By Crystal Welch, HHQI RN Project Coordinator
World Stroke Day is observed on October 29th as an effort to bring public awareness to the seriousness and incidence of stoke worldwide.
In 2013, HHQI was tasked by the Centers for Medicare & Medicaid Services (CMS) to develop new resources that would help home health agencies contribute to the national Million Hearts® initiative’s goal of preventing 1 million heart attacks and strokes in the United States by 2017. We jumped at the opportunity to create new Best Practice Intervention Packages (BPIPs) on the ABCS of preventive cardiovascular care and to develop an online data registry that would help home health agencies track the impact of their improvement efforts.
The ABCS are the pillars of preventive cardiovascular care — Aspirin as Appropriate, Blood Pressure Control, Cholesterol Management, and Smoking Cessation. By developing resources, tools and partnerships that focus on improvements in these four areas, the national Million Hearts® initiative has already made great strides in dramatically reducing heart disease in this country.
There are many factors that can increase the risk for a heart attack or stroke. Knowing the risk factors is the first step to improving cardiovascular health.
- Age – after the age of 55 your risk doubles every 10 years
- Family history of a stroke
- African Americans are the ethnic group at highest risk
- Women are at a higher risk for stroke than men; this is the opposite to the incidence of heart attacks where men are at a higher risk
- Medical conditions from the neck up that increase your risk include prior stroke, TIA or “mini-strokes,” or carotid artery disease (the arteries in your neck that supply the brain with blood) – conditions from the neck down that increase your risk include high blood pressure, diabetes, coronary artery disease, heart attack, heart failure, other heart disease or any other artery disease, Sickle Cell disease and high cholesterol levels.
- Users of tobacco, alcohol, and drugs
- Lack of physical activity, being overweight, and poor
Signs of a stroke can include one or more of the following:
- The face droops to one side
- Sudden numbness or weakness in one or both arms, legs, or one side of the face
- Confusion or trouble understanding
- Vision issues in one or both eyes
- Difficulty walking, being unsteady on your feet, or even falling
- Severe headache with no reason
- Slurred speech
FAST is an easy way to remember the symptoms of a stroke and what to do about it.
- F – Face drooping
- A – Arm weakness
- S – Speech difficulty
- T Time to call 911
For more information and resources on patient self-management for stroke, take a look at HHQI’s Best Practice Intervention Packages (BPIP’s):
- Cardiovascular Health Part 1: Aspirin as Appropriate & Blood Pressure Control
- Cardiovascular Health Part 2: Cholesterol Management & Smoking Cessation
Maintaining a healthy, low-sodium diet that is high in fruits and vegetables and keeping blood pressure low can reduce risks for heart attack and stroke. The DASH (Dietary Approaches to Stop Hypertension) diet is a low-sodium diet endorsed by the following organizations:
- National Heart, Lung, and Blood Institute (one of the National Institutes of Health of the U.S. Department of Health and Human Services)
- American Heart Association (AHA)
- 2010 Dietary Guidelines for Americans
- S. Guidelines for Treatment of High Blood Pressure
- 2011 AHA Treatment Guidelines for Women
- Mayo Clinic
The DASH diet emphasizes vegetables, fruit and low-fat dairy foods and moderate amounts of whole grains, fish, poultry and nuts. In addition to the standard DASH diet, there is also a lower-sodium version of the diet. You and your doctor can choose the version of the diet that best meets your health needs:
- Standard DASH Diet: You can consume up to 2,300 milligrams (mg) of sodium per day.
- Lower sodium DASH Diet: You can consume up to 1,500 mg of sodium per day.
Both versions of the DASH diet aim to reduce the amount of sodium in your diet compared with what you might get in a more traditional diet, which can amount to 3,500 mg of sodium per day or more.
For more information on lowering you blood pressure with DASH, visit:
HHQI developed a patient video titled “Are you at Risk for a Heart Attack or Stoke?” Watch on YouTube and has a patient workbook My Healthy Heart Workbook – also available in Spanish: Mi libro de trabajo para un corazón sano