Stroke Prevention
Public Stroke Prevention Guidelines
80% of all strokes are preventable.
National Stroke Association’s stroke prevention guidelines will help you learn how you may be able to lower your risk for a first stroke.
The Stroke Prevention Guidelines were established by National Stroke Association’s Stroke Prevention Advisory Board, an elite group of the nation’s leading experts on stroke prevention. They were first published in a 1999 issue of Journal of the American Medical Association (JAMA) and have been updated to reflect current medical standards.
National Stroke Association suggests you ask your doctor for advice on how to best use these guidelines.
1. Know your blood pressure.
Have it checked at least annually. If it is elevated, work with your doctor to keep it under control.
High blood pressure (hypertension) is a leading cause of stroke.
You can check your blood pressure at your doctor’s office, at health fairs, at home with an automatic blood pressure machine, or at your local pharmacy or supermarket.
If the higher number (your systolic blood pressure) is consistently above 120 or if the lower number (your diastolic blood pressure) is consistently over 80, talk to your doctor.
If your doctor decides that you have high blood pressure, s/he may recommend some changes in your diet, regular exercise, or medicine.
Blood pressure drugs have improved. Once you and your doctor find the right medicine for you, it will almost never cause side effects or interfere with your quality of life.
2. Find out if you have atrial fibrillation.
Atrial fibrillation (AF) is an irregular heartbeat that changes how your heart works and allows blood to collect in the chambers of your heart.
This blood, which is not moving through your body, tends to clot.
The beating of your heart can move one of these blood clots into your blood stream, and can cause a stroke.
Your doctor can diagnose AF by carefully taking your pulse.
AF can be confirmed or ruled out with an electrocardiogram (ECG) (a recording of the electrical activity of the heart) which can probably be done in your doctor’s office.
If you have AF, your doctor may choose to lower your risk for stroke by prescribing medicines called blood thinners. Aspirin and warfarin (CoumadinR) are the most commonly prescribed treatments.
3. If you smoke, stop.
Smoking doubles the risk for stroke.
If you stop smoking today, your risk for stroke will immediately begin to drop.
Quitting smoking today can significantly reduce your risk of stroke from this factor.
4. If you drink alcohol, do so in moderation.
Studies now show that drinking up to two alcoholic drinks per day can reduce your risk for stroke by about half. More alcohol than this each day can increase your risk for stroke by as much as three times and can also lead to liver disease, accidents and more. If you drink, we recommend no more than two drinks each day, and if you don’t drink, don’t start!
Remember that alcohol is a drug and it can interact with some drugs. It’s a good idea to ask your doctor or pharmacist if any of the medicines you are taking could interact with alcohol.
5. Find out if you have high cholesterol (a soft, waxy fat (lipid) in the bloodstream and in all body cells).
Know your cholesterol number.
If your total cholesterol level (LDL and HDL) is over 200, talk to your doctor. You may be at increased risk for stroke.
LDL, known as the “bad” cholesterol, is the form that builds up and causes plaque which may narrow arteries and limit or stop blood flow. LDL can be inherited from your family members or be a result of your body chemistry. It can also be the result of a diet high in saturated fats, lack of exercise, or diabetes.
HDL is the “good” cholesterol that sweeps the blood and removes plaque.
Lowering your cholesterol (if elevated) may reduce your risk for stroke.
High cholesterol can be controlled in many individuals with diet and exercise.
Some individuals with high cholesterol may require medicine.
6. If you are diabetic…
Follow your doctor’s advice carefully to control your diabetes.
Often, diabetes may be controlled through careful attention to what you eat.
Work with your doctor and your dietitian (a health care professional who helps promote good health through proper eating) to develop a healthy eating program that fits your lifestyle.
Your doctor can prescribe lifestyle changes and medicine that can help control your diabetes.
Having diabetes puts you at an increased risk for stroke; by controlling your diabetes, you may lower your risk for stroke.
7. Exercise.
Include exercise in your daily activities.
A brisk walk for as little as 30 minutes a day can improve your health in many ways, and may reduce your risk for stroke.
Try walking with a friend; this will make it more likely that you’ll make it a habit.
If you don’t enjoy walking, choose another exercise or activity that you do enjoy, such as biking, swimming, golf, tennis, dance, or aerobics.
Make time each day to take care of yourself by exercising.
8. Enjoy a lower sodium (salt), lower fat diet.
By cutting down on sodium and fat in your diet, you may be able to lower your blood pressure and, most importantly, lower your risk for stroke.
Work towards a balanced diet each day with plenty of fruits, vegetables, grains, and a moderate amount of protein (meat, fish, eggs, milk, nuts, tofu, and some beans).
Adding fiber, such as whole grain bread and cereal products, raw, unpeeled fruits and vegetables and dried beans, to the diet can reduce cholesterol levels by 6 to 19 percent.
9. Circulation (movement of the blood through the heart and blood vessels) problems. Ask your doctor if you have circulation problems which increase your risk for stroke.
Strokes can be caused by problems with your heart (pump), arteries and veins (tubes), or the blood which flows through them. Together, they are your circulation. Your doctor can check to see if you have problems in the circulation supplying blood to your brain.
Fatty deposits – caused by atherosclerosis (a hardening or buildup of cholesterol plaque and other fatty deposits in the arteries) or other diseases – can block the arteries which carry blood from your heart to your brain. These arteries, located on each side of your neck, are called carotid and vertebral arteries.
This kind of blockage, if left untreated, can cause stroke.
You can be tested for this problem by your doctor. Your doctor can listen to your arteries just as s/he listens to your heart, or look at x-rays called ultrasound or MRI images.
If you have blood problems such as sickle cell disease, severe anemia (lower than normal number of red blood cells), or other diseases, work with your doctor to manage these problems. Left untreated, these can cause stroke.
Circulation problems can usually be treated with medicines. If your doctor prescribes aspirin, warfarin (CoumadinR), ticlopidine (TiclidR), clopidogrel (PlavixR), dipyridamole (AggrenoxR), or other medicine for circulation problems, take it exactly as prescribed.
Occasionally, surgery is necessary to correct circulation problems such as a blocked artery.
10. Symptoms.
If you have any stroke symptoms, seek immediate medical attention.
These include:
Sudden numbness or weakness of face, arm or leg – especially on one side of the body.
Sudden confusion, trouble speaking or understanding.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, loss of balance or coordination.
Sudden severe headache with no known cause.
If you have experienced any of these symptoms, you may have had a TIA or mini-stroke. Ask your doctor if you can lower your risk for stroke by taking aspirin, or by other means.
If you think someone may be having a stroke, act F.A.S.T. and do this simple test:
Act F.A.S.T.
FACE
- Ask the person to smile.
- Does one side of the face droop?
ARMS
- Ask the person to raise both arms.
- Does one arm drift downward?
SPEECH
- Ask the person to repeat a simple sentence.
- Are the words slurred? Can he/she repeat the sentence correctly?
TIME
- If the person shows any of these symptoms, time is important.
- Call 911 or get to the hospital fast. Brain cells are dying.