Alcohol Consumption Linked to Stroke Risk

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Welcome to the show. This is your Weekly Dose of Wellness. I'm Deborah Howell, and today's guest is Angie West, the director of the Stroke Center and division of interventional neuroradiology program at Long Beach Memorial. She's responsible for developing educational programs and stroke competencies to educate employees, patients, and their families about stroke, risk factors, and secondary stroke prevention. Welcome, Angie.

Angie West, RN: Thank you so much. Welcome, it's nice to be here.

Deborah Howell (Host): It's wonderful to have you. And you know, a lot of people still don't know that regularly drinking large amounts of alcohol really greatly increases a person's risk of stroke. So today we're going to try to get some good information out about how we can help prevent this.

Angie West, RN: That sounds good. Thanks.

Deborah Howell (Host): Let's start from the beginning. What exactly is a stroke?

Angie West, RN: Well, a stroke happens in your brain and it happens when an area of your brain doesn't get blood supply, and the blood supply carries oxygen and glucose. So your brain can't do without oxygen or glucose, or the sugar. And so if you have a blocked artery and blood can't get to an area of your brain, then that would be considered a stroke. Or if you have an artery in your brain that ruptures, that would also be considered a stroke. Any part of your brain that doesn't get oxygen or glucose, that would be considered a stroke.

Deborah Howell (Host): I love it, you put it right in a nutshell and make it so easy to understand.

Angie West, RN: Thanks.

Deborah Howell (Host): Now, research shows that drinking large amounts of alcohol can greatly increase a person's risk of having a stroke. And why is that?

Angie West, RN: Well, I actually did a little extra research on this last night. And what alcohol does is it actually increases your blood pressure, which is a huge risk factor or a huge reason for people to have strokes. So drinking large amounts of alcohol increases your blood pressure, and that's a big risk factor for having a stroke. It also makes your blood thinner.

Deborah Howell (Host): Mmhmm.

Angie West, RN: And so when your blood is thinner, and you have high blood pressure, it increases your risk for a hemorrhagic stroke or bleeding into the brain. So that's actually the worst kind of stroke and it increases your risk for that one.

Deborah Howell (Host): I'm supposing a lot of people listening are thinking, okay, what is a large amount for women and what is a large amount of alcohol for men?

Angie West, RN: Well, the American Heart Association is where I'm going to reference this information. And they recommend one or two drinks a day for a man, and only one drink a day for a woman. I don't understand what the reasoning is for men getting to have an extra drink, but that's what they recommend…

Deborah Howell (Host): That’s so unfair!

Angie West, RN: It is unfair! And one drink equals 12 ounces of beer, or 4 ounces of wine, or an ounce and a half of some other kind of hard liquor. So you know, my wine glass is a pretty big wine glass...

Deborah Howell (Host): That's what I was gonna say!

Angie West, RN: ...it doesn't mean that I get a whole glass of wine.

Deborah Howell (Host): And in restaurants sometimes they have these huge red wine glasses, and we're not really aware that we're probably getting a glass and a half.

Angie West, RN: Right, so it's a pretty small amount, and actually the American Heart Association allows that once a day, so that's fine. In the research it actually does show that small amounts of alcohol in moderation like those amounts can actually help your risk for stroke. So very small amounts of alcohol are a good thing. Doesn't mean if you're not a drinker to go out and start drinking. But small amounts of alcohol are okay. But it's the large amounts that are not okay. And just as a caveat, you can't save them up during the week and drink them all on the weekend. That doesn't work either.

Deborah Howell (Host): Because people are, humans are humans, they're gonna do what they can, right?

Angie West, RN: Absolutely, we'll try and rationalize to work it out, of course.

Deborah Howell (Host): Yeah. So you're a guy and you've got the guys over on the couch and you're cracking the beers and you know, I mean, maybe there are some tips that you can share, you know, to help people cut back on their alcohol intake?

Angie West, RN: Well, there are a few tips and I did a little bit of extra research on this one as well. One of the things, and I joked with my husband about this last night was, look at the cost-benefit analysis on the drinking because, you know, depending on what you like to drink, think of how much money you're spending on the alcohol, and whether that's really what you want to spend your money on. And then some of the other ideas were to set a goal and try and decrease your alcohol each day, and set a goal while you're not drinking as to how much you would like to reduce your drinking. Add the fact that your alcohol intake is a risk for stroke. And then look at what your other risk factors are, which I know we're going to talk about in a minute, but do you really want to throw in that extra risk factor that can cause a stroke when it's something that's very controllable?

Deborah Howell (Host): Right, and preventable.

Angie West, RN: Yeah, and then one of the other ideas is, a lot of people use drinking as a stress or coping mechanism. And there's many other things that can help deal with your stress, and you know, increase your exercise, eat healthy, avoid stress as best as you can. One thing that somebody actually suggested which I thought was great is if you're a beer drinker or even a wine drinker, make sure you drink a full glass of water in between every glass or bottle of alcohol and that will help decrease your intake.

Deborah Howell (Host): That'll take you to the end of the football game and...

Angie West, RN: Yes, exactly, it cuts it in half.

Deborah Howell (Host): Also, I'd like to add something. You know, they have such great, like, Buckler beer now is a wonderful tasting non-alcohol beer. So if you still want to be with the guys and do the peer thing, you know, just the non-alcoholic beers are wonderful these days. And there's even some non-alcoholic wine.

Angie West, RN: Absolutely, absolutely, very good suggestion.

Deborah Howell (Host): So let's talk about some of those other stroke risk factors that people should be aware of.

