7 STEPS TO REDUCE STROKE RISK

By BILL GOTTLIEB

A man's last years ought to be spent strapped to the fighting chair of a game-fisher while battling a black marlin, not tethered to a nursing-home bed, incontinent and unable to talk.

But the latter is a likely scenario if you're one of approximately 600,000 Americans who will have a stroke this year.

"Your chance of dying is 20 percent-but you have a 40 percent chance of being disabled and a 25 percent chance of being severely disabled," says Dr. David Spence, director of the stroke-prevention center at the Robarts Research Institute in Canada.

An ischemic stroke—the kind that affects most men—occurs when an artery to the brain is blocked by arterial plaque that has broken loose and caused a blood clot. In fact, it's just like a heart attack, only instead of heart cells dying for lack of blood, brain cells are kicking off-thousands of brain cells. Perhaps paralyzing half of your body. Or slurring your speech. Or plunging you into senility.

But a "brain attack" is not inevitable.

"Fifty to 80 percent of strokes can be prevented," says Dr. David Wiebers, a professor of neurology at the Mayo Clinic and author of Stroke-Free for Life. "Making the simple choices at 25, 35, or 45 years of age can make an enormous difference in preventing stroke when you're in your 60s, 70s, or 80s."

Swallow Nature's Blood Thinner

Loma Linda University researchers found that men who drank five or more 8-ounce glasses of water daily cut their stroke risk by 53 percent compared with guys who drank fewer than three glasses. Water helps to thin the blood, which in turn makes it less likely to form clots, explains Jackie Chan, Dr.P.H., the lead study author.

But don't chug your extra H2O all at once.

"You need to drink water throughout the day to keep your blood thin, starting with a glass or two in the morning," adds Dr. Chan.

Swig Less Soda

Unless it's the diet stuff. The Loma Linda University researchers also discovered that the men who drank large quantities of fluids other than water actually had a higher risk of stroke—46 percent higher.

One theory is that sugary drinks like soda draw water out of the bloodstream, thickening the blood. Another explanation may be the boost in triglycerides caused by sipping liquid sugar.

"Elevated levels of triglycerides-any level above 150-are a risk factor for arterial disease," says Dr. Daniel Fisher, an assistant professor at the New York University School of Medicine.

Count to 3

You may have just lowered your stroke risk.

In a study published in the journal Stroke, researchers noted that of 2,100 men, the anxious guys were three times more likely to have a fatal ischemic stroke than the more serene men. "

Anxiety causes chronic overproduction of dopamine, a neurotransmitter that regulates the brain's control of circulation," says Ernest Friedman, M.D., a professor of psychiatry at Case Western Reserve University.

Counting to three—or reining in your racing mind in any other way—helps by stabilizing your levels of serotonin, the antidote to excess dopamine, says Dr. Friedman.

Hold Your Breath

At least when you're around a smoker. University of Auckland researchers found that people exposed to secondhand smoke are 82 percent more likely to suffer a stroke than those who never inhale. It seems that carbon monoxide promotes clot formation by interfering with nitric oxide, a biochemical that relaxes blood vessels.

"To get rid of every single bit of carbon monoxide after a night at the bar, you'd have to breathe fresh air for about 8 hours. But most of the carbon monoxide will be gone from your body in the first hour," says Laurence Fechter, Ph.D., a professor of toxicology at the University of Oklahoma.

So on your way home, make sure you roll down the car windows and start sucking in some clean air.

Beat Homocysteine

Research suggests that people with high blood levels of this amino acid are more likely to stroke out than those with low readings. Extra folate will help reduce the risk, but only for some people. "Fifty to 60 percent won't respond with lower homocysteine," says Dr. Seth J. Baum, medical director of the Mind/Body Medical Institute, a Harvard affiliate.

Dr. Baum recommends 1,000 micrograms (mcg) of folate, plus 25 milligrams (mg) of vitamin B6, 1,000 mcg of B12, and 1,800 mg of the amino acid N-acetyl-cysteine (NAC). "With folate, B6, B12, and NAC supplements, almost everyone will have normal homocysteine levels," says Dr. Baum.

Pick Up an Iron Supplement

Aerobic exercise is antistroke medicine. Can't run or cycle to save your life? Then lift. "Regular resistance training decreases blood pressure, elevates HDL cholesterol, lowers LDL cholesterol, and decreases the stickiness of the blood," says Dr. Jerry Judd Pryde, a physiatrist at Cedars-Sinai Hospital in Los Angeles.

If you don't already weight-train, try the American Heart Association program: Lift weights two or three times a week, targeting the major muscle groups. For each of the following, choose a weight you can lift eight to 12 times at most, and do one set to fatigue: bench press, shoulder press, lying triceps extension, biceps curl, seated row, lat pulldown, crunch, squat, Romanian deadlift, and calf raise.