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Preventing stroke

Stroke - prevention; CVA - prevention; Cerebral vascular accident - prevention; TIA - prevention; Transient ischemic attack - prevention

A stroke occurs when the blood flow is cut off to any part of the brain. The loss of blood flow can be caused by a blood clot in an artery of the brain. It can also be caused by a blood vessel in a part of the brain that becomes weak and bursts open. A stroke is sometimes called a "brain attack."

What are Risk Factors and Preventive Care?

A risk factor is something that increases your chance of having a stroke. You can't change some risk factors for stroke. But some, you can.

Changing risk factors that you can control will help you live a longer, healthier life. This is called preventive care.

An important way to help prevent stroke is to see your health care provider for regular physical exams. Your provider will want to see you at least once a year.

Risk Factors You Cannot Change

You can't change some risk factors or causes of stroke:

  • Age. Your risk of stroke increases as you get older.
  • Sex. Men have a higher risk of stroke than women. But more women than men die from stroke.
  • Genetic characteristics. If one of your parents had a stroke, you are at higher risk.
  • Race. African-Americans have a higher risk of stroke than all other races. Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk of stroke.
  • Diseases such as cancer, chronic kidney disease, and some autoimmune diseases.
  • Weak areas in an artery wall or abnormal arteries and veins.
  • Pregnancy, both during and in the weeks right after pregnancy.

Blood clots from the heart may travel to the brain and cause a stroke. This may happen in people with

  • Man-made or infected heart valves
  • Certain heart defects with which you were born

Changes to Your Lifestyle

You can change some risk factors for stroke, by taking the following steps:

  • DO NOT smoke. If you do smoke, quit.
  • Control high blood pressure through diet, exercise, and medicines, if needed.
  • Exercise at least 30 minutes a day for at least three days every week.
  • Maintain a healthy weight by eating healthy foods, eating smaller portions, and joining a weight loss program if needed.
  • Limit how much alcohol you drink. This means no more than 1 drink a day for women and 2 a day for men.
  • DO NOT use cocaine and other illegal drugs.

Eating healthy is good for your heart and can help lower your risk of stroke.

  • Eat plenty of fruits, vegetables, and whole grains.
  • Choose lean proteins, such as chicken, fish, beans, and legumes.
  • Choose nonfat or low-fat dairy products, such as 1% milk and other low-fat items.
  • Avoid fried foods, processed foods, and baked goods.
  • Eat fewer foods that contain cheese, cream, or eggs.
  • Avoid foods with a lot of sodium (salt).

Read labels and stay away from unhealthy fats. Avoid foods with:

  • Saturated fat
  • Partially-hydrogenated or hydrogenated fats

Medical Problems May Lead to Stroke

Control your cholesterol and diabetes with a healthy diet, exercise, and medicines if needed.

If you have high blood pressure:

Talk to your provider about the risks of taking birth control pills.

  • Birth control pills can increase the chance of blood clots, which can lead to stroke.
  • Clots are more likely in women taking birth control pills who also smoke and who are older than 35.

Your provider may suggest taking aspirin or another drug to help prevent blood clots from forming. DO NOT take aspirin without talking to your provider first.

References

Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 65.

Goldstein LB. Prevention and management of ischemic stroke. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 65.

January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014;64(21):e1-e76. PMID: 24685669 www.ncbi.nlm.nih.gov/pubmed/24685669.

Riegel B, Moser DK, Buck HG, et al; American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6(9). pii: e006997. PMID: 28860232 www.ncbi.nlm.nih.gov/pubmed/28860232.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 www.ncbi.nlm.nih.gov/pubmed/29146535.

