Preventing Strokes: What You Can Do Now

Strokes are a leading cause of death and long-term disability in adults. They can also cause brain damage. However, the good news is that the majority of strokes are preventable. While there are some risk factors that are beyond our control, such as age, gender, family history, and ethnicity, there are also many lifestyle-related factors that we can control to reduce our risk of having a stroke. These include maintaining a healthy weight, eating a nutritious diet, exercising regularly, limiting alcohol consumption, and not smoking. Additionally, managing underlying conditions such as high blood pressure, high cholesterol, diabetes, and heart disease can also help lower the risk of stroke.

Lower blood pressure

High blood pressure is the biggest contributor to the risk of stroke in both men and women. It can lead to blocked arteries, which can cause a stroke. Therefore, lowering your blood pressure is one of the most important steps you can take to lower your risk of stroke.

The ideal blood pressure is considered to be 120/80. However, depending on your circumstances, you and your doctor may decide on a less aggressive goal, such as no higher than 140/90. To achieve this, you can make several lifestyle changes:

• Reduce your salt intake: Eat no more than 1,500 milligrams of salt per day (about half a teaspoon).
• Eat a healthy diet: Consume 4 to 5 cups of fruits and vegetables every day, with one serving of fish two to three times a week. Choose foods that are low in saturated fats, trans fat, and cholesterol, and high in fiber.
• Exercise regularly: Aim for at least 30 minutes of physical activity per day. This can include walking, golfing, or playing tennis. If you can't manage 30 minutes in one go, break it up into 10- to 15-minute sessions throughout the day.
• Maintain a healthy weight: Being overweight increases your risk of high blood pressure and other health issues. Losing just 10 pounds can significantly impact your stroke risk.
• Limit alcohol consumption: Drinking too much alcohol can raise your blood pressure. Men should have no more than two drinks per day, and women should have no more than one.
• Quit smoking: Smoking increases your risk of high blood pressure and other health issues.

Exercise regularly

Exercise is key to reducing your risk of stroke. According to the World Stroke Organization, 1 million strokes a year are linked to physical inactivity. By exercising regularly, you can take action to address several stroke risk factors, including hypertension, diabetes, high cholesterol, depression, and stress.

The recommended amount of exercise to reduce your risk of stroke is at least 150 minutes of moderate aerobic exercise or 75 minutes of vigorous aerobic exercise per week. This can be achieved through activities such as running, walking, or gardening, and it is suggested that you aim to be active for at least 30 minutes a day, 5 days a week. If you are unable to manage 30 minutes in one session, it is perfectly acceptable to break this time down into smaller, more manageable blocks of 10 minutes or more throughout your day and gradually build up.

The American Heart Association recommends getting at least 150-300 minutes of moderate aerobic exercise or 75-150 minutes of vigorous aerobic exercise weekly to improve cardiovascular health. Studies have shown that even small amounts of daily physical activity, such as running for 5-10 minutes, can lower your risk of cardiovascular mortality by up to 45% compared to not running at all. Additionally, participating in moderate-intensity aerobic activities can reduce the likelihood of stroke by 20%, and this risk can be reduced by up to 60% with daily moderate-intensity activities for 30-60 minutes.

It is important to note that any type of physical activity is better than none. With the rise of sedentary lifestyles due to the COVID-19 pandemic, it is crucial to prioritize physical fitness and incorporate movement into your daily routine. This can be as simple as taking the stairs instead of the elevator, choosing to walk instead of driving, or engaging in household chores and gardening.

By committing to regular physical activity and making exercise a part of your daily life, you can effectively reduce your risk of stroke and improve your overall health and well-being.

Eat healthily

Eating healthily is a crucial aspect of stroke prevention. According to the Centers for Disease Control and Prevention (CDC), 80% of strokes can be prevented through lifestyle changes, particularly nutritional adjustments. Here are some dietary guidelines to reduce your risk of stroke:

Embrace the Mediterranean Diet:

The Mediterranean diet, inspired by the traditional foods of countries bordering the Mediterranean Sea, is a heart-healthy approach linked to a reduced risk of stroke. This diet emphasizes the consumption of healthy fats, such as fatty fish, seafood, nuts, seeds, avocado, and extra-virgin olive oil. These foods are rich in unsaturated fats, which can help lower "bad" cholesterol levels when used in place of saturated fats and refined carbohydrates.

Increase Fruit and Vegetable Intake:

Fruits and vegetables are essential components of a stroke-preventive diet. Aim for four to five servings each day. They are naturally low in fat and calories but packed with nutrients like potassium, fiber, folate, vitamin A, and vitamin C. Potassium-rich foods, in particular, help maintain healthy blood pressure, which is a leading risk factor for stroke. Additionally, the fiber content in fruits and vegetables aids in weight control, as it helps you feel full.

