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Preventing Strokes

  • Chris Woolston, M.S.
  • Posted March 11, 2013

You've heard about the importance of a heart-healthy lifestyle. You might even have one. But have you given much thought to your brain? Every year, over 160,000 Americans die from strokes, and many more become permanently disabled. Like heart attacks, strokes are closely tied to a person's daily habits. By making a few healthy changes, especially if you're under 55, you can dramatically cut your risk of one of the most devastating maladies around.

Most strokes -- about 80 percent -- are caused by clogged arteries in the brain. Doctors call these ischemic strokes, but it's easier to think of them as "brain attacks." Not surprisingly, many of the lifestyle changes that prevent clogged arteries around the heart will also ward off ischemic strokes. The other 20 percent of strokes, known as hemorrhagic strokes, occur when a blood vessel in the brain bursts. Again, by adopting some of the basic tenets of healthy living, many of these strokes can be prevented.

Here's a look at the best ways to prevent a stroke. Taking these precautions makes sense for everyone, but it's especially crucial for people at high risk of stroke, including those who have already had a transient ischemic attack (mini-stroke).

Control your blood pressure

Keeping your blood pressure in check is the single most important way to prevent a stroke. Over time, high blood pressure damages blood vessels in the brain, increasing the risk of both hemorrhagic and ischemic strokes. The threat of ischemic stroke is especially severe. The risk of having blockages in the brain is eight times higher for people with extreme hypertension (180/90 or more) than it is for those with normal blood pressure, according to the journal Postgraduate Medicine. Even mild hypertension -- slightly above 140/90 -- can raise the odds by 50 percent. Blood pressure that falls between 120-139/80-89 is considered prehypertension and increases your risk of developing hypertension.

If you have high blood pressure, changing your eating habits can bring it down significantly. The American Heart Association advises adding more fruits, vegetables, and fat-free dairy products to your diet. Vegetables and fruits are high in potassium, magnesium, and calcium, and these minerals can help lower or prevent high blood pressure when combined with a low-fat, low-salt diet, according to the AHA.

If your blood pressure is already a little high, recommendations from the National Heart, Lung and Blood Institutes DASH diet advise that you consume 4,700 mg of potassium a day, or the equivalent of about seven large bananas. Fortunately, you can also get plentiful supplies of potassium from other foods, such as potatoes, avocados, tomatoes, citrus fruits, yogurt, and tuna. (If you have kidney problems, check with your doctor before increasing your potassium intake.)

Diet in combination with exercise can have an even more profound effect. A report in Sports Medicine showed that regular exercise can also decrease blood pressure by as much as 10 points. Aerobic exercise -- like swimming, bicycling, brisk walking, or dancing -- for 25 to 30 minutes at least three times a week can make the biggest difference.

Avoid smoking

Smoking wreaks havoc on arteries throughout the body, and those in the brain are no exception. Smokers with high blood pressure are prime targets for a hemorrhagic stroke. According to the National Stroke Association, smoking doubles the risk for stroke. The more a person smokes, the greater the danger. If you're a smoker, it's time to quit.

Stay active

Even if you don't have hypertension, regular exercise will strengthen your arteries and prevent the buildup of plaque in blood vessels. In combination with a healthy diet, exercise can help you to ward off obesity or excessive weight, which makes people more likely to have high cholesterol, high blood pressure, and diabetes, all of which increase your risk for stroke. A 2003 issue of Stroke reported that moderate and high levels of exercise were associated with significantly fewer strokes. In the 2003 report, researchers examined 23 studies over 36 years and found a reduced risk of between 20 and 27 percent. To give your brain a boost, the National Stroke Association recommends making time each day to exercise, noting that a brisk walk for 30 minutes a day may reduce your risk for stroke. The benefits of exercise extend to stroke survivors as well: The American Heart Association has issued guidelines stressing the importance of aerobic and strengthening exercises for improving overall health and reducing the risk of subsequent strokes.

Go easy on alcohol

One alcoholic drink each day if you're a woman, or two if you're a man, is unlikely to do any harm, and may even help prevent a stroke. But three or more drinks each day can increase the risk of an ischemic stroke by up to three times, according to the National Stroke Association. If you have trouble stopping at one or two drinks, you're better off quitting completely.

Ask about aspirin

This common painkiller may help prevent the blood clots that can cause ischemic strokes or heart attacks. At least 133 studies involving more than 53,000 subjects have found that daily doses of aspirin cut the risk of having a stroke or heart attack by about 30 percent. However, a 2005 study reported in the New England Journal of Medicine suggests that women may not get as much benefit from aspirin therapy as men do. The women-only study found that 100 mg of aspirin every other day only reduced the risk of stroke by 17 percent. Aspirin can cause ulcers and other stomach problems, so you shouldn't take it regularly unless your doctor says it's okay. Also, a 2003 study reported in the medical journal Lancet suggests that taking ibuprofen can interfere with the cardiac benefits of aspirin, so check with your doctor if you use ibuprofen regularly for pain relief.

Work closely with your doctor

Despite all of your best efforts, lifestyle changes aren't always enough. If diet and exercise don't lower your pressure to a safe level, your doctor may prescribe blood pressure medication.

Also, if you have diabetes -- a disease that damages blood vessels -- heart disease, or a history of stroke, it will take a team effort to protect your brain. Patients with diabetes should work carefully with their doctors to make sure their blood sugar is under control. If you're at risk for blood clots, your doctor may prescribe blood-thinning drugs or even surgery. With aggressive treatment, your odds of stroke will drop dramatically. Now that's peace of mind.

References

National Institute of Neurological Disorders and Stroke. Brain Basics: Preventing Stroke. July 1, 2001.

Ingall TJ. Preventing ischemic stroke. Postgraduate Medicine. May 15, 2000. 107(6): 34-50.

MacDonald TM, et al. Effect of ibuprofen on cardioprotective effect of aspirin. Lancet 2003; 361:573-74.

Ryan M, et al. Preventing stroke in patients with transient ischemic attacks. American Family Physician. November 15, 1999. 60(8): 2329-2336.

Joshipura, KJ, et al. Fruit and vegetable intake in relation to risk of ischemic stroke. Journal of the American Medical Association 282 (October 6, 1999): 1233-39.

National Institutes of Health. New Recommendations to Prevent High Blood Pressure by the National High Blood Pressure Education Program. October 15, 2002. http://www.nih.gov/news/pr/oct2002/nhlbi-15.htm

NHLBI Issues New High Blood Pressure Clinical Practice Guidelines. May 14, 2003. NIH News. http://www.nhlbi.nih.gov/new/press/03-05-14.htm

Statement from Elizabeth G. Nabel, M.D., Director of the National Heart, Lung, and Blood Institute of the National Institutes of Health on the Findings of the Women's Health Study. NIH News. March 7, 2005.

American Heart Association. Saying yes to regular physical activity says no to stroke. September 2003. http://www.americanheart.org/presenter.jhtml?identifier=3015386

National Stroke Association. Public Stroke Prevention Guidelines. http://www.stroke.org/site/PageServer?pagename=PREVENT

NHLBI. Your Guide to Lowering Your Blood Pressure with DASH. 2006 April. http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/how_plan.html

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