Stroke prevention

• Medicine: anti-hypertensive medicine is given in patients with a TIA or recurrent ischemic stroke with a systolic BP higher than 140 mm Hg or diastolic BP higher than 90 mm Hg. The medicine is given for several days following the event. Drugs such as thiazide diuretics alone or with an angiotensin-converting enzyme (ACE) inhibitor is given.5–7

2. Control Cholesterol

High cholesterol level is associated with the formation of fatty plaque in the arteries. The plaque in brain arteries causes reduced blood flow to the brain leading to stroke. Thus, controlling your cholesterol levels potentially reduce the chances of stroke.

Medicine: Recurrent stroke or TIA of suspected atherosclerotic origin, should receive a statin (lipid-lowering drug) such as rosuvastatin (20 mg) or atorvastatin (40 mg or more).

3. Manage Blood Sugar

High levels of blood sugar for long damages your heart and blood vessels, which may lead to the development of clots or blockages in the arteries of the brain.

Controlling your diabetes with lifestyle changes and medicines or insulin can help to reduce the risk of stroke.

The AHA/ASA suggests diabetic screening in all patients of ischemic stroke. Tests done are HbA1C, fasting plasma glucose, or oral glucose tolerance test.

4. Do Physical Activity

Doing regular physical activity reduces the stroke risk factors such as diabetes, high cholesterol levels, and BP.

It is advisable to do aerobic physical activity for at least 120 to 150 minutes a week. You should perform a medium-intensity exercise (brisk walking) or a vigorous-intensity exercise (jogging), preferably spread evenly.

6. Lose Weight

Losing extra weight can help to reduce the associated risk factors such as high triglycerides, diabetes, etc. A weight loss of 5% to 10% results ina fall of HbA1c by 0.5 percent and systolic blood pressure by 3 to 6 mm Hg. It also increases the good cholesterol (HDL) by 3 mg/dL.

7. Eat healthy diet

You should eat a diet that is low on sodium, cholesterol, and sugar. If you had a stroke or TIA, you should restrict your sodium intake to less than 2.4gm per day. A Mediterranean-type diet is advisable, consisting of whole grains, vegetables, fruits, low-fat dairy products, poultry, fish, and legumes.

8. Smoking

Smoking is a significant risk factor for the first stroke and a recurrent stroke. According to the AHA guidelines, if you have a history of stroke or TIA, you should quit smoking.

9. Alcohol

If you are a heavy drinker (more than two drinks per day) or does binge drinking (more than 4 drinks in a sitting), you may have a high risk of developing a recurrent stroke.

If you have a stroke history and are a heavy drinker, you should stop or reduce alcohol consumption.