Stroke: Uncontrollable vs. Controllable Risk Factors

Today I met a 46 year old woman who was admitted to the hospital because she had a small stroke. I was asked to see her to assess her language and thinking skills, to see what kind of support she needed to transition back home. One of my favorite evaluation questions to learn more about a person's communication and verbal organization skills is: "What kinds of things do you like to cook? Tell me how you make a ______." Let's just say she didn't mention many vegetables in her response.

I am asked to work with a stroke patient under the age of 65 a few times per month, sometimes two in one week. This is far TOO OFTEN, in my opinion.

Read the National Stroke Association literature and you will find that there are a number of risk factors. They divide these seventeen risk factors into "controllable" and "uncontrollable" risk factors. In fact, I wonder if nearly all of the risk factors are controllable. For example, "Family History": I wonder if this is judged to be a risk factor because if healthful food and lifestyle choices are not a priority in a person's family, they are more likely to inherit that outlook around health and therefore more likely to have diabetes, hence a stroke. "A Previous Stroke", I'd argue, could have been prevented. Even "Race" is likely related to SES, education, and access to healthy foods.

See the NSA's Risk Factors Below:

Controllable Risk Factors:

• High Blood Pressure
• Atrial Fibrillation
• High Cholesterol
• Diabetes
• Atherosclerosis
• Circulation Problems
• Tobacco Use and Smoking
• Alcohol Use
• Physical Inactivity
• Obesity 

Uncontrollable Risk Factors:

• Age
• Gender
• Race
• Family History
• Previous Stroke or TIA 
• Fibromuscular Dysplasia
• Patent Foramen Ovale (PFO or Hole in the Heart)

Cited from: http://www.stroke.org/site/PageServer?pagename=risk

Controlling these controllable risk factors can seem mysterious to many. The prevalence of the Standard American Diet (SAD), marketing of processed food as "health food," and the limited access to education about health are all working against us.

But there is hope! Education, accountability, and moving toward a less-processed, plant-based diet for each of us are important first steps.