Thursday, November 26, 2015

Drink Water and Defend Strokes

Almost 800,000 Americans have a stroke every year according to the U.S. Centers for Disease Control and Prevention. The vast majority of strokes occur when a clot blocks the blood flow to a portion of the brain resulting in nearly 130,000 deaths annually in the United States. We know that strokes are dangerous – but what you may not know is that your own hydration can have a positive impact.

People who are not well hydrated, when they have a stroke, are about four times more likely to have a worse outcome than people who regularly have more fluids in their system, a new study suggests. When stroke patients end up in the hospital they are often severely dehydrated. When compared with patients who were not dehydrated prior to a stroke, dehydration at hospital arrival was associated with a four-fold increase in the risk of having clinically worsening symptoms between the patients arrival and their discharge, according to Dr. Mona Bahouth, a cerebrovascular fellow in the department of neurology at Johns Hopkins Hospital in Baltimore, who presented her study findings at the annual meeting of the International Stroke Conference in February, 2015. “We have known that a large percentage of patients are dehydrated at the time of their stroke,” she said, adding that it is now clear that this presentation has implications for short-term prognosis. Simply put: it’s better to have a hydrated body than a dehydrated body. But can dehydration be a risk factor for stroke? The study did not address cause and effect, and Bahouth said it is not yet clear if dehydration is an actual risk factor for stroke. “I think we had a hunch that hydration would be a key feature for stroke patients,” Bahouth said. “So it’s not too surprising, but it’s just the beginning.”

A Scottish study in 2012 also found the same thing. Researchers in that study concluded that dehydration is common in patients admitted to the hospital following a stroke and is associated with severe stroke and poor outcomes at the time of their discharge. They suggest that focusing on interventions to reduce the frequency and duration of dehydration have the potential to improve patient outcomes after a stroke. Independent risk factors for dehydration included older age, female gender, and prescribed diuretics, which rids the body of vital fluids.

The John Hopkins study included 168 patients admitted to Johns Hopkins Hospital from August 2013 to May 2014. The patients underwent MRI scans to assess how much damage had been done to the brain by the stroke. Forty-four patients were deemed to be dehydrated at the time of hospital admission. There were not significant differences in hydrated and dehydrated patients with regard to stroke severity or the type of stroke they had, however water consumption showed that healthy hydration had undeniable benefit. “The dehydration group tended to end up in the worst quartile,” Bahouth said. “These were the patients who got worse over further hospitalization or didn't change at all.” And dehydration remained a significant predictor of having a worse outcome after leaving the hospital. “There is a physiological response to dehydration,” she said. “The blood gets sludgy, like thick paint, and this puts stress on blood vessel walls and it changes the dynamic of how blood vessels function.”

Dr. Paul Bendheim, a clinical professor of neurology from the University of Arizona College of Medicine in Tucson, said there are no hard-and-fast rules for staying well hydrated, though recommendations of drinking eight glasses of water each day is still standard policy. “The critical thing is that people maintain frequent volumes of urinary output during the day, that they don't feel thirsty and they regularly consume sufficient liquids,” added Bendheim, who wasn’t involved in the Hopkins study. Dr. Bahouth cautioned that anyone who thinks they might be having a stroke should not try to drink anything since brain damage might make it difficult for them to swallow correctly. That could cause them to inhale fluid into the lungs.

It’s no surprise that being properly hydrated helps with a variety of physical ailments. Water is known to help fight fatigue, eliminate toxins from the body, keep the skin healthy and more. But human nature is such that, though people may know they need to drink more water, they don’t often monitor their water intake. Yes, something as simple as water can provide meaningful long-term health benefits. Water is not a cure all of course, but drinking water at home, at work, at the gym, and on the go is never a wrong choice. Drinking more water won’t protect you from a stroke, heart attack or anything else, but if your body is properly hydrated and these studies suggest you will be helping to protect yourself in the long run.


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