Preventing Strokes: Can You Stop Them Before They Start?

Strokes are a life-threatening medical emergency, and immediate action is critical to preventing permanent brain damage or death. While stroke treatment is challenging, prevention is possible through a combination of lifestyle changes and medical intervention. Knowing the signs of a stroke and acting quickly can be the difference between life and death. This article will explore the steps to identify and prevent strokes, as well as the importance of timely treatment.

Recognising the signs of a stroke: balance, eyes, face, arm, speech, and time (BE FAST)

Recognising the signs of a stroke is critical. Strokes are a life-threatening emergency, and immediate medical attention is crucial to prevent permanent damage or death. Here's how to recognise the signs using the BE FAST acronym:

B – Balance

Be watchful for a sudden loss of balance. This could manifest as dizziness, a loss of coordination, or trouble walking.

E – Eyes

Look out for a sudden loss of vision in one or both eyes. Are they experiencing double vision?

F – Face

Ask the person to smile. Look for a droop on one or both sides of their face, which is a sign of muscle weakness or paralysis.

A – Arm

A person having a stroke often has muscle weakness on one side. Ask them to raise both arms; if they have one-sided weakness, one arm will stay higher while the other will sag and drop downward.

S – Speech

Strokes often cause a person to lose their ability to speak. They might slur their speech or have trouble choosing the right words.

T – Time

Time is critical, so don't wait to get help! If possible, note the time when any of the symptoms first appear. This information can help healthcare providers determine the best treatment options.

Preventative measures: lifestyle changes and treatments

Strokes are the fifth cause of death and the leading cause of serious long-term disability in the U.S. They are also the second leading cause of death worldwide. However, they are preventable and treatable. Knowing the signs of a stroke and acting quickly can make the difference between life and death or serious disability.

• Improve your diet: Eat at least four to five cups of fruits and vegetables every day, have one serving of fish two to three times a week, and incorporate several servings of whole grains and low-fat dairy. Limit your consumption of high-cholesterol foods, such as burgers, cheese, and ice cream, and reduce your sodium intake to no more than 1,500 milligrams per day.
• Exercise regularly: Engage in at least 30 minutes of physical activity per day, or more if possible. Consider activities such as walking, golfing, or playing tennis, and try to make activity a part of your daily routine.
• Maintain a healthy weight: Work with your doctor to develop a weight loss strategy that is appropriate for your body and activity level. Aim to consume between 1,500 and 2,000 calories per day and incorporate regular exercise into your routine.
• Manage underlying health conditions: Certain conditions, such as high blood pressure, abnormal heart rhythms, sleep apnea, Type 2 diabetes, and high cholesterol, can increase your risk of having a stroke. Work with your healthcare provider to manage and treat these conditions effectively, including taking prescribed medications such as blood thinners.
• Control blood pressure: High blood pressure is a significant risk factor for strokes, so it is important to monitor and control it. This can be achieved through lifestyle changes, such as diet and exercise, and/or medications. Aim for a blood pressure of less than 120/80, but consult with your doctor to determine the most suitable target for your specific circumstances.
• Limit alcohol consumption: Drinking alcohol in moderation, such as one drink per day, is generally considered acceptable. However, consuming more than two drinks per day significantly increases your risk of having a stroke. If possible, choose red wine as it may offer some protective benefits against heart disease and stroke.
• Treat atrial fibrillation: Atrial fibrillation is an irregular heartbeat that can lead to clot formation in the heart. These clots can travel to the brain and cause a stroke. If you experience symptoms such as heart palpitations or shortness of breath, consult your doctor for an examination. Treatment options may include anticoagulant drugs to reduce your stroke risk.
• Monitor blood sugar: High blood sugar can damage blood vessels over time, increasing the likelihood of clot formation. Work with your doctor to monitor and control your blood sugar levels through diet, exercise, and/or medications.
• Quit smoking: Smoking accelerates clot formation and increases plaque buildup in the arteries. Quitting smoking is one of the most effective lifestyle changes you can make to reduce your risk of having a stroke. Seek advice from your doctor on the best methods and resources for smoking cessation.

Controlling blood pressure

High blood pressure is a common condition, especially among older adults, and it often has no symptoms. However, it can lead to serious health issues such as heart attacks and strokes. Therefore, controlling blood pressure is crucial to maintaining overall health and reducing the risk of stroke. Here are some detailed instructions to help you manage your blood pressure:

