, being knowledgeable about the signs of stroke and educating others can help direct patients and their loved ones to the emergency department as soon as possible where we can provide life saving interventions.  A 2006 article in Stroke estimates that for very minute in which a large stroke is untreated, the average patient loses 1.9 million neurons, 13.8 billion synapses and 12 km (7 miles) of axonal fibers!

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