Wednesday 23 Jul 2014

Information and opinions presented here do not always represent the views of the American Heart Association.

Improving health can also improve, extend life after a stroke

Published: 2:40 pm CDT, April 28, 2014

Seven health factors deemed “the fountain of youth” for preventing heart disease and stroke can also greatly improve and extend the lives of people who have already had a stroke, according to two research abstracts presented this week at the American Academy of Neurology’s annual meeting.

Called “Life’s Simple 7,” the factors were determined as essential for good health. They include:  not smoking; regular physical activity; healthy diet; healthy weight and maintenance of good levels of cholesterol, blood pressure and glucose.

Behavioral change is difficult, especially for someone who has had a stroke, said Amytis Towfighi, M.D., lead author of the studies and associate chief medical officer and chair of the department of neurology at the Rancho Amigos National Rehabilitation Center in Los Angeles.

However, stroke can spur survivors to make positive changes.

“One of the things about having a stroke is that it’s such a life-changing moment. If you can reach individuals right after the stroke and help them develop different routines and habits, they’re more motivated,” said Towfighi, also associate professor of neurology at the University of Southern California in Los Angeles. “They realize their lifestyle may have impacted their lives, so it’s a golden opportunity to get them to change.”

In the first study, researchers looked at the health factors of stroke survivors, including changes over time and factors influencing their health. They used a sample of 1,293 U.S. adults who participated in the National Health and Nutrition Examination Survey from 1988-2010.

Based on achieving Life’s Simple 7, people are in ideal health only if they meet all seven health factors, according to the AHA. In this study, however, the proportion of the unhealthiest stroke survivors — those who met no health factors or only met one — grew from 18 percent in 1994 to 34 percent in 2010, according to researchers.

The odds of having a low health score was nearly four times higher in blacks, more than three times more likely for the poorest people and three times more likely for those with a high school education or less.

In looking at the seven health factors during the 22-year study, the percentage of stroke survivors with high cholesterol dropped substantially. But the proportion with obesity increased. Here are changes for each health factor:

  • High cholesterol: 40 percent to 16 percent
  • Prediabetes or diabetes: 51 percent to 42 percent
  • High blood pressure: 43 percent to 35 percent
  • Never smoked: 38 percent to 42 percent
  • Ideal physical activity: 20 percent to 17 percent
  • Eating a healthy diet: 22 percent to 13 percent
  • Obesity: 29 percent to 43 percent

In a separate study, researchers found that the more of the seven health factors stroke survivors met, the longer they lived. They took a sample of 649 adults who had strokes and participated in NHANES during 1988-1994.

Those who met four or more health factors had significantly lower 10-year death rates than those who met none or only one factor.

Ten-year death rates per number of health factors that were met were:

  • 57 percent: zero to one factors
  • 48 percent: two factors
  • 43 percent: three factors
  • 36 percent: four factors
  • 30 percent: five or more factors

The association between health factors met and death rates continued after researchers adjusted the results for age, sex, race, income and education.

Because less than 1 percent of survivors in both studies met all seven health factors, researchers concluded that more programs are needed to improve their health.

“Community-based interventions work best that take into account people’s lives and lifestyle. You have to look at individual barriers and obstacles,” Towfighi said. “Programs that are culturally appropriate and best fit into people’s lives are better than hospital-based programs not tailored to people.”

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