Stroke awareness: How early detection can save lives and reduce risk

May is Stroke Month, a time to raise awareness about stroke prevention, symptoms and recovery.

Stroke is a leading cause of death and disability, but timely recognition and treatment can significantly improve outcomes. A stroke occurs when there is a disruption in blood supply to the brain, either due to a blocked artery or a burst blood vessel. This lack of blood flow can cause brain cells to die, leading to permanent damage or even death.

Boulder Community Health (BCH) is proud to offer advanced stroke care through our Primary Stroke Center, certified by The Joint Commission and the American Heart Association/American Stroke Association. In this guide, we’ll cover key aspects of stroke care, the importance of early detection and how to reduce stroke risk, especially for women and individuals with specific heart conditions.

Recognizing stroke symptoms: The B.E.F.A.S.T. approach

When it comes to stroke, quick action can save lives. Every second counts in the event of a stroke, and recognizing the signs early can make all the difference in treatment and recovery. One of the most effective ways to identify a stroke is by using the BEFAST method. This simple acronym can help anyone spot the common signs of a stroke, even if they have no prior medical training.

What does B.E.F.A.S.T. stand for?

• B - Balance
  Look for sudden loss of balance or coordination. If someone is dizzy, stumbling, or has difficulty walking, it could be a sign of a stroke.

• E - Eyes
  Check for sudden vision problems. This could include blurred or double vision, or even the loss of vision in one or both eyes.

• F - Face
  Ask the person to smile. One side of their face may droop, or they might be unable to smile evenly. This is a key sign of a stroke.

• A - Arms
  Ask the person to raise both arms. If one arm drifts downward or they can't raise it at all, it could indicate a stroke.

• S - Speech
  Listen for slurred or garbled speech. If the person is having trouble speaking or understanding speech, it’s crucial to get help immediately.

• T - Time
  If you notice any of these symptoms, it’s time to act. Call 9-1-1 or your local emergency number immediately. Time is critical when treating a stroke, and the faster you can get the person medical attention, the better their chances for recovery.

Why B.E.F.A.S.T. matters

Knowing how to spot a stroke with the B.E.F.A.S.T. method empowers individuals to take immediate action and seek emergency care. Early treatment can reduce the risk of permanent damage, improving the chances of a full recovery. If you or someone you know is exhibiting any of these symptoms, don’t wait—call 9-1-1 for help right away.

Stroke risk and prevention for women: What you need to know

According to the American Heart Association, stroke is the third leading cause of death among women, claiming the lives of over 90,000 women each year. In fact, one in five women will experience a stroke in their lifetime, and each year, about 55,000 more women than men suffer from a stroke. It’s a critical issue, especially for certain groups of women who face an elevated risk. Understanding the risk factors and steps you can take to lower your chances of having a stroke is essential to better health and prevention.

Why women are at higher risk

Women face unique health challenges that can increase their risk of stroke. For instance, Black women have the highest prevalence of stroke among women, which highlights a significant area of concern. It's also important to note that strokes can present differently in women compared to men. Women are more likely to experience non-traditional symptoms, such as nausea, shortness of breath and fainting, which can delay recognition and treatment. The American Heart Association and Go Red for Women have provided valuable insights into specific risk factors and preventive measures for women:

Key risk factors for stroke in women:

• Pregnancy
  Pregnant women are at a higher risk of stroke, being three times more likely to experience a stroke compared to non-pregnant women of the same age.

• Preeclampsia
  This pregnancy complication, characterized by high blood pressure, doubles a woman's risk of stroke later in life.

• Birth control pills
  Women who use birth control pills may double their risk of stroke, particularly if they have high blood pressure. There are birth control options available that do not put women at a higher risk.

• Hormone replacement therapy (HRT)
  While HRT was once thought to reduce stroke risk in postmenopausal women, it has been shown not to lower stroke risk as previously believed.

• Migraines with aura and smoking
  Women who experience migraines with aura and who smoke are at a higher risk of stroke compared to those without these conditions.

• Atrial fibrillation
  This irregular heartbeat condition can increase stroke risk by five times, making it crucial for women with this condition to closely monitor their health.

Lowering stroke risk

The good news is that stroke risk can be reduced with proactive care and lifestyle changes. Here are some important steps women can take:

• Talk to your healthcare professional
  If you’re pregnant or planning to become pregnant, it’s crucial to discuss blood pressure management and medication options with your doctor. Make sure you understand the safest medications for high blood pressure during pregnancy.

• Monitor blood pressure
  For women taking birth control pills, it's important to get your blood pressure checked before starting and monitor it regularly, at least every six months. This will help you catch any changes early on that could increase stroke risk.

