1. How long have you been in the medical field?

I’ve graduated in 2021 and I’ve been in training since 2021, as well. I recently just passed the
Physician Licensure Examination last year during the November 2022 Exam. And, currently I am a
faculty member at the UST Faculty of Medicine and Surgery.

2. Because of your profession, are you exposed to stroke patients? If so, is there any age range
they may have?
Patients are usually > 50 years old, men are usually affected.

3. What are the common lifestyles that may lead to stroke?

a. Non-Modifiable Risk Factors
i. Age = Risk of stroke doubles for each successive decade after age 55
ii. Race/Ethnicity = African American and some Hispanic Americans have higher
stroke incidence and mortality rates compared with European Americans
iii. Sex = generally more prevalent in men than in women
iv. Genetic Factors = both parental and maternal history of stroke  6x increased
risk (probably due to genetic heritability of stroke risk factors, familial sharing of
cultural/environmental and lifestyle factors)
b. Modifiable Risk Factors
i. Hypertension = most readily recognized factor in primary intracerebral
hemorrhage
 ii. Diabetes Mellitus
iii. Other CV Diseases = CAD, Heart Failure, Peripheral Arterial Diseases
iv. Dyslipidemia = high total cholesterol, high LDL, low HDL
v. Atrial Fibrillation = most important risk factor for embolic stroke
vi. Cigarette smoking
vii. Sickle cell disease
viii. Dietary factors
ix. Obesity

x. Physical Activity
 We should do at least 150–300 minutes of moderate-intensity aerobic
physical activity; or at least 75–150 minutes of vigorous-intensity
aerobic physical activity; or an equivalent combination of moderate- and
vigorous-intensity activity throughout the week.
xi. Hormone Replacement Therapy
xii. Asymptomatic carotid stenosis

4. What are the signs that someone may be having a stroke? And how can we identify it?
 5. Do you have any advice on how to avoid stroke?
Stroke prevention focuses on reducing modifiable risk factors and treating conditions that
increase the risk of cerebrovascular ischemia and/or hemorrhage. In patients with risk factors for
both ischemic and hemorrhagic stroke, the risks and benefits of each prevention strategy should
be carefully weighed.
Primary prevention
 General preventive measures (all stroke subtypes)
 Reduce modifiable risk factors for atherosclerosis.
 Optimize management of hypertension.
 If possible, avoid medications that increase bleeding risk in patients with known
cerebral small vessel disease.
 Avoid aspirin for primary prevention of ischemic stroke.
 In patients with Afib, use DOACs instead of vitamin K antagonists or consider left
atrial appendage closure.
 The two main modifiable risk factors for the primary prevention of hemorrhagic
stroke are hypertension and the use of anticoagulants.
Prevention of stroke recurrence
 Manage hypertension and address lifestyle risk factors.
 Treat hypercholesterolemia. Statin therapy increases the risk of recurrent
hemorrhagic stroke but is nonetheless typically indicated.
o PCSK9 inhibitors can be considered as an alternative.
 Avoid long-term use of NSAIDs and use SSRIs with caution.

Additional:

6. Types of Stroke
a. Cerebral Thrombosis (usually d/t hypertension)
b. Cerebral Embolism (usually d/t cardiac arrhythmia)
c. Cerebral Hemorrhage (usually d/t hypertension)
d. Subarachnoid Hemorrhage (usually d/t ruptured aneurysm, ruptured AVM)