Maggie McKay (Host): The prospect of having a stroke is concerning, but the good news is there are stroke prevention strategies to use, if you know them. So today, Shellee Stine, Clinical Program Coordinator for the Primary Stroke Center at the University of Maryland Charles Regional Medical Center, joins us to tell us more.

Welcome to the Live Greater podcast series, information for a healthier you from the University of Maryland Medical System. I'm your host, Maggie McKay. Thank you so much for being here today, Shellee.

Shellee Stine, BSN, RN: Thank you for having me.

Host: So, what are the main risk factors for stroke that people should be aware of?

Shellee Stine, BSN, RN: So, the main risk factors for stroke are high blood pressure, high cholesterol, diabetes, alcohol consumption, cigarette usage and living a sedentary lifestyle.

Host: How can lifestyle modifications like diet and exercise, for example, help in preventing strokes?

Shellee Stine, BSN, RN: So when you start to change your diet and you start to change your exercise routine, you are changing your level of health overall. Getting out, moving every day, getting some cardio exercise when the doctor says that that's okay is very important, because it helps to stop heart disease. And when you are stopping the development of heart disease, you are increasing your ability to avoid having a stroke.

Host: Shellee, what role does high blood pressure play in stroke risk? How can it be managed effectively?

Shellee Stine, BSN, RN: So, the first thing that a person needs to do is talk to their primary care provider, and they need to discuss taking medications and what the recommendations from their provider are as to how much exercise they can have and safely do. And then, the next thing that they need to do is not only follow that advice from their provider, but start making some changes in their lifestyle when it comes to their diet, their exercise. And they can take little steps at first that will start to make a difference over time, such as choosing a leaner protein when they're eating, which would be substituting a hamburger with chicken or fish, something leaner, and they can also decrease their salt intake. Those type of steps will make a big deal in the long run and start making them feel better in the short run.

Host: Are there specific warning signs or symptoms that we should know that might indicate an increased risk of stroke?

Shellee Stine, BSN, RN: When a person is having a stroke, there are key symptoms that are seen. We use the mnemonic BE FAST in order to help spot a stroke, and it's what we teach in our community education. And BE FAST is B for balance, a person who's having some sudden onset of balance difficulties, dizziness, and/or headache. E is for eyes and vision, so they're having blurred vision in their eyes, they're having loss of vision in one eye or the other, or it could be both. F is for facial droop, so they develop a sudden onset of a facial droop. And A is for arm or leg weakness. S is speech, and this can be speech for confusion of understanding speech as well as speech for the ability to be able to articulate and actually give the spoken word. And then, T, T is for time. And that is call 911.

Host: And you don't necessarily have to have all those, right? Maybe you have three out of four.

Shellee Stine, BSN, RN: No, definitely not. If someone has just one of those symptoms and they're sudden onset, they need to call 911.

Host: Okay. And how does stress and mental health impact stroke prevention efforts?

Shellee Stine, BSN, RN: So, stress causes a lot of changes in your body. It can cause changes in your blood pressure, causing you to have high blood pressure. It can cause other stresses as far as if you have a lot of depression or anxiety, if you're struggling with an issue, you might not be making the choices that you need to make to stay healthy. You might not be getting the proper amount of sleep. You might not be choosing the proper diet. You may be going for the comfort foods instead of the healthier foods. You may be limiting your exercise because you just don't feel up to it. So, stress does play a very big part in a person's health and their ability to avoid risk factors for stroke.

Host: Shellee, let's talk about preventive measures. What are some for people with a family history of stroke?

Shellee Stine, BSN, RN: Okay. So if you have a family history of stroke, the thing to do is to find out what your risk factors are and so that way you can control the ones that are controllable. Some people have a family history of high blood pressure, so they tend to have higher blood pressure than the average person. So with that being something that they're aware of, that should be one of their focuses. If they have a family history of high cholesterol, where everyone in their family has unusually high cholesterol, that's one of the first things that they should start working on and then focus on any other risk factor that they may have. So that way, they can lower it. Because even with a family history of high cholesterol, you can take medications that will help interrupt some of that and lower their cholesterol, which lowers that risk. If they make sure that they don't have high blood pressure, or if they do have high blood pressure, that they manage it. If they have diabetes, that they manage it. So that way, the risk factors that they can control, they take command of and do control. Even with a hereditary link with stroke and high blood pressure and diabetes and high cholesterol, they can still control enough things to help limit their risk factor for stroke.

Host: And it's not a given that if your parents had a stroke, you're going to have one, right?

Shellee Stine, BSN, RN: Correct. It's not.

Host: Okay. So, let's talk about the importance of regular medical checkups in stroke prevention.

Shellee Stine, BSN, RN: So, I think that as adults, especially young adults, they don't necessarily go to the doctor as much as older adults do. Going to the provider is very important because you're going to get blood work. You're going to get your blood pressure taken. You're going to get the ability to discuss things that concern you that on the surface may not seem that important.

You may have signs and symptoms of diabetes and the signs and symptoms are what's bothering you, but you didn't put it together that you actually might have diabetes. So going to the doctor, even at a younger adult age on a regular basis is very important to find out what risk factors you have, what risk factors can be controlled, and what risk factors you can avoid.

Host: And in closing, Shellee, are there any key takeaways that you'd like to leave the listeners with?

Shellee Stine, BSN, RN: Yes. If you find that talking to your provider and looking at your medical history that you have an increased risk of stroke because of multiple risk factors, don't become overwhelmed. Follow up with your doctor first. Take their medical advice and then work on your lifestyle changes one step at a time. You can make a dietary change this week and continue it into the next week. But then, the next week add 10 minutes of walking and the next week add, "I'm now I'm going to change the fact that every afternoon I have a snack. Now, instead of an unhealthy snack, I'm going to have a healthier snack." All of this can be done in a step by step basis and still come up with the same results. You don't have to feel overwhelmed like you have to tackle everything at once.

Host: That's very good advice in life in general, actually. Well, this has been such useful information. Thank you so much for sharing your expertise.

Shellee Stine, BSN, RN: You're welcome. Thank you for having me.

Host: Absolutely. Again, that's Shellee Stine. To learn more and to find more shows just like this one, please visit umms.org/podcast and on YouTube. I'm Maggie McKay. Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. We look forward to you joining us again and please share this on your social media.