  • Stroke

    Animation

  •  

    Stroke - Animation

    When blood flow to an area of your brain stops, it's serious. It's called a stroke, and will often cause permanent, debilitating damage to your brain and change your life. Let's talk about strokes. If blood flow to your brain is stopped for longer than a few seconds, your brain can't get blood and oxygen. Brain cells die, causing permanent damage. There are two types, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when a blood clot forms in a very small artery, or when a blood clot breaks off from another artery and lodges in your brain. Hemorrhagic strokes can happen when a blood vessel in your brain becomes weak and bursts open. High blood pressure is the number one risk factor for strokes. People with atrial fibrillation, when your heart rhythm is fast and irregular, diabetes, a family history of stroke, and high cholesterol are most at risk. You are also at risk for stroke if you are older than age 55. Other risk factors include being overweight, drinking too much alcohol, eating too much salt, and smoking. Symptoms of a stroke usually develop suddenly, without warning. You may have a severe headache that starts suddenly, especially when you are lying flat, often when you awake from sleep. Your alertness may suddenly change. You may notice changes in your hearing, your sense of taste, and your sense of touch. You may feel clumsy or confused or have trouble swallowing or writing. So, how are strokes treated? A stroke is a medical emergency. Immediate treatment might save your life and reduce disability. Call your local emergency number -- or have someone call for you -- at the first sign of a stroke. Most of the time, someone having a stroke should be in the hospital within three hours after symptoms first begin. If a doctor suspects you've had a stroke, the doctor will check for problems with your vision, movement, feeling, reflexes, and your ability to understand and speak. You may have several tests to check for blocked or narrowed arteries. If the stroke is caused by a blood clot, you'll be given a clot-busting drug to dissolve the clot. Treatment depends on how bad your stroke is and what caused it. But you will probably need to stay in the hospital for a few days. Besides clot-busting drugs, called thrombolytics, you may need blood thinners, medicine to control high blood pressure, and surgery to unclog one of your carotid arteries-which carry blood to the brain. After your stroke, treatment will focus on helping you recover as much function as possible, and preventing future strokes. Most people need stroke rehabilitation therapy. If you can return home, you may need help making safety changes in your home and to help you with using the bathroom, cooking, dressing, and moving around your home. After a stroke, some people have trouble speaking or communicating with others, and a speech therapist might help. Depending on the severity of the stroke, you may have trouble with thinking and memory, problems with your muscles, joints, and nerves, trouble going to the bathroom, and difficulty swallowing and eating. Therapies and support for you and your family are available to help with each of these problems. Your treatment will also focus on preventing another stroke. You may need to be on several medications to help prevent this. And, eating healthy and controlling problems like diabetes and high blood pressure can be very important.

  • Stroke

    Animation

  •  

    Stroke - Animation

    When blood flow to an area of your brain stops, it's serious. It's called a stroke, and will often cause permanent, debilitating damage to your brain and change your life. Let's talk about strokes. If blood flow to your brain is stopped for longer than a few seconds, your brain can't get blood and oxygen. Brain cells die, causing permanent damage. There are two types, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when a blood clot forms in a very small artery, or when a blood clot breaks off from another artery and lodges in your brain. Hemorrhagic strokes can happen when a blood vessel in your brain becomes weak and bursts open. High blood pressure is the number one risk factor for strokes. People with atrial fibrillation, when your heart rhythm is fast and irregular, diabetes, a family history of stroke, and high cholesterol are most at risk. You are also at risk for stroke if you are older than age 55. Other risk factors include being overweight, drinking too much alcohol, eating too much salt, and smoking. Symptoms of a stroke usually develop suddenly, without warning. You may have a severe headache that starts suddenly, especially when you are lying flat, often when you awake from sleep. Your alertness may suddenly change. You may notice changes in your hearing, your sense of taste, and your sense of touch. You may feel clumsy or confused or have trouble swallowing or writing. So, how are strokes treated? A stroke is a medical emergency. Immediate treatment might save your life and reduce disability. Call your local emergency number -- or have someone call for you -- at the first sign of a stroke. Most of the time, someone having a stroke should be in the hospital within three hours after symptoms first begin. If a doctor suspects you've had a stroke, the doctor will check for problems with your vision, movement, feeling, reflexes, and your ability to understand and speak. You may have several tests to check for blocked or narrowed arteries. If the stroke is caused by a blood clot, you'll be given a clot-busting drug to dissolve the clot. Treatment depends on how bad your stroke is and what caused it. But you will probably need to stay in the hospital for a few days. Besides clot-busting drugs, called thrombolytics, you may need blood thinners, medicine to control high blood pressure, and surgery to unclog one of your carotid arteries-which carry blood to the brain. After your stroke, treatment will focus on helping you recover as much function as possible, and preventing future strokes. Most people need stroke rehabilitation therapy. If you can return home, you may need help making safety changes in your home and to help you with using the bathroom, cooking, dressing, and moving around your home. After a stroke, some people have trouble speaking or communicating with others, and a speech therapist might help. Depending on the severity of the stroke, you may have trouble with thinking and memory, problems with your muscles, joints, and nerves, trouble going to the bathroom, and difficulty swallowing and eating. Therapies and support for you and your family are available to help with each of these problems. Your treatment will also focus on preventing another stroke. You may need to be on several medications to help prevent this. And, eating healthy and controlling problems like diabetes and high blood pressure can be very important.

    A Closer Look

     

    Self Care

     
     

    Review Date: 6/23/2019

    Reviewed By: Alireza Minagar, MD, MBA, Professor, Department of Neurology, LSU Health Sciences Center, Shreveport, LA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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