Preventing Repeat Strokes: Timing And Risk Factors

Having a stroke is a terrifying experience, and the road to recovery can be long and challenging. Unfortunately, the danger is not necessarily over after the first stroke, as those who have had one are at a higher risk of experiencing another. This risk is especially high in the first week after a transient ischemic attack (TIA), also known as a warning stroke, where it can be as high as 12.8%. In this article, we will explore the factors that influence the likelihood of having another stroke, the steps that can be taken to prevent it, and the emotional impact of living with the fear of recurrence.

Lifestyle changes to prevent a second stroke include moving more, healthy eating, quitting smoking, etc

Having a stroke puts you at a higher risk of having another one. However, understanding the factors that may have caused your stroke will help you reduce the risk of having another.

Move More

Regular exercise can improve your health and fitness, reducing your risk of a stroke. Aim for at least 30 minutes of exercise a day, or a minimum of 150 minutes of moderate physical activity per week. Walking, golfing, and playing tennis are some ways to incorporate more movement into your routine.

Healthy Eating

Adopting a healthier diet can help lower your risk of a second stroke. Eat at least 4 to 5 cups of fruits and vegetables daily, with several servings of whole grains and low-fat dairy. Consume fish two to three times a week instead of red meat, and limit your intake of high-cholesterol foods like burgers, cheese, and ice cream. The Mediterranean diet is also recommended for lowering cholesterol.

Quit Smoking

Smoking damages and tightens blood vessels, increasing the risk of stroke. Seek advice from your doctor on programs and products that can aid you in quitting.

Manage Blood Pressure and Cholesterol

High blood pressure is a significant contributor to stroke risk. Monitor your blood pressure and treat it if elevated. Reducing salt intake, exercising, and maintaining a healthy weight can help lower blood pressure. Additionally, focus on lowering your cholesterol by incorporating heart-healthy foods into your diet.

Get Healthy Sleep

Healthy sleep is essential for reducing the risk of a second stroke. Aim for adequate and consistent sleep each night.

Manage Stress

Stress management is crucial. Consult your doctor or healthcare provider about techniques to lower your stress levels.

Control Blood Sugar

If you have diabetes, controlling your blood sugar levels is essential for preventing a second stroke. Monitor your blood sugar as directed by your doctor and use diet, exercise, and medication to keep it within the recommended range.

A recurrent stroke means a person has had their brain deprived of oxygen at least twice

The risk of a second stroke is high, with 1 in 4 stroke survivors experiencing another stroke. The risk is highest in the first week after a transient ischemic attack (TIA), also known as a “warning stroke”, at 12.8%. If no lifestyle changes are made, the risk of a second stroke within five years can be as high as 30%. However, 80% of recurrent strokes can be prevented with diet and lifestyle modifications, such as increasing physical activity, reducing alcohol consumption, managing psychosocial stress and depression, and controlling blood pressure and cholesterol levels.

The prognosis after a second stroke is worse than that of a first stroke, with higher mortality rates and more severe and long-lasting disabilities. A 2021 study found that people who had a second stroke experienced more extensive disabilities and more serious symptoms than those who had their first stroke.

It is important for people who have had a stroke to discuss strategies for minimizing their risk of a recurrent stroke with their doctor. Lifestyle changes, medication, and ongoing monitoring can help prevent another stroke. Some medications that may be recommended include blood thinners, aspirin, cholesterol-lowering medication, and drugs to lower blood pressure. Additionally, managing chronic health conditions such as diabetes and heart arrhythmias is crucial. Quitting smoking, maintaining a moderate weight, and increasing physical activity can also help reduce the risk of a recurrent stroke.

A second stroke is more dangerous, causing more serious symptoms and a higher mortality rate

A Second Stroke Is More Dangerous

Having a stroke puts you at a higher risk of a second one. According to a 2017 study, of the 800,000 strokes that happen each year in the United States, over one-fourth are recurrent strokes. This means that 1 in 4 stroke survivors will have another stroke.

Every stroke has the potential to harm the brain, and having more than one stroke may result in more severe impairment. A 2021 study found that the disability following a second stroke was more severe and resulted in more serious symptoms. The likelihood of dying increases following a subsequent stroke. A 2022 study of stroke victims in Denmark found that the mortality rate for first-time ischemic stroke survivors was 17% after one year and 56% after ten years. After a second ischemic stroke, the 1-year mortality rate rose to 25% and the 10-year mortality rate rose to 70%.

The risk of a second stroke can be reduced by following a doctor's orders, taking medications correctly, and making lifestyle changes such as moving more, healthy eating, managing blood pressure, getting healthy sleep, and quitting smoking and vaping.

Warning signs of a second stroke: slurred speech, one-sided weakness, sudden loss of balance, etc

Having a stroke puts you at a higher risk of having another one. In fact, 1 in 4 stroke survivors will have a second stroke. However, many strokes can be prevented by making lifestyle changes such as exercising more, eating healthily, managing blood pressure, getting healthy sleep, and quitting smoking and vaping. It's also important to follow your doctor's orders and take your medications correctly.

• Slurred speech: If you have had issues with slurred speech since your first stroke, and you suddenly have more problems finding words, this could indicate a stroke in a different part of the brain.
• One-sided weakness: If you have one-sided weakness and you suddenly become weak in another part of your body, or your existing weakness gets worse, this could be a sign of another stroke.
• Loss of balance: Loss of balance is a possible stroke sign. If you suddenly lose your balance or experience dizziness, get it checked out.
• Facial drooping: If one side of your face droops, or feels numb, this could be a sign of a stroke. Ask someone if your smile looks uneven.
• Arm weakness: If one of your arms feels weak or numb, and it drifts downward when you try to raise both arms, this could be a warning sign of a stroke.
• Vision problems: If you experience any trouble with your vision, such as losing vision in one or both eyes, having blurry vision, or double vision, this could be a warning sign.
• Severe headache: A sudden, severe headache with no known cause could indicate a stroke.
• Confusion: If you experience confusion, trouble speaking, or understanding speech, this could be a warning sign.

Treatments for recurrent strokes include blood thinners, blood pressure management, thrombectomy, etc

Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Treatments for recurrent strokes include blood thinners, blood pressure management, thrombectomy, and more.

Blood Thinners

People who have had a stroke may be recommended to take blood-thinning medication to prevent another one. This is because blood thinners can help to remove blood clots, which are the cause of ischemic strokes. However, people who are already taking blood thinners and experience a hemorrhagic stroke will need to stop taking these drugs immediately.

Blood Pressure Management

Hypertension is a major risk factor for ischemic strokes, and treatment can drastically reduce the risk of recurrence. Lowering blood pressure can be achieved through lifestyle changes, such as weight loss, adopting a Mediterranean-style diet, reducing sodium intake, and limiting alcohol consumption. Additionally, blood pressure medication can be prescribed to help manage hypertension.

Thrombectomy

In severe cases of ischemic stroke, or if a person does not respond to blood thinners, a doctor may perform a thrombectomy. This is a medical procedure that removes a blood clot.

Antiplatelet Therapy

Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. Aspirin is typically suggested as the initial treatment, with clopidogrel as an alternative for those allergic to aspirin. The combination of clopidogrel and aspirin, however, is not recommended for long-term use due to an increased risk of bleeding.

Lifestyle Changes

Lifestyle changes can also help to reduce the risk of recurrent strokes. These include quitting smoking, reducing alcohol consumption, and increasing physical activity. Losing weight, eating a healthy diet, and managing blood glucose levels are also important factors in preventing another stroke.

It is always important to follow your doctor's orders and take medications correctly to reduce the risk of a second stroke.

Frequently asked questions