• Consider low-dose aspirin
  Women who are pregnant, particularly those at risk for preeclampsia, should talk to their healthcare provider about taking low-dose aspirin starting in the second trimester (week 12) to lower their risk of developing high blood pressure during pregnancy.

• Review hormone replacement therapy (HRT)
  If you're postmenopausal and considering hormone replacement therapy, it’s important to review the risks and benefits with your doctor to make an informed decision about whether it’s the right choice for you.

Take action now

Stroke is a preventable condition, and talking to your healthcare professional is the first step in lowering your risk. By understanding the factors that contribute to stroke and following prevention guidelines, women can take control of their health and reduce their chances of having a stroke.

Reducing stroke risk for some AFib patients

Taking care of heart problems can help prevent stroke. For example, atrial fibrillation (AFib) raises a person's risk for stroke by 500%, according to the American Stroke Association. This is because AFib can significantly decrease the heart’s pumping capacity which increases the risk of clots forming—particularly in the left atrial appendage (LAA), a small sac in the left atrium (the top left heart chamber). If a clot escapes and travels to another part of the body, it may limit blood supply to the brain and cause a stroke. Patent foramen ovale (PFO), an opening between the two upper chambers of the heart, can also cause blood clots.    

BCH’s Srini Iyengar, MD, Structural Heart & Valve Program Director at Boulder Heart, is one of the most experienced interventional cardiologists in Colorado performing minimally invasive, catheter-based procedures for reducing stroke risk from AFib and PFO. 

Blood-thinning medications, such as warfarin, can be an effective way to reduce stroke risk in AFib patients. However, there are potential barriers for certain individuals—primarily an increased risk of major bleeding, especially for older adults at high risk of falls. Additionally, people who enjoy an active lifestyle may want to avoid long-term use of blood-thinners due to concerns about bleeding in the event they sustain an injury while pursuing a favorite sport or activity. Finally, long-term use of blood-thinners requires frequent blood tests, dietary restrictions and high prescription costs. The WATCHMAN procedure could be the right alternative for some individuals. 

WATCHMAN implantation

Boulder Heart is proud to offer patients the WATCHMAN FLX™ Pro Left Atrial Appendage Closure (LAAC) Device. Dr. Iyengar's team at Foothills Hospital was the first in Colorado (full market release) in Feb. 2024 to implant this next-generation, updated device with three new features that advance performance and safety and ensure the best long-term outcomes. These features include a permanent device coating to promote faster healing time, an additional device size to treat the widest range of anatomies, and visualization markers to position and anchor the device with an enhanced level of accuracy. This technology is built upon the most studied and implanted LAAC device in the world. 

Dr. Iyengar has a 100% success rate for WATCHMAN implantation and is the highest volume Interventional Cardiologist in Colorado implanting WATCHMAN. The device, about the size of a quarter, is made from very light and compact materials commonly used in many other medical implants. Read more about WATCHMAN here.  

Primary Stroke Center

BCH has been awarded Advanced Certification as a Primary Stroke Center by The Joint Commission and the American Heart Association/American Stroke Association. This means we offer the latest in emergency treatments and diagnostic technology and have specially trained nurses and rehabilitation therapists to support stroke patients. Our program includes:

• Quick access to neurologists. Patients who arrive at our emergency department with signs of a stroke will be seen by a BCH neurologist, without waiting to be admitted to the hospital.

• Expedited care through Stroke Alert Protocol. Paramedics begin care in the ambulance and alert our stroke-care team so patients receive immediate treatment upon arrival at our Emergency Department.

• Specialized inpatient care. During your hospital stay, an experienced neurologist will direct your care and work closely with skilled nurses who have received extra stroke care education.

• Access to a caring support network. Boulder Community Health’s expansive Rehabilitation department offers important resources to stroke survivors who have some disability. Rehabilitation is an important part of full recovery, helping patients regain everyday skills that can be lost from a stroke. BCH has the most extensive rehabilitation resources in our area, providing customized therapy programs in the hospital and after you return home.

Understanding stroke symptoms, risk factors, and prevention measures is crucial for maintaining health, especially for women and those with specific heart conditions like AFib. Early detection and intervention can drastically improve recovery outcomes, and taking proactive steps to manage stroke risk is a powerful tool for better health. At Boulder Community Health, we are committed to providing the highest level of stroke care through our Primary Stroke Center, offering advanced treatment options and a robust support system to help patients recover. Don't wait—if you suspect a stroke, act immediately and call for help.

If you or someone you know is having a stroke, please call 9-1-1.