Prevention of Stroke

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The following measures may help prevent stroke:

  • Do not smoke.
  • Exercise regularly.
  • Limit dietary intake of salt, alcohol, and saturated fat.
  • Maintain body weight within an ideal range.
  • Use airbags, seatbelts, and child safety seats in automobiles.
  • Wear protective helmets when engaging in contact sports, horseback riding, or riding bicycles.

Carotid endarterectomy is a surgical procedure in which atherosclerotic deposits (plaque) in a carotid artery are removed. This procedure can reduce the risk for stroke.

People with hypertension or diabetes can reduce their risk for stroke by controlling their condition through proper medication and appropriate lifestyle modifications (e.g., regular exercise, weight loss).

Diabetes and Stroke Prevention

Our sister publication Diabetes Focus (Fall 2015) reported that each year about 610,000 people in the United States experience a stroke for the first time, according to the Centers for Disease Control and Prevention (CDC). While these strokes are not always be fatal, they can lead to years of physical and mental impairments that rob survivors of quality of life. Having diabetes means your stroke risk is twice as high as someone without the disease.

Experts from the American Heart Association (AHA) and the American Stroke Association (ASA) released updated guidelines for the prevention of stroke in individuals who have never suffered a stroke or a transient ischemic attack (TIA, mini-stroke). You can't change certain stroke risk factors, such as age and family history. But there are things you can control, such as what you eat, how active you are and how you manage certain aspects of self-care. Following are three highlights from the updated guidelines:

  • Go Mediterranean The benefits of a low-sodium, high-potassium diet rich in fruits and vegetables have been touted in both past and current guidelines, but this is the first time the guidelines suggest people consider the Mediterranean diet specifically to lower first-time stroke risk. The eating plan focuses on olive oil, tree nuts and peanuts, fresh fruits, vegetables, legumes, poultry, fish and optional wine with meals. It discourages soda, commercial baked goods, red meat and fatty spreads such as butter and margarine. What's more, the stroke guidelines encourage supplementing the diet with a daily serving of nuts instead of the Mediterranean diet's practice of one serving of nuts at least three times a week.
  • Take Charge of High Blood Pressure The updated recommendations place added emphasis on preventing prehypertension—defined by the guidelines as a blood pressure reading of 120 to 139/80 to 89 mm Hg—from becoming full-blown hypertension (high blood pressure). If you're prehypertensive, get screened for hypertension at least once a year by your doctor. Lifestyle changes such as regular physical activity and a healthful diet low in sodium can help lower blood pressure. If you have hypertension, consider antihypertensive drugs to lower blood pressure to 140/90 mm Hg or below. Also, if you have high blood pressure, you should be monitoring it at home, say the guidelines. Lowering blood pressure is the best strategy for stroke prevention. Studies demonstrate that routine self-measured monitoring with a digital upper-arm cuff device, along with continued regular screening by doctors, can help you keep blood pressure under control.
  • Consider Alternative Drugs Atrial fibrillation (AF), a type of abnormal heart rhythm, is associated with a four- to fivefold increased risk of ischemic stroke (the blockage of an artery that delivers blood to the brain). The blood-thinning drug warfarin (Coumadin)—the most commonly prescribed drug to control AF in patients at high risk of stroke—is still recommended. But many AF patients are reluctant to take warfarin because of its burdensome monitoring regimen (which entails frequent blood tests), dietary restrictions and potential adverse effects, such as high risk of excessive bleeding. The new guidelines add dabigatran (Pradaxa), apixaban (Eliquis) and rivaroxaban (Xarelto) as recommended anticoagulants for patients with nonvalvular AF and a high risk of stroke. Compared with warfarin, all three of these medications have an easier regimen, are safer and don’t restrict diet—but they are also more expensive and, unlike warfarin, they lack an antidote, such as vitamin K, to reverse any severe bleeding. If you have valvular AF and are at high risk of stroke, the guidelines recommend that you stick with warfarin.

Updated by Remedy Health Media

Publication Review By: Stanley J. Swierzewski, III, M.D.

Published: 01 Jan 2000

Last Modified: 16 Oct 2015