The Heart and Stroke Foundation SA states that most strokes "don’t not have a single cause, but rather many factors that together increase the chance of heart disease which eventually results in a stroke."
There can be subtle early warning signs to help you minimize your risk. “It’s especially important to have these warning signs checked if you considered high risk – which includes being overweight, diabetic, hypertensive or a smoker," says Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation SA.
It’s also worth noting that after menopause, women are as much at risk as men, as their levels of heart-protective oestrogen drop.
1. Sleep problems
Do you wake often during the night, or rise in the morning still feeling unrested? You may have sleep apnoea.
Sleep apnoea is when you stop breathing periodically while snoring, and is most common if you are overweight. It may not only deprive you of sleep, but deprive your brain of oxygen. This forces your blood vessels to work harder to keep blood flowing, increasing your risk of high blood pressure, abnormal heart rhythms, heart failure and stroke.
Speak to your health provider who may advise a sleep specialist.
2. Shortness of breath
“If you’re easily winded – just climbing a few steps – or become breathless at night in bed and have to sit up or walk around to regain breath, you may have a heart problem," says East London cardiologist Dr Dave Kettles. Unusual shortness of breath can signal heart failure, coronary artery disease or a heart valve problem.
Persistent extreme fatigue is another sign your heart may not be not pumping properly, carrying oxygenated blood to your muscles to fuel them.
You may also feel light-headed from insufficient blood-flow to your brain, or experience loss of libido or erectile problems from insufficient flow to your sex organs.
3. Fluid retention
If your feet, ankles or legs swell so much that your finger leaves an indent when you touch them, it can be a sign of heart failure.
So can a persistent cough, as heart failure often causes fluid to build up in your lungs, triggering wheezing and coughing.
It’s important to get these symptoms checked by a doctor, as swollen legs and ankles can also be caused by venous insufficiency (when valves in your legs don’t work well), or by kidney disease or liver failure, all of which are best addressed early.
4. Unusual discolouration
If your skin gets a blue tinge (cyanosis), it may signal insufficient flow of oxygenated blood, possibly caused by a heart problem or lung problem.
An orange-yellow rash around the knuckles of your fingers or toes or on your bottom can signal extremely high levels of triglyceride fats in your blood. This can lead to hardening of your arteries and other conditions, raising your risk for heart disease and stroke.
Dark spots under your finger or toenails may be specks of blood trapped there because of endocarditis: an infection in your heart lining or valves. They may also be a sign of diabetes, which can double your heart disease and stroke risk.
Preventative measures
The foundation advises “eating for your heart”, which includes a little animal protein, regular vegetable protein (beans, legumes), plenty of vegetables and fruit, some unsaturated fat (avocado, raw nuts) and omega 3 fatty acids (fatty fish).
It’s also important to exercise regularly: 30 minutes five times a week, to help manage weight and stress.
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