Which client would the nurse identify as being most at risk for experiencing a CVA?
A. A 39-year-old pregnant female.
B. A 67-year-old Caucasian male.
C. An 84-year-old Japanese female.
D. A 55-year-old African American male.
Correct Answer: D. A 55-year-old African American male.
African Americans have twice the rate of CVAs as Caucasians; males are more likely to have strokes than females except in advanced years. Of all the risk factors, hypertension is the most common modifiable risk factor for stroke. Hypertension is most prevalent in African-Americans and also occurs earlier in life.
Option A: Pregnancy is a minimal risk factor for CVA. Stroke is the fifth leading cause of death in the US. The incidence of stroke is around 800,000 people annually. Stroke is the leading cause of disability. The incidence of stroke has declined, but the morbidity has increased. Due to longer life expectancy, the lifetime risk of stroke is higher in women. Globally, at least 5 million people die from strokes and millions of others remain disabled.
Option B: One-third of the adults in the USA have elevated low-density lipoprotein (LDL), leading to plaque formation in the intracerebral vasculature. Eventually, due to the excessive plaque build-up thrombotic strokes occur.
Option C: Asians have a lower risk, possibly due to their high omega-3 fatty acids. Lifestyle measures such as weight loss, salt restriction, taking more fruits and vegetables (such as the Mediterranean diet) are helpful in decreasing blood pressure. Every 10 mm Hg reduction in blood pressure is associated with a 1/3rd reduction in stroke risk in primary prevention.
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