Live Right Live Well: Health & Fitness

Silent Stroke: Are You at Risk?

By Michael Castleman for Live Right Live Well

Silent Stroke: Are You at Risk?

Could you have a stroke and not know it? Researchers at Boston University School of Medicine recently discovered a condition they’ve dubbed “silent stroke” -- a stroke so subtle it rarely produces symptoms but can result in real (albeit minor) brain damage and presage full-blown stroke in the future. What’s more, silent stroke may be at least five times more common than full-blown stroke in people in their 40s, 50s and early 60s. But first, a little perspective.

Strokes Come in Different Sizes
Mention stroke and most people think of physical collapse, paralysis and often death. That’s true -- stroke is the nation’s third leading cause of death (after heart disease and cancer). But many strokes are more subtle. Mini-strokes, known as transient ischemic attacks or TIAs, typically strike people over 65, causing symptoms that come on suddenly, last only briefly and then clear up on their own. Symptoms of TIA include the following:

  • Dizziness
  • Confusion
  • Numbness or weakness in the limbs
  • Trouble walking
  • Difficulty speaking
  • Vision problems

If such symptoms come on suddenly, especially in an older person, they should not be ignored, as they may indicate a TIA, which is a major risk factor for full-blown stroke. Consult a doctor promptly.

Silent Stroke
An even more subtle condition, silent stroke rarely produces symptoms but can be detected using MRI brain scans. As part of the ongoing Framingham Heart Study, researchers at Boston University performed brain MRIs on 925 adults ages 42 to 74 and followed them for five years. During that time, 10.2 percent experienced silent stroke, including 2.4 percent of people in their 40s.

What’s important to keep in mind here is that it’s never too early to protect yourself from stroke. “Like TIA, silent strokes are a warning sign that a life-threatening stroke might be in the person’s future,” says study leader Dr. Jose Rafael Romero, a neurologist and assistant professor at Boston University. “Although they are very subtle, silent strokes may also cause enough brain damage to cause minor cognitive impairment and increase risk of dementia,” he adds.

How to Protect Yourself From Stroke

Romero says it would be impractical and prohibitively costly to screen everyone for silent stroke. The best course, he advises, is to maintain a healthy blood pressure level, since high blood pressure is the biggest risk factor for stroke. “Anytime anyone over 40 has a checkup, the doctor should measure blood pressure, and if it’s high, encourage lifestyle changes or drug treatment,” says Romero.

To keep your blood pressure in a healthy range and reduce your risk of any kind of stroke, aim for the following healthy lifestyle choices:

  • Get at least 30 minutes of exercise five days a week. A good start: two 15-minute walks a day (one during your lunch break and one after work).
  • Maintain a healthy weight.
  • Don’t smoke.
  • Eat at least 4.5 cups of fruits and vegetables each day -- ketchup and lettuce on your burger don’t count!
  • Limit salt -- no more than 1,500 mg of sodium a day. Keep in mind that up to 75 percent of the sodium people eat comes from processed food, not the saltshaker.  

Go easy on fatty meats, junk food, fried food and processed food. Occasional splurges are OK, but try to keep these foods to once or twice a week max.

Michael Castleman has been called "one of the nation's leading health writers" (Library Journal). He is the author of 11 consumer health books and more than 1,500 health articles for magazines and the Web. Michael is a frequent contributor to Live Right Live Well.

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