Angie West, RN: Well, I mentioned the hypertension, and that's probably one of the worst risk factors or the worst causes for strokes. And there's so many people that don't even know that they have high blood pressure.

Deborah Howell (Host): Right.

Angie West, RN: And the people that do know that they have high blood pressure and are going to the physicians to treat their high blood pressure don't monitor it, don't ever reach the goal of not having high blood pressure. They'll be on two or three meds and it still runs a little bit high. We really need to be very aggressive about getting our blood pressure under control.

Deborah Howell (Host): Right.

Angie West, RN: Second risk factor or reason that would cause strokes is cholesterol. And it builds up in your vessels, in your arteries. That plaque builds up in your arteries, and I mentioned when you have a stroke it's the arteries that are feeding your brain. And as that plaque builds up in those arteries, the vessel gets smaller and smaller until it closes off altogether.

Deborah Howell (Host): Right.

Angie West, RN: So we can control our cholesterol by how we eat and how much we exercise. Diabetes is another cause for stroke. And diabetes is one of those, you can't cure it, but what you can do is keep your blood sugar under control. And so if someone is a diabetic, they just need to keep their blood sugar lower. If your blood sugar, if you walk around with a high blood sugar as a diabetic, it causes your blood to be thicker and stickier. And it also damages the inside of the vessels. And so, you know, you partner that up with the cholesterol and high blood pressure, which damages the vessels, you're just building, your every risk factor that you have just builds the, increases your risk for the stroke.

Deborah Howell (Host): Right. And let me just stop you there. On the diabetes front, wine versus beer, beer has a lot less sugar than wine, correct?

Angie West, RN: It does, you know, the thing with a diabetic is it's about choices. And so if you prefer wine, then you build it into your carb counts and your sugar counts for the day. And so you can manipulate what you eat in order to get what you want. Enjoy what you want if you will, and still be able to control it. But yes, wine has more sugar. But beer has a ton of carbs, and the carbs... those carbohydrates turn to sugar. So...

Deborah Howell (Host): Okay.

Angie West, RN: Yeah.

Deborah Howell (Host): All right. Now if someone is at high risk for a stroke, what should they do?

Angie West, RN: Well, you control the things that you can control. Which I mentioned most of them. Lowering your alcohol intake to reduce stroke. If you're a diabetic, then keep your blood sugar down. When you go to the doctor and your blood pressure's high, you need to find out where your blood pressure should be, and then have a blood pressure cuff at home and check it every few days or once a week. You need to take ownership of your own body and control the things that you can control. The one that's the magic to control everything is exercise. So healthy eating and exercise will control most of the risk for stroke. Just eat healthy and in small amounts, and eat lots of fruits and vegetables. Just follow a very basic healthy diet and exercise every day. Don't smoke. Smoking is a huge risk factor for stroke, and control your blood pressure. You can pretty much prevent most strokes. American Heart Association says 80% of strokes could be prevented. That's 80% is just huge.

Deborah Howell (Host): Wow. That is staggering.

Angie West, RN: Yeah, it really is. And those 80% that can be, are usually from the people that have strokes from not controlling these things that are controllable.

Deborah Howell (Host): Okay. And then speaking of strokes, we need to just quickly go over the signs of stroke.

Angie West, RN: Well, that's easy. If you think BE FAST for stroke. Okay, so the first BE, the B is for balance. And that is if you have a stroke in your cerebellum in the back of your brain that controls your balance. E is for eyes. And if you have a stroke in your occipital lobe again towards the back of your brain, you can have blurred vision or double vision or visual field cuts. So any kind of problems with your eyes. And then F is facial droop. And the A is arm or leg weakness or numbness, and it's usually on one side of the body. Speech is the S. So speech difficulties, either difficulty speaking or understanding speech. And the T is for time. I really want everybody to understand out there that there are things we can do to reverse your stroke if you get to the hospital fast enough. So many people have stroke signs and there's no pain involved, and they'll go and lay down and take a nap.

Deborah Howell (Host): Right.

Angie West, RN: And if that happens when they wake up, they've had a massive stroke, a long time has gone by, and there's not much we can do when they come to the hospital. If you have any of these signs, think BE FAST for stroke. So balance, eye problems, facial droop, arm or leg weakness or numbness on one side of the body, speech problems. And then the 911 is, pick up the phone and call 911 and take an ambulance, tell them you're having a stroke. And in LA and Orange County they will take you to a stroke center. The ambulances know where the stroke centers are and they'll take you to a stroke center.

Deborah Howell (Host): Time is brain.

Angie West, RN: Time is brain. You are absolutely right.

Deborah Howell (Host): So Angie, where can people call to get more information on the stroke program and support groups available at Long Beach Memorial?

Angie West, RN: Well, the main line to call here at Long Beach Memorial for the stroke program is 562-933-4006. That actually is a direct line to my office, and if anyone were to call in, I could get them whatever it is that they need. If they want information on stroke, they want further education, they want support group information, anything that they would need, I would be able to mail it out or give them the information over the phone.

Deborah Howell (Host): Can't ask for more than that. Thank you so much, Angie, for coming on the show today. We really learned a lot.

Angie West, RN: Well, my pleasure. I appreciate the opportunity to get the word out to people, and maybe save lives.

Deborah Howell (Host): Fingers crossed, or prevent strokes. Now to learn more, to listen to a podcast of this show, please visit memorialcare.org. I'm Deborah Howell, join us again next time as we explore another Weekly Dose of Wellness. Have yourself a fantastic day and BE FAST.