9 Easy Steps to Avoid a Stroke

One of the most feared problems that can happen to any of us as we get older is to have a stroke and end up being permanently paralyzed. So how likely are you to have one?

To find out, many people and doctors alike tend to focus on reducing cholesterol levels and/or blood pressure to decrease the risk. But how effective is this? It turns out that measuring cholesterol levels are completely useless. And measuring blood pressure is by no means perfect either.

According to Dr. Stanley Hazen, MD, PhD and Section Head of Preventive Cardiology and Rehabilitation at the Cleveland Clinic, “Clearly high blood pressure is a major risk factor for stroke, but measuring blood pressure alone is not sufficient to capture those at increased risk.”

So, what’s the best way to analyze your risk and avoid a stroke?

It may be that it’s a simple blood test that most people have never even heard of can determine your risk.

The test is called the Lp-PLA2 test (also called the PLAC test). It measures the enzyme lipoprotein-associated phospholipase A2. Lp-PLA2 is produced from certain inflammatory immune cells underneath the plaque in the arteries. It’s an indicator that the arteries are inflamed, and there’s a significant risk that the plaque is at risk of rupturing and causing a stroke. This kind of plaque is called “vulnerable plaque” because, unlike hard plaque, it can break off and then suddenly cause a heart attack or stroke. And guess what?

Clinical studies show that the higher your Lp-PLA2 levels are, the higher your risk for not only a stroke, but also a heart attack. And, it looks like measuring your Lp-PLA2 levels may be an even better indication of your stroke risk than blood pressure. Men and women with normal blood pressure but high Lp-PLA2 levels are 200% more likely to have a stroke even though their blood pressure is normal. But, here’s the kicker. When high levels of Lp-PLA2 go together with high blood pressure, the risk goes all the way up to 700%!

In one study, the researchers followed 12,762 healthy middle-aged men and women for an average of six years. During that time, 194 had a stroke. When they compared the Lp-PLA2 levels, they found a 223% increased risk of stroke in those with the highest levels. This was even true no matter what their blood pressure was, and no matter what their LDL-cholesterol levels were.

So, by now you may be asking yourself the question, why haven’t I heard more about Lp-PLA2? The answer is that Big Pharma has yet to make a drug for it. But, that’s OK. Because you don’t need drugs to get a handle on Lp-PLA2. The treatments are all natural.

In one published study in The American Journal of Clinical Nutrition, the authors followed 853 healthy women and 878 healthy men for about six years. They wanted to find out what lifestyle factors played a significant role in Lp-PLA2 levels. Here’s what they found.

Post-menopausal women who were not restoring their hormone levels with hormone replacement, and who also had elevated Lp-PLA2, were 64% more likely to have a stroke than women on hormonal replacement. This is because one of the actions of estrogen is to decrease the activity of Lp-PLA2. It’s one reason why women on hormonal replacement are so much less likely to have a heart attack. The other factors they discovered were increased body fat, smoking, cholesterol-lowering medication, aspirin, alcohol intake, carbohydrate intake, and protein intake.

Increased body fat raises Lp-PLA2 levels because fat cells produce inflammatory molecules that increase inflammation in the arteries. Smoking, like excess fat, increases the risk for the same reason. But here’s something really remarkable that the researchers learned.

Cholesterol medications and aspirin not only do not reduce Lp-PLA2 levels, they actually increase them!

And, as far as diet goes, they found that diets lower in carbohydrates and higher in protein were associated with lower Lp-PLA2 levels. Additionally, they learned that alcohol intake was protective. It acts to reduce Lp-PLA2 levels. The researchers did not evaluate exercise status, but the literature is clear – being in good aerobic condition very significantly reduces stroke risk.

So, even if your blood pressure is normal, and especially if it’s high, you should have your doctor check your Lp-PLA2 levels. If they are over 200 ng/ml, it’s time to get to work and lower your risk. Here’s a good plan:

(1) Make sure you are taking enough fish oil to get your EPA and DHA levels in an optimal range. You can measure them at www.omegaquant.com or by checking the Omega Check test at Quest labs. Make sure your Omega6/3 ratio is close to five and that your EP and DHA levels are close to median.

(2) Start taking niacin. While there is plenty of niacin in QuickStart, you may need to take even more. Higher amounts are often needed to decrease your Lp-PLA2. If that’s the case, I would suggest 500-1000 mg of timed-release niacin per day (best taken before bed).

(3) If you are a smoker, here’s one more reason to stop.

(4) If you are a teetotaler because you believe that it is healthier for you, think again. For people who can tolerate it, moderate alcohol consumption is a very healthy habit to have.

(5) Avoid regular aspirin use unless you have a good medical reason for taking it. And always avoid cholesterol-lowering drugs. They are dangerous and serve no good purpose. As I have reported before, the cholesterol that is in plaque does not come from the blood stream – so no use to lower it.

(6) Make sure your weight is under control. The risk for elevated Lp-PLA2 levels starts at a BMI greater than 25. Your BMI is your weight in kilograms divided by your height in meters squared. If you don’t want to do the math, use an online calculator like this one: www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm.

(7) If you are a post-menopausal woman, this is just one more reason to replenish your sagging hormones.

(8) As far as the diet goes, keep a lid on the refined carbs and make sure you are getting enough protein.

(9) Dental studies have repeatedly shown that strokes and cardiovascular disease in general are increased in people with dental infections. Apparently, these infections find their way into the inner aspect of the arteries. So, make sure your dental hygiene is perfect, and get a professional examination and cleaning at least once a year.

One of the aforementioned articles makes this sobering statement. “Stroke is the second-leading cause of death worldwide and is a disabling disease of both older and younger adults. Stroke is also among the most highly preventable disorders because there are well-defined risk factors and preventatives.” Strokes stand out. Rarely is there such a deadly problem that at the same time is close to 100% preventable. So, check your Lp-PLA2 levels, and make sure you avoid having that problem.

Yours for better health,

Frank Shallenberger, MD