My mother, age 85, had a stroke this month. It is now difficult for her to find words and interpret images she sees. After 55 years running the family business, sadly, she had to ask my brother to step in.

While much of Hawaii’s attention has been rightly focused on the COVID-19 pandemic, which has taken over 700 lives on the islands, management of so many other health issues has taken a back seat. Stroke, a prime example, stealthily claims over 600 Hawaii lives each year and is the No. 1 cause of disability. Actually, these numbers are on the rise as many with possible stroke symptoms are reluctant to go the emergency room for fear of contracting COVID-19.

In fact, the likelihood that an individual, 25 years of age or older, will have a stroke in his or her lifetime is 25%. The social and economic impact of stroke is enormous. In the U.S. the average cost of stroke, including hospitalization, follow-up care and rehabilitation, is over $140,000 per person. The cost of disability is also substantial.

The risk factors for stroke are well known and include elevated blood pressure, cigarette smoking, diabetes, heart disease, sedentary lifestyle, vascular disease and high cholesterol.

And how are we doing with managing these risk factors? Well, according to the American College of Cardiology, Americans’ lifetime risk of high blood pressure is 86%. The incidence of adults with diabetes in Hawaii is 10%; the incidence of smoking has improved and is now at 12%. Fruit and vegetable consumption has been strongly associated with a lower risk of stroke, yet only 9% of Hawaii residents consume two servings of fruits and three servings of vegetables a day. In contrast, 10% of people use nonmedicinal drugs.

Sleep deprivation, whether from sleep apnea, overwork or insomnia, is also a major risk factor, one that is approaching its own epidemic proportions. Forty-three percent of Hawaii’s population does not get enough sleep, which earns it the distinction of being the least healthy state for this metric, according to 2020 data from the U.S. Census Bureau.

So how do we combat this epidemic of stroke in Hawaii? We need to pay attention to the silent killers! I worry that individuals are delaying or avoiding routine screening and care during this time of COVID-19. People must know their blood pressure, cholesterol and blood sugar. It is a dangerous proposition to think that if I feel good I’m healthy. It turns out that what you don’t know can kill you!

My recommendations are the following: Above all, get into your medical provider for a good checkup to evaluate those elements of health that you cannot easily check on your own. Plus:

>> Check your blood pressure, and if it’s elevated, get it treated.

>> If you’re still smoking, get some help and quit. It is probably the single most important thing you can do for yourself and for your family. Your health provider can offer some options.

>> Eat two daily servings of fruits and vegetables. It turns out that an apple a day really does keep the doctor away!

>> Get a good night’s sleep! Most adults require at least seven to eight hours a night, and our keiki nine to 10 hours a night, for optimal health. If your bed partner says you snore or stop breathing at night and you don’t feel rested during the day, you might need a sleep study to check for apnea.

>> Make exercise a part of your daily routine. We are all incredibly fortunate to call Hawaii home. So get out and enjoy it.

For all those who do have a stroke or a near or ministroke, all of the same risk factors need to be managed. In fact, these risk factors are really no different for heart disease. You probably also will need rehabilitation.

One of the many reasons I decided to become director of the Pacific Headache Center at Manakai is because of the multidisciplinary team that works so closely together. When it comes to stroke prevention and treatment, our medical providers collaborate with our Niolopua sleep lab and physical therapy, acupuncture and psychology departments.

Mahalo and enjoy the ride!

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Dr. David Kaminskas is a board-certified neurologist and director of the Pacific Headache Center at Manakai o Malama Integrative Healthcare Group. Dr. Ira Zunin has turned over his column to Kaminskas this month. Zunin’s column appears the first Wednesday of every month. Please submit your questions to info@manakaiomalama.com.