Stroke Prevention
Mechanism
A stroke happens when blood flow to part of the brain is blocked or when a blood vessel in the brain bursts. This can cause brain cells to die, leading to problems with movement, speech, or thinking. Stroke is a leading cause of disability, but many strokes can be prevented.
Types of Stroke
Ischemic stroke: The most common type, caused by a blocked blood vessel in the brain.
Hemorrhagic stroke: Caused by bleeding in the brain from a burst blood vessel.
Transient ischemic attack (TIA): Sometimes referred to as a "mini-stroke," it causes temporary symptoms and is a warning sign for future strokes. By definition in a TIA there is no injury to the brain tissue which is why the brain MRI is unremarkable (not showing signs of any tissue damage). In actually ischemic stroke (cut-off of blood flow to the brain) brain MRI shows the tissue damage. For this reason use of phrase "mini-stroke" is inappropriate since there is no evidence of stroke in TIA. Probably the best analogy to what TIA is to a stroke is relationship between "angina" chest pain and actual heart attack. While angina can be stabilized with medications (or by body itself normalizing the blood flow delivery to the heart in this case), the actual heart attack leads to irreversible tissue damage which is seen on all imaging modalities after the event. Same is true of ischemic (and hemorrhagic stroke for that matter as well) - all brain MRI's and / or CT head scans will show the evidence of the stroke going forward.
Preventing a First Stroke (Primary Prevention)
Control blood pressure: Keeping blood pressure below 130/80 mm Hg is one of the most important ways to lower stroke risk.
Manage cholesterol: Lowering LDL ("bad") cholesterol with medicines like statins helps prevent stroke. A healthy target is less than 70 mg/dL for people at risk.
Treat diabetes: Keeping blood sugar (A1C) below 7% helps reduce complications.
Quit smoking: Smoking doubles stroke risk. Quitting is one of the best things you can do.
Limit alcohol: No more than two drinks per day for men and one for women.
Eat healthy: A Mediterranean-style diet, rich in fruits, vegetables, whole grains, and healthy fats, is recommended. Reducing salt can help lower blood pressure.
Exercise: Aim for at least 40 minutes of moderate activity each week, such as brisk walking.
Maintain a healthy weight: Losing even a small amount of weight can help lower risk.
Preventing Another Stroke (Secondary Prevention)
Take prescribed medicines: These may include blood thinners (antiplatelet or anticoagulant drugs), blood pressure medicines, cholesterol-lowering drugs, and diabetes medicines.
Follow up with your neurologist: Regular check-ups help manage risk factors and adjust treatment as needed.
Lifestyle changes: The same healthy habits that prevent a first stroke are important after a stroke. Quitting smoking, eating well, staying active, and limiting alcohol all help lower the chance of another stroke.
Special treatments: Some people may need surgery or procedures, such as opening blocked neck arteries or closing a hole in the heart, depending on the cause of their stroke.
Key Takeaways:
Most strokes are preventable. Managing blood pressure, cholesterol, diabetes, and making healthy lifestyle choices are proven ways to lower risk.
If you have had a stroke or TIA, your risk of an actual stroke is higher. Taking medicines and making lifestyle changes can greatly reduce this risk.
Talk to us about your personal risk factors and the best plan for you.