• Regular Checkups: It is important to get your blood pressure checked regularly, especially if you are at risk of developing high blood pressure. This includes individuals who are over 40 years old, have a family history of high blood pressure, or have other risk factors such as ethnicity or an unhealthy diet. Many pharmacies and workplaces offer free or low-cost blood pressure checks.
• Lifestyle Changes: Adopting a healthy lifestyle can significantly impact blood pressure levels. This includes maintaining a healthy, balanced diet with limited salt and alcohol intake. It is also crucial to exercise regularly, aiming for at least 150 minutes of physical activity per week. Losing weight, if overweight, can also help lower blood pressure.
• Stress Management: Long-term stress can contribute to high blood pressure. Finding healthy ways to manage stress, such as through relaxation techniques or therapy, can help reduce blood pressure and improve overall well-being.
• Medication: If lifestyle changes alone are not sufficient to control blood pressure, medication may be necessary. A doctor will typically prescribe medication if an individual's blood pressure is very high, they are at high risk of related problems like stroke, or their blood pressure remains elevated despite lifestyle changes. There are various medications available, and the recommended treatment will depend on individual factors such as age and ethnicity.
• Monitor Progress: It is important to regularly monitor your blood pressure, especially after making lifestyle changes or starting medication. This can be done through home blood pressure monitors, follow-up doctor visits, or portable monitors that take readings over 24 hours. This helps confirm if your blood pressure is under control and allows for adjustments to be made as needed.

By following these steps and working closely with your healthcare team, you can effectively control your blood pressure and significantly reduce your risk of stroke and other related health complications.

Controlling cholesterol

Cholesterol is a fatty substance, or lipid, that occurs naturally in the blood. While it is important for our digestive and hormonal systems, high cholesterol is harmful. It is very common, affecting more than one in five adults in the UK. If left untreated, high cholesterol can damage your blood vessels, leading to heart disease and stroke.

There are two types of cholesterol: 'good' and 'bad'. Good cholesterol, or HDL (high-density lipoprotein), is beneficial because it takes cholesterol away from cells and back to the liver, where it is destroyed. Bad cholesterol, or LDL (low-density lipoprotein), moves cholesterol to where it is needed in your cells. However, too much LDL can lead to fatty deposits in your arteries, increasing your risk of stroke.

High cholesterol is often caused by eating too much saturated fat and not enough unsaturated fats. It can also be caused by drinking too much alcohol, as well as factors like age, gender, general health, and family history.

If you are concerned about high cholesterol, it is important to get a blood test to check your levels. Your doctor may recommend a full lipid profile test, which involves taking a blood sample from your arm, or a finger-prick test, which uses a small drop of blood from your finger.

If you have high cholesterol, your doctor may suggest long-term treatment to help manage it. This could include statins, which are the main type of medication given to reduce the risk of stroke and heart attack. Other lipid-lowering drugs are also available, such as selective cholesterol absorption inhibitors like ezetimibe.

In addition to medication, you can make dietary changes to help lower your cholesterol. This includes cutting down on foods high in saturated fat, such as full-fat dairy, fatty meat, cakes, pastries, and biscuits. Instead, opt for foods high in soluble fibre, like oats, beans, nuts, and fruits and vegetables. Eating oily fish, such as salmon or mackerel, and using olive or rapeseed oil for salad dressings can also help.

By controlling your cholesterol levels through a combination of medication and dietary changes, you can reduce your risk of stroke.

Recognising risk factors: age, family history, atrial fibrillation, etc

While anyone can have a stroke at any age, certain factors can increase your chances of having one. Recognising these risk factors is crucial in preventing strokes. Here are some key factors to be aware of:

Age

The likelihood of having a stroke increases with age. The chance of having a stroke roughly doubles every 10 years after the age of 55, with about two-thirds of strokes occurring in people over 65. However, it's important to note that stroke can occur at any age, and around one in seven strokes happen in people aged 15 to 49.

Family History

Genetics and family history can play a role in stroke risk. People with a family history of stroke may share common environments and lifestyles that increase their chances. Additionally, the combination of heredity and unhealthy lifestyle choices, such as smoking and an unhealthy diet, can further elevate the risk.

Atrial Fibrillation

Atrial fibrillation (AF) is a significant preventable cause of ischemic stroke. It is estimated that AF affects around 33 million people worldwide, and the risk of stroke in patients with AF ranges from 1% to 20% annually. AF can lead to blood clots, which can cause ischemic strokes if they travel to the brain.

To assess the risk of stroke in people with AF, doctors use prediction tools such as the CHADS2 or CHA2DS2-VASc scoring systems. These tools consider factors like age, hypertension, diabetes, and previous stroke history to stratify the risk and guide treatment decisions.

Other Risk Factors

In addition to age, family history, and atrial fibrillation, there are other essential risk factors to consider:

• High blood pressure (hypertension) is a leading cause of stroke and is a significant contributor to increased risk, especially in people with diabetes.
• High cholesterol (hyperlipidemia) can lead to the build-up of plaque in the arteries, blocking blood flow to the brain.
• Type 2 diabetes increases the risk of stroke, as high blood sugar levels can damage blood vessels and affect blood flow to the brain.
• Previous stroke or transient ischemic attack (TIA): If you've had a stroke or TIA, your chances of having another stroke are higher.
• Lifestyle choices: Unhealthy behaviours, such as an unhealthy diet, physical inactivity, obesity, alcohol consumption, smoking, and drug misuse, can increase your risk of stroke.

Frequently asked questions