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steps to push back against stroke risk amid the pandemic

dr. gordon ko offers advice about living well during lockdowns and endless time online.

three steps to push back against stroke risk during the pandemic
three tips to keep in mind during stroke awareness month. getty
“you’ve got to eat right, move more, sleep better,” explains dr. gordon ko, a physiatrist and medical director at the canadian centre for integrative medicine.

june is stroke awareness month, where conversation turns to preventing strokes and other cerebrovascular diseases, one of the leading causes of death in canada. this year the topic is particularly important as the covid-19 pandemic has caused skyrocketing levels of stress and has kept many people essentially housebound. many health agencies have also become concerned that people experiencing signs of stroke or heart attack have been avoiding emergency rooms out of concern over the virus.

in canada, stroke, the most common of all cerebrovascular diseases, was the fourth leading cause of death in 2019, accounting for 13,660 deaths in just one year. more than 62,000 strokes occur each year, meaning that every five to ten minutes someone, somewhere in canada is experiencing a stroke, according to a 2019 report by the heart and stroke foundation. it is believed that more than 405,000 people in canada are currently living with the effects of a stroke.

the most common type of stroke, accounting for approximately 85 per cent of all cases, is called ischemic stroke, where a blood clot restriction the flow of blood through the brain. in the remaining 15 per cent of cases, the blood clot causes a blood vessel in the brain to rupture, which is known as a hemorrhagic stroke.

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canadian society for exercise physiology

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get in your exercise, but don’t overdo it.
being housebound for much of the day can wreak havoc on physical health.

“i’m worried with the pandemic, everybody’s zooming online, doing stuff from home…that’s like prepping a person for stroke,” says ko.

the american college of sports medicine (acsm) recommends that, unless advised otherwise by a healthcare professional, adults under the age of 65 years should participate in moderate intensity cardio for a minimum of 30 minutes five days per week, or vigorous intensity cardio for a minimum of 20 minutes three days per week. the acsm also recommends general strength training that engages all major muscle groups — don’t skip leg day! — twice a week.

however, ko warns that there is an upper limit to how hard you should be working out, especially as you age.
“there’s a paradox where if you overtrain, like say you’re pushing yourself doing marathons and stuff like that, then you actually increase your risk of overdoing it,” he explains.

going from being predominantly sedentary, as is the case with many of us during the various stay-at-home orders, to an intense work-out session can also create more risk than is necessary.

one way to ensure you are getting a good workout without overdoing it is to monitor your heart rate. one rule of thumb is the karvonen formula , which uses a concept called the “heart rate reserve” to determine target heart rate zones based on age. light-intensity exercise is defined as 30 to 40 per cent of the heart rate reserve, moderate-intensity exercise using 40 to 60 per cent, and vigorous-intensity activity using 60 to 90 per cent.

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calculators for the karvonen formula are available online. you can also speak to a doctor to determine your target heart rate based on age and health history.
for those who don’t own a heart rate monitor, a good bet is to work out at a level where you can talk but not sing, says ko.

whole food, plant-based diets
a diet full of plant-based foods like greens, whole grains, and beans, and lower in added sugars and refined grains is associated with lower risk of stroke, cardiovascular disease and diabetes, according to a study from the harvard t.h. chan school of public health.

the study looked at health and diet data from more than 200,000 men and women from the nurses’ health study (nhs), nhsii and health professionals follow-up study. all participants were without cardiovascular disease and cancer at the start of their study. over the period of the study the researchers found that following a healthy, plant-based diet was correlated with a ten per cent reduced risk of overall stroke.

however, for the effect to be present, participants needed a healthy plant-based diet. diets that were largely plant based but included refined sugars and carbs did not see this preventative effect.

check in with your doctor regularly
hypertension, or high blood pressure, is one of the biggest risk factors for stroke. this is because high blood pressure puts extra strain on the blood vessels, which can cause them to become stiff and narrow, a condition known as atherosclerosis. when plaque begins to build up, it’s more likely to cause a blockage.

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heart disease is the second most prevalent risk factor for stroke, which is not surprising since many forms of heart disease share similar risk factors, according to johns hopkins medicine. other risk factors, like smoking, drinking too much and living with diabetes also play a role.

and in case you are wondering what the best way is navigate these risks, ko advises canadians to make sure they get regular medical checkups.

emjones@postmedia.com@jonesyjourn

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