Choose Whole Grains:

Opt for whole-grain bread, cereal, oatmeal, and brown rice instead of refined grain products like white bread and white rice. Whole grains are rich in fiber, B vitamins (including folate and thiamin), magnesium, and iron, all of which promote heart health and reduce stroke risk.

Consume Lean Protein:

When it comes to protein sources, opt for lean meats, poultry, fish, eggs, tofu, and nuts. Fish, especially oily fish like salmon and trout, are excellent sources of omega-3 fatty acids, which help regulate blood pressure and cholesterol levels. Aim for two to three servings of fish per week to promote heart health and lower stroke risk.

Opt for Low-Fat Dairy:

Dairy products like cheese, milk, and yogurt provide essential nutrients like calcium, protein, vitamin D, and potassium. However, full-fat dairy products also contain saturated fat and cholesterol, which can increase the risk of heart disease and stroke. Therefore, it's best to choose low-fat or non-fat alternatives to reap the nutritional benefits without the added risks.

Reduce Salt, Sugar, and Processed Foods:

Limit your intake of salt, sugar, and processed, packaged, and canned foods. These often contain high amounts of sodium, added sugars, and unhealthy fats, which can contribute to high blood pressure and an increased risk of stroke. Most people should consume less than 2,300 milligrams of sodium per day, and even less if you are in a high-risk group. Additionally, limit added sugars to no more than 24 grams (6 teaspoons) for women and 32 grams (9 teaspoons) for men per day.

Manage Portion Sizes:

It's important to be mindful of portion sizes, especially when eating out. Restaurants often serve larger portions than necessary, which can be high in salt and fat. Practice portion control by eating moderate amounts, regardless of the food on your plate.

Stay Hydrated:

Drink plenty of water throughout the day. Water helps flush out toxins, improves circulation, and supports overall health, all of which contribute to stroke prevention.

Remember, it's not necessary to overhaul your diet overnight. Start by making small, gradual changes, such as adding more fruits and vegetables or incorporating healthy fats and whole grains into your meals. These cumulative adjustments will lead to long-lasting, sustainable improvements in your overall health and stroke risk reduction.

Drink alcohol in moderation

Drinking alcohol can lead to high blood pressure and atrial fibrillation, which are both risk factors for strokes. Alcohol can also contribute to weight gain and make diabetes harder to control, which are also risk factors for strokes. Therefore, it is important to drink alcohol in moderation to prevent strokes.

According to the Australian Guidelines, healthy men and women should have no more than 10 standard drinks per week and no more than 4 standard drinks on any one day. However, it is important to note that these guidelines are for healthy individuals, and it is always best to consult with a doctor about what is safe for you. The less you drink, the lower your risk of harm from alcohol.

If you are drinking, keep count of how many standard drinks you have. A standard drink is defined differently for different types of alcohol. For spirits, 30 ml of spirits with 40% alcohol by volume is considered one standard drink. For beer, a 285 ml glass of full-strength beer is 1.1 standard drinks, while the same volume of low-strength beer is 0.6 standard drinks. For wine, 100 ml is considered one standard drink, but it is important to note that the average glass served in restaurants and pubs is typically 150 ml.

It is also important to be mindful of your drinking habits in social situations. Some tips include drinking slowly, alternating alcoholic drinks with non-alcoholic drinks, choosing low-alcohol options, and being confident in saying "I'm not drinking" without feeling the need to justify your decision.

While moderate drinking (less than one drink per day) has been associated with a reduced risk of ischemic stroke compared to heavier drinking, it is important to note that excessive alcohol consumption (more than two drinks per day) can increase the risk of both ischemic and hemorrhagic strokes. Additionally, moderate drinking does not provide protection against hemorrhagic strokes and may even increase the risk compared to abstaining from alcohol.

Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. These clots can travel to the brain, causing a stroke. Atrial fibrillation carries a near fivefold risk of stroke and should be taken seriously.

If you have atrial fibrillation, it is important to get it treated. Treatment options include lifestyle changes, medicines, and procedures, including surgery.

Lifestyle Changes

• Aim for a healthy weight to reduce the severity and number of atrial fibrillation episodes.
• Limit or avoid alcohol or stimulants that may increase your heart rate.
• Be physically active.
• Quit smoking.
• Choose heart-healthy foods.

Medicines

• Beta-blockers: Slow the rate at which the heart's lower chambers pump blood throughout the body.
• Blood thinners: Prevent blood clots and lower the risk of stroke.
• Calcium channel blockers: Control the rate at which the heart's lower chambers pump blood throughout the body.
• Other heart rhythm medicines: Slow a heart that is beating too fast or change an abnormal heart rhythm to a normal, steady rhythm.

Procedures/Surgery

• Electrical cardioversion: Restores your heart rhythm using low-energy shocks to your heart.
• Catheter ablation: Destroys the tissue that is causing the arrhythmia.
• Maze procedure: Creates scars within the left atrium to help restore the heart's normal rhythm.

Frequently asked questions