You may have read prior discussions of stroke and malpractice, and may now know the symptoms to look for. So, what causes a stroke? Knowing the cause of a stroke is critical for identifying the problematic risk factors. The fact is, many of the risk factors for stroke are modifiable. It is up to the provider to identify these risk factors and discuss with her patient their significance.
Significant modifiable risk factors include hypertension, tobacco, heart disease, diabetes, obesity, and mediations. Risk factors like age, genetics, gender, and race are considered non preventable risk factors. Keep in mind, these are only partial lists.
So, if most strokes are of the ischemic kind (clots), then it makes sense that treating modifiable risk factors focuses on decreasing the incidence of clot formation. Hypertension causes clots because the pressure accumulating in arteries causes clots to form as blood cells pile up. Nicotine raises your heart rate, and tobacco smoke causes platelets to stick together and reduces the amount of oxygen in your blood. Heart disease is a risk factor because irregularities in heartbeat, defective heart valves, and arthrosclerosis can cause clots to form. Diabetes injures your blood vessels, and obesity causes inflammation from excess fatty tissue. Finally, some medications, like blood thinners, may decrease the risk of ischemic stroke, but too much and the patient is at risk for a hemorrhagic stroke. Certain medications like low-dose estrogen birth control pills can increase the risk of stroke.
Where the risk factors are modifiable, it is up to the patient’s provider to discuss the conditions, treatment options, and develop a treatment plan. Some conditions, though, go unaddressed by overworked or inattentive providers. For example, hypertension (higher than 140/90) is a leading preventable cause of stroke. Failing to identify hypertension, and failing to work with the patient to identify the causes of stress and get the patient on blood pressure medication, may open the provider to liability. Similarly, failing to get a patient on a treatment regimen for a condition like Afib may needlessly expose a patient to heightened risk of stroke.
The best treatment may well be prevention, so having a provider properly identify and address risk factors is a critical way to prevent a devastating stroke.
