Stanford Stroke Center

Stroke Prevention

There are many positive steps that you can take now to reduce your risk of stroke. The most common risk factors for stroke are listed below. These include some conditions that can be changed by lifestyle modification or medical treatment, and some, such as hereditary factors, that cannot be changed.

How to Reduce Your Risk

Most of the controllable risk factors for stroke relate to cardiovascular fitness. Because stroke is a form of cardiovascular disease, it makes sense that keeping your heart and blood vessels as healthy as possible will reduce your risk of stroke. The following are the most important measures you can take to control your stroke risk. These include changing risk factors by medical treatment as well as by positive lifestyle modifications.

Regular Medical Check-ups

Risk factors such as heart disease, high blood pressure, and elevated blood cholesterol must be monitored by your physician on a regular basis. These risk factors can be changed or, at minimum, controlled by proper medical treatment and appropriate diet and lifestyle modifications.

Control Blood Pressure

High blood pressure (hypertension) is the single most important risk factor for stroke. Even mild hypertension, if not adequately treated, increases stroke risk. In general, blood pressure should be below 120/80.

Elevated blood pressure promotes atherosclerosis and puts abnormal pressure on blood vessel walls, which can cause a rupture at a weak spot. Hypertension is often called the“silent killer” because there may be no obvious symptoms. It is important to check your blood pressure regularly. Controlling blood pressure, whether by a low-sodium diet, weight control, stress management and/or medication will reduce your risk of stroke.

Remember: medication to control hypertension is effective only if taken on a regular basis, so it is important to follow your physician's instructions.

Treatment of hypertension in older adults is also important. However, in elderly individuals, an abrupt fall in blood pressure may actually cause a stroke. Therefore, treatment of high blood pressure in the elderly may need to start with small doses of medication, so that blood pressure is reduced gradually.

Stop Smoking

Studies confirm that smokers have a higher risk of stroke, regardless of other factors such as age, high blood pressure, or heart disease. The risk declines dramatically within a few years of stopping smoking.

Treat Heart Disease

A variety of heart conditions, including irregular heart rhythms (atrial fibrillation), heart attacks and heart valve disorders, can cause stroke. Treatment of these disorders can reduce stroke risk.

Improve Diet

Consumption of foods high in fat, cholesterol and salt increases the risk for stroke. The following recommendations are among the most important for stroke prevention. Ask your doctor for more help in identifying dietary culprits and making appropriate substitutions.

  1. Avoid excess fat
    High intakes of fat, particularly saturated fat, and cholesterol may contribute to atherosclerosis, which is associated with stroke. Dietary fat and cholesterol may be reduced by limiting fat or oil added in cooking, trimming fat and skin from meats and poultry, using low-fat or non-fat dairy products, broiling and baking foods rather than frying, and limiting eggs to no more than three a week.

  2. Avoid excess sodium
    Excess sodium in the diet is linked to hypertension. Table salt is the primary source of dietary sodium. There is also “hidden” salt in most processed and canned foods. Disodium phosphate, monosodium glutamate, sodium nitrate, or any similar compounds in the list of ingredients indicate a high sodium content. Try to eat fresh food whenever possible.

  3. Limit alcohol intake
    Individuals who drink alcoholic beverages (more than two drinks per day) have an increased risk of stroke. For heavy drinkers, the risk of stroke increases further. Healthy young adults are just as susceptible to the risk of stroke incurred by heavy alcohol consumption as are older persons.

Maintain a Healthy Weight

Being overweight strains the heart and blood vessels and is associated with high blood pressure. Obesity also predisposes a person to heart disease and diabetes, both of which increase the risk for stroke. Keeping your weight to recommended levels for your height and build is a prudent preventive measure.

Exercise Regularly

The percentage of fat in our bodies tends to increase with age. Regular exercise helps keep this increase to a minimum. There appears to be an inverse relationship between exercise and atherosclerosis, i.e., more exercise is linked to lower levels of atherosclerosis.

If you have not exercised regularly and would like to start an exercise program, or if you have medical problems or family history of serious disease, consult your physician before beginning an exercise program. Select an exercise program that is most suitable for you. Experts recommend at least 20 to 30 minutes of aerobic exercise three to four times a week in order to achieve and maintain an improved level of fitness.

Treat Diabetes

The association between diabetes and increased stroke risk seems to be related to the circulatory problems caused by diabetes. Good control of diabetes appears to reduce the cardiovascular complications of the disease.

Reduce Stress

Because stress may increase blood pressure, it is linked indirectly to stroke risk. A one-time stressful event rarely causes a stroke, but long-term unresolved stress can contribute to high blood pressure. Stress management, including relaxation techniques, biofeedback, exercise and counseling, appear to be useful in the treatment of high blood pressure, thus lowering the risk of stroke.

Use of Oral Contraceptives

Oral contraceptives, especially those with high estrogen content, appear to increase the risk of blood clots, including clots that cause stroke, especially in women over age 30. The risk is even higher in women who smoke. Consult your physician for advice regarding alternative methods of birth control if you have stroke risk factors and are currently using oral contraceptives.

Post-menopausal Estrogen Use

Recent studies have shown that post-menopausal estrogen resplacement is associated with a small increase in the risk of stroke.

Risk Factors That Cannot be Changed

New Risk Factors

The Stanford Stroke Center is participating in clinical trials that are evaluating some recently described stroke risk factors. These risk factors may predispose to atherosclerosis or blood clot formation and appear to be treatable.

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