Preventing Stroke: The Role Of Medication

Strokes are a serious medical condition that can be prevented through a combination of healthy lifestyle choices and medication. High blood pressure is a significant risk factor for strokes, and medication can be used to lower blood pressure and prevent blood clots, which are a common cause of strokes. Doctors may prescribe blood pressure medication such as ACE inhibitors, beta-blockers, or calcium channel blockers to reduce blood pressure and lower the risk of stroke. Additionally, anticoagulants and antiplatelet medications can be used to prevent blood clots from forming or growing larger. Lifestyle changes, such as a healthy diet, regular exercise, and quitting smoking, are also important in preventing strokes and improving overall health.

Blood-thinning medication

There are several types of blood-thinning medication, including anticoagulants and antiplatelets, which work in different ways. Anticoagulants such as warfarin and heparin can stop blood clots from growing and prevent new ones from forming. However, they can also cause abdominal pain, dizziness, and headaches. People with certain risk factors, such as a bleeding disorder, may not be suitable for anticoagulants. Antiplatelets such as aspirin, clopidogrel, dipyridamole, and ticlopidine prevent blood clots by making it harder for platelets in the blood to stick together. However, they are associated with a high risk of bleeding and may not be suitable for people without a prior history of atherosclerotic cardiovascular disease.

If you have had an ischemic stroke (the most common type of stroke), you will almost certainly be prescribed a drug to prevent future blood clots. This could be an anticoagulant or an antiplatelet, depending on your medical history and risk factors. Doctors may also prescribe blood-thinning medication to people who have had a bleeding stroke if they deem the benefits to outweigh the risks.

In addition to blood-thinning medication, there are several other ways to prevent strokes. These include lowering blood pressure, controlling blood sugar, maintaining a healthy weight, exercising regularly, and quitting smoking.

Lower blood pressure

Lowering your blood pressure is a crucial step in reducing your risk of stroke. High blood pressure is the biggest contributor to stroke risk in both men and women. It can be a factor in the formation of blood clots, which can lead to an ischemic stroke. Therefore, controlling your blood pressure can significantly reduce your chances of having a stroke.

There are several medications that can help lower blood pressure, including:

• Diuretics, or "water pills," help your body get rid of extra salt and fluids. They can be taken with other blood pressure medications but may lower potassium levels, leading to weakness and fatigue. Eating potassium-rich foods or taking supplements can prevent these side effects.
• Angiotensin-converting enzyme (ACE) inhibitors relax and widen your blood vessels, making blood flow more easily.
• Beta-blockers counteract the effects of adrenaline, slowing the heart rate and reducing blood pressure. They are usually prescribed after trying other blood pressure medications first.
• Calcium channel blockers prevent calcium from entering cells in the heart and blood vessels, helping the vessels to relax and open up, thus lowering blood pressure. They can also slow the heart rate.
• Angiotensin II receptor blockers make it easier for the heart to pump blood by blocking chemicals that narrow the blood vessels.

In addition to medication, there are lifestyle changes you can make to help lower your blood pressure:

• Reduce your salt intake to no more than 1,500 milligrams (about half a teaspoon) per day.
• Avoid high-cholesterol foods like burgers, cheese, and ice cream.
• Consume 4 to 5 cups of fruits and vegetables daily, with fish two to three times a week, and include whole grains and low-fat dairy.
• Exercise for at least 30 minutes a day, at a moderate intensity.
• Quit smoking.
• If you drink alcohol, do so in moderation. It's recommended that men have no more than two drinks per day, and women no more than one.

Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes blood to pool in the heart, which can lead to clots forming and travelling to the brain, causing a stroke. If you have atrial fibrillation, it is important to get it treated.

Medicines

There are several medications that can be used to treat atrial fibrillation. These include:

• Blood thinners, such as warfarin, dabigatran, apixaban, rivaroxaban, or edoxaban. These medications prevent blood clots from forming and lower the risk of stroke.
• Beta-blockers, such as bisoprolol, metoprolol, propranolol, or timolol. These drugs slow the heart rate and can help to control the heartbeat.
• Calcium channel blockers, such as diltiazem or verapamil. These also slow the heart rate and can be used by patients with lung problems who cannot take beta-blockers.
• Antiarrhythmic drugs, such as sodium channel blockers or potassium channel blockers. These slow the electrical signals in the heart to bring it back to a normal rhythm.

Procedures

If medications and lifestyle changes do not improve atrial fibrillation, your doctor may recommend a procedure. Some procedures to treat atrial fibrillation include:

• Electrical cardioversion, which uses low-energy shocks to restore a normal heart rhythm.
• Catheter ablation, which uses electrical signals or freezing techniques to destroy the tissue causing the irregular heartbeat.
• The Maze procedure, which involves making small cuts in the upper part of the heart to form scar tissue that stops abnormal signals. This is usually done during open-heart surgery for other issues.
• Pacemaker implantation, which can be used to treat atrial fibrillation triggered by a slow heartbeat.

Lifestyle Changes

In addition to medications and procedures, your doctor may recommend the following lifestyle changes to help manage atrial fibrillation:

• Healthy weight: Maintaining a healthy weight can reduce the severity and number of atrial fibrillation episodes.
• Limit alcohol and stimulants: Alcohol and stimulants can increase your heart rate, so it is important to limit or avoid them.
• Physical activity: Regular physical activity can help to strengthen your heart and improve atrial fibrillation.
• Smoking cessation: Quitting smoking is important for improving heart health and reducing the risk of stroke.
• Healthy diet: Adopting a heart-healthy diet, such as the DASH eating plan, can help to lower blood pressure and improve heart health.

Control blood sugar

High blood sugar can damage blood vessels over time, making clots more likely to form inside them. This can increase your risk of stroke. Therefore, it is important to keep your blood sugar under control.

Monitor your blood sugar

It is important to monitor your blood sugar levels as directed by your doctor. This is especially important if you have diabetes or are at risk of developing it.

Diet

A healthy diet can help keep your blood sugar within the recommended range. Choose healthy foods and drinks that are low in saturated fats, trans fat, and cholesterol, and high in fibre. Be sure to eat plenty of fresh fruits and vegetables. Eating foods with lower sodium (salt) can also help control blood sugar.

Exercise

Physical activity can help control blood sugar by helping you stay at a healthy weight and lowering your cholesterol and blood pressure levels. For adults, it is recommended to get at least 30 minutes of moderate-intensity aerobic exercise, such as a brisk walk, each day.

Medication

If lifestyle changes alone are not enough to control your blood sugar, your doctor may prescribe medication. These medications can help your body produce more insulin or slow the rate at which carbohydrates break down in your bloodstream.

Statins to lower cholesterol

Statins are the most common medication for high cholesterol. They are taken as a tablet once a day, and usually for life. They work by reducing the amount of cholesterol produced by the body.

High cholesterol is a major risk factor for strokes. If you are at high risk of having a stroke, your doctor may prescribe statins if your cholesterol level has not decreased through diet and lifestyle changes.

Statins are also prescribed after a stroke to lower the risk of a second stroke. This is because they seem to lower the risk of a second stroke, even if your "bad" cholesterol (LDL) is already lower than 100 mg/dL.

High blood pressure is another major risk factor for strokes. It is the biggest contributor to stroke risk in both men and women. If you have high blood pressure, you can lower it through medication, diet, and lifestyle changes.

Frequently asked questions