Exercise, Stress Management May Reduce Stroke Risk and Severity

Recent stroke research recommends a lifestyle that promotes blood pressure control.

If you exercise at least a few hours a week and find ways to manage your stress, you are both lowering your risk of a stroke and raising the odds of a healthy outcome in case you do have a stroke.

Of course, you certainly want to avoid what is sometimes referred to as a “brain attack”Ñeven a mild oneÑbut a study out of Sweden suggests you may be able to help protect yourself if a stroke occurs. The research, published in the American Academy of Neurology journal Neurology, found that people who engage in light-to-moderate exercise, such as walking, at least four hours a week have much less severe strokes than people who are inactive.

“You don’t have to do much to reduce the severity of a stroke,” says neurologist Jonathan Rosand, MD, medical director of the Neuroscience Intensive Care Unit, Massachusetts General Hospital. “Four hours a week is not a lot. That’s good news.”

Hypertension and the Brain

Dr. Rosand, who was not involved in the Neurology study, adds that the research underscores the importance of maintaining good health as the years advance and your risk of stroke increases. In particular, you want to keep your blood pressure under controlÑa goal that exercise can help you meet.

High blood pressure (hypertension) can lead to white matter changes in the brain. White matter lies in the deeper parts of the brain and contains nerve fibers, which are extensions of nerve cells (neurons). Myelin is the thin sheath that envelopes the nerve fibers and gives the region its white appearance. The changes wrought by hypertension include a wearing away of the myelin and permanent damage to the nerve fibers within.

“High blood pressure damages the brain silently over time,” Dr. Rosand explains. “You want as little silent brain damage done before the damage isn’t silent.” Dr. Rosand adds that people with more “silent brain damage” have more severe strokes.”

Stress and High Blood Pressure

In a different study out of Australia, published in the journal Future Neurology, researchers found that mindfulness interventions (tai chi, yoga, meditation, etc.) can help reduce blood pressure and blood glucose levelsÑboth risk factors for strokeÑand therefore reduce stroke risk.

“Mindfulness meditation does help reduce blood pressure,” Dr. Rosand says. “It doesn’t necessarily replace the need for medications, but it can reduce the number of medications needed to control blood pressure.”

Scientists are still uncovering clues at the molecular level about how de-stressing and relaxation techniques actually bring down inflammation, and in so doing help reduce blood pressure. But research has shown and continues to show that, among other consequences, stress triggers a “fight-or-flight” response in the body that causes inflammation, a spike in blood pressure, and a faster heart rate.

How you can achieve mindfulness and relaxation is less important than that you make the effort to find a healthy de-stress that works for you. If tai chi, an ancient Chinese martial art that focuses on slow, deliberate moves, concentration, breathing and balance, isn’t your cup of tea, that’s okay. Dr. Rosand says that there are a lot of ways to reduce your stress.

Taking a brisk walk every day or playing tennis a few times a week can help lower stress and improve your fitness. Regular exercise provides several benefits, including blood pressure and cholesterol reduction, as well as weight control, which also helps manage or prevent type 2 diabetes.

“What I advise folks is finding what works for you,” Dr. Rosand says. “There are many different methods. It could be regular yoga, runningÑyou’ll know it when you get it. You’ll miss doing it if you stop for some reason.”

Medications and More

Of course, reducing your stroke risk requires more than exercise and stress-management practices. While those are two critically important pieces of the puzzle, there are some other choices necessary to protect yourself against a potentially life-threatening cerebrovascular event.

In addition to things like smoking cessation and maintaining a healthy weight, blood pressure control often depends on taking your anti-hypertensive medications as prescribed.

Dr. Rosand notes that people often associate taking a pill with being sick. But since high blood pressure usually presents no symptoms, there is a tendency among many individuals with hypertension to stop taking their medications because they feel fine.

“We have a big problem with people not taking their medications,” Dr. Rosand says. “Persuading patients and doctors to take blood pressure treatment adequately is a challenge, but it’s one we can’t ignore.”

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