Knowing your risk factors and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. In general, a healthy lifestyle means that you:
• Control high blood pressure (hypertension). One of the most important things you can do to reduce your stroke risk is to keep your blood pressure under control. If you've had a stroke, lowering your blood pressure can help prevent a subsequent transient ischemic attack or stroke. Exercising, managing stress, maintaining a healthy weight, and limiting sodium and alcohol intake are all ways to keep high blood pressure in check. In addition to recommendations for lifestyle changes, your doctor may prescribe medications to treat high blood pressure, such as diuretics, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers.
• Lower your cholesterol and saturated fat intake. Eating less cholesterol and fat, especially saturated fat, may reduce the plaques in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication.
• Don't smoke. Quitting smoking reduces your risk of stroke. Several years after quitting, a former smoker's risk of stroke is the same as that of a nonsmoker.
• Control diabetes. You can manage diabetes with diet, exercise, weight control and medication. Strict control of your blood sugar may reduce damage to your brain if you do have a stroke.
• Maintain a healthy weight. Being overweight contributes to other risk factors for stroke, such as high blood pressure, cardiovascular disease and diabetes. Weight loss of as little as 10 pounds may lower your blood pressure and improve your cholesterol levels.
• Exercise regularly. Aerobic exercise reduces your risk of stroke in many ways. Exercise can lower your blood pressure, increase your level of high-density lipoprotein (HDL) cholesterol, and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to 30 minutes of activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week.
• Manage stress. Stress can cause a temporary spike in your blood pressure — a risk factor for brain hemorrhage — or long-lasting hypertension. It can also increase your blood's tendency to clot, which may elevate your risk of ischemic stroke. Simplifying your life, exercising and using relaxation techniques are all approaches that you can learn to reduce stress.
• Drink alcohol in moderation, if at all. Alcohol can be both a risk factor and a preventive measure for stroke. Binge drinking and heavy alcohol consumption increase your risk of high blood pressure and of ischemic and hemorrhagic strokes. However, drinking small to moderate amounts of alcohol can increase your HDL cholesterol and decrease your blood's clotting tendency. Both factors can contribute to a reduced risk of ischemic stroke.
• Don't use illicit drugs. Many street drugs, such as cocaine and crack cocaine, are established risk factors for a TIA or a stroke.
Follow a healthy diet
In addition, eat healthy foods. A brain-healthy diet should include:
• Five or more daily servings of fruits and vegetables, which contain nutrients such as potassium, folate and antioxidants that may protect you against stroke.
• Foods rich in soluble fiber, such as oatmeal and beans.
• Foods rich in calcium, a mineral found to reduce stroke risk.
• Soy products, such as tempeh, miso, tofu and soy milk, which can reduce your low-density lipoprotein (LDL) cholesterol and raise your HDL cholesterol level.
• Foods rich in omega-3 fatty acids, including cold-water fish, such as salmon, mackerel and tuna.
If you've had an ischemic stroke, your doctor may recommend medications to help reduce your risk of having a TIA or stroke. These include:
• Anti-platelet drugs. Platelets are cells in your blood that initiate clots. Anti-platelet drugs make your platelets less sticky and less likely to clot. The most frequently used anti-platelet medication is aspirin, taken daily. Your doctor can help you determine the right dose of aspirin for you.
Your doctor may also consider prescribing Aggrenox, a combination of low-dose aspirin and the anti-platelet drug dipyridamole, to reduce blood clotting. If aspirin doesn't prevent your TIA or stroke or if you can't take aspirin, your doctor may instead prescribe an anti-platelet drug such as clopidogrel (Plavix) or ticlopidine (Ticlid).
• Anticoagulants. These drugs include heparin and warfarin (Coumadin). They affect the clotting mechanism in a different manner than do anti-platelet medications. Heparin is fast acting and is used over the short term in the hospital. Slower acting warfarin is used over a longer term.
Warfarin is a powerful blood-thinning drug, so you'll need to take it exactly as directed and watch for side effects. Your doctor may prescribe these drugs if you have certain blood-clotting disorders; certain arterial abnormalities; or an abnormal heart rhythm, such as atrial fibrillation, or other heart problems.