A head-to-toe checkup

Today, Duncan Reid is a busy lawyer who enjoys books and photography. With his love of learning, Duncan is also looking forward to going back to university when he retires to complete a PhD.

It was a much different story five years ago when Duncan suffered a near fatal stroke at the age of only 51.

With a family history of stroke, Duncan knew he was also at risk. “I always hoped that I wouldn’t be the next stroke victim,” says Duncan. “But one morning, I awoke feeling achy and tired, as though I had the flu. Later at work, I couldn’t pick up a pen to sign a letter and I recalled how my father could not lift a spoon the day he had suffered a stroke. Although I didn’t want to admit what was happening to me, I went immediately to the hospital.” Duncan is one of the 50,000 Canadians each year who experience a stroke and about 30,000 who survive.

The most common cause of stroke — as well as heart attack and peripheral arterial disease (PAD) — is a disease called atherothrombosis. Although nearly 12 million people worldwide die every year from diseases associated with atherothrombosis, few Canadians know much about this life-threatening condition. In fact, atherothmbosis-related illness is predicted to be the leading cause of death worldwide in 2020.

It Can Start with a Small Blood Clot
So what is atherothrombosis? Atherothrombosis is a lifelong disease that affects the body’s network of blood vessels. It occurs when a blood clot forms on fatty deposits in the inside wall of an artery in the heart, brain or leg. This is dangerous because if the clot grows and blocks an artery, blood stops flowing and the tissue is starved of oxygen and the nutrients it needs.

If blood flow is not restored in time, atherothrombosis can result in life-threatening consequences, permanently damaging the brain, the heart and even the legs. In many cases, the damage is so extensive that death can occur. This is why atherothrombosis can be said to affect the body from head to toe.

Stroke: Every Second Counts
Atherothrombosis will result in an ischemic stroke when a blood clot blocks the artery supplying the brain and reduces or cuts off the blood flow. After the age of 55, the risk of having a stroke doubles every 10 years. Also, a stroke survivor has a 20 per cent chance of having another stroke within two years.

For someone suffering a stroke, quick reaction is pivotal — chances of survival significantly increase if the person seeks medical help at an early stage of its occurrence.

A stroke often leaves a debilitating impact on different brain functions. For example, stroke has affected Duncan’s memory and the left side of his face — his speech and his smile. But not being able to smile fully does not prevent Duncan from being positive. “After my episode, I was determined to spend Christmas with my family and I was released from the hospital a week after my stroke,” recalls Duncan.

Duncan is fortunate. Besides impacting the ability to see, move, speak or remember, in many cases, suffering a stroke can also damage a part of the brain affecting emotions, personality and behaviours.

If you experience any of the following symptoms, seek immediate medical help. The sooner you receive help, the higher are your chances of survival. The warning signs of stroke include:
• Sudden weakness or paralysis of the face, arm or leg.
• Sudden loss of vision, particularly in one eye.
• Sudden severe headache.
• Unexplained dizziness.
• Loss of speech; difficulty talking or understanding language.

Heart Attack: Fast Action is the Best Weapon
Atherothrombosis also plays the central role in causing a heart attack. “Atherothrombosis occurs in arteries in several parts of the body at the same time, but when a blood clot suddenly blocks blood flow to the heart, it can cause a heart attack,” explains Dr. Milan Gupta, Chief of Cardiology at the William Osler Health Centre. “This risk is much higher in elderly people, particularly those with additional risk factors.” Similar to stroke, fast action is the best weapon against the serious consequences of a heart attack.

On average, Canadians wait almost five hours before deciding to get help; this reduces their chances of survival. Indeed, half of all heart attack deaths in Canada occur within two hours after the beginning of the heart attack and/or before the victim reaches the hospital.

Peripheral Arterial Disease: A Walking Threat
Although not immediately life-threatening, peripheral arterial disease (PAD) can result in life-threatening consequences. In fact, patients with PAD are six times more likely to die from a heart attack or stroke compared to those without PAD.

PAD is caused by poor circulation in the legs. Arteries often become narrowed and blocked due to atherothrombosis, preventing enough blood from getting to the muscles. This causes a cramping muscle pain in the calves, thighs or buttocks, often falsely mistaken for a sign of aging.

Take Charge of Your Health
Atherothrombosis poses an ongoing risk for future potentially life-threatening events. However, everyone can do something to protect their health, as there are risk factors that can be changed to help prevent the development of atherothrombosis. Some people need to control their cholesterol levels or high blood pressure, others need to modify their eating habits or reduce alcohol intake.

Duncan understands that controlling his blood pressure is a very important part of preventing another stroke. Although still an active lawyer, part-time judge and Chair of the Stroke Recovery Network (a peer-led support group for stroke survivors and caregivers), Duncan has also learned that managing his stress level will improve his chances of living a long life.

“I have learned to pace myself. I go on with my life but listen to my body, live healthier and rely on my medication,” explains Duncan.

Recovery and Therapy
Recovery from a stroke or heart attack can be very challenging for sufferers and their families. The greatest concern for those who have survived either a stroke or a heart attack is to prevent another one. In the case of PAD sufferers, the possibility of a stroke or heart attack remains the greatest concern.

In addition to lifestyle modifications, there are effective therapies, which reduce the risk of further atherothrombotic events. Duncan is taking an antiplatelet agent proven to help keep platelets (particles of blood) from sticking together and forming clots, which helps keep the blood flowing.

“I am fortunate to have a second chance, but anybody can be a victim of a heart attack or stroke,” says Duncan. “Because I have been able to take responsibility for my well-being, I can see a more healthy future – and a PhD after my name!”

The recognizable warning signs of a heart attack include:
• Chest pain and squeezing, heaviness or pressure discomfort.
• Discomfort in the neck, jaw, shoulders, arms or back.
• Difficulty breathing.
• Nausea.
• Sweating.
• Fear or anxiety.

Lifestyle changes to prevent events caused by atherothrombosis
Research has shown that lifestyle changes can significantly lower the risk of atherothrombosis. If you have PAD or are at known risk of a stroke or heart attack, you can take these steps to improve your symptoms and reduce your risk:
• Stop smoking.
• Find a good way to manage stress levels.
• Maintain a healthy weight.
• Manage your blood pressure and cholesterol.
• Control your blood sugar if you have diabetes.
• Speak with your physician regarding an exercise program.

For reliable information on atherothrombosis or related diseases, check out these sources:
• The Heart and Stroke Foundation Canada – www.heartandstroke.ca
• Stroke Recovery Network – www.srn.ca (residents outside of Ontario, please call: 1-888-540-6666 for stroke recovery services in your province)
• Atherothrombosis.com – www.atherothrombosis.com
• Understanding PAD – www.understandingpad.com
• Vascular Disease Foundation – www.VDF.org

This Special Sponsored Feature was produced by the editors of 50Plus magazine in co-operation with Sanofi-Synthelabo.