Lifestyle Changes Can Help Prevent A Second Stroke

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Experts say diet, exercise, stress reduction, and adequate sleep are all lifestyle changes that should be adopted. Azman Jaka/Getty Images

  • The American Heart Association and the American Stroke Association have released guidelines for people who have had a stroke.
  • The organization encourages doctors to consult with other medical professionals to help determine the cause of a person’s stroke to reduce the risk of a second stroke.
  • They also advise people who have had a stroke to adopt a regular exercise program, eat a healthy diet, get enough sleep, and reduce stress.

Having had a stroke or transient ischemic attack (TIA) increases your risk of having another attack.

But you can take steps to lower that risk.

Each year, about 795,000 people in the United States have a stroke. About 185,000 strokes occur in people who have had at least one stroke.

In addition, approximately 240,000 people have a TIA, or ministroke, each year. About 9 to 17 percent of these people will have a stroke within 90 days.

Stroke is the leading cause of long-term disability. And everyone dies of a 4 minute stroke.

New guidelines from the American Heart Association (AHA) and the American Stroke Association (ASA) outline recommendations for doctors to help their patients avoid another stroke.

“About 80 percent of strokes can be prevented by controlling blood pressure, eating a healthy diet, getting regular physical activity, not smoking, and maintaining a healthy weight,” he said. Dr. Amytis Towfighi, co-chair of the guidelines writing group for the AHA and director of neurological services at the Los Angeles County Department of Health Services, said in a statement.

The first step in lowering the risk of a second stroke is to quickly determine the cause of the first stroke.

The AHA-ASA guidelines require healthcare professionals to complete diagnostic or ongoing tests within 48 hours of the onset of stroke symptoms. Other recommendations for healthcare professionals include:

  • using multidisciplinary care teams, shared decision making, and personal care
  • screening for and treating atrial fibrillation (AFib)
  • prescribe blood thinners or aspirin to certain people
  • placing a stent or surgically removing the blockage if necessary
  • manage risk factors aggressively

Dr. Andrew Freeman is a cardiologist at National Jewish Health in Denver. He told Healthline that AFib is the most common cause of stroke.

“Atrial fibrillation is an epidemic, especially in those who are older, as the risk increases with age. We are looking for this. And we almost always get an echocardiogram of the heart to make sure there are no other abnormalities,” Freeman said.

Neurologists look for damage in the brain, so they may do a CT scan or MRI.

“There is a lot of coordination between neurologists and cardiologists. We will conduct a thorough search to find the cause,” Freeman said.

“There is significant variability in how strokes occur and how debilitating they are. After you have a stroke due to atrial fibrillation, we are aggressive on blood thinners to reduce clotting. We’re also quite aggressive about blood pressure control and statins to lower cholesterol when necessary.”

For those who have had a stroke or TIA, secondary prevention guidelines include managing risk factors such as high blood pressure, type 2 diabetes, cholesterol and triglyceride levels, and not smoking.

The guidelines say that stroke survivors should limit salt intake and follow a Mediterranean diet. Those who are physically capable should do at least 10 minutes of moderate-intensity aerobic activity, four times a week, or vigorous-intensity aerobic activity for at least 20 minutes twice a week.

“A vascular event of any kind is a whole-body systemic process. You have to make significant changes like not smoking,” Freeman said.

Freeman offers five important lifestyle changes to help lower the chances of a second stroke:

  • Daily exercise. After your cardiologist has explained everything, do a 30-minute “breathless” walk or similar activity that you enjoy each day. The goal is to pant a little (no difficulty breathing) while you exercise.
  • Diet. Eat a mostly low-fat, whole-food, plant-based diet. This type of diet has been shown to stop the development of coronary and vascular disease, and can help maintain a moderate body weight.
  • Emphasize. Stress has a huge impact on blood pressure, and it’s important to control both.
  • connectedness. there are data to show that connectedness with family and friends markedly improves vascular outcomes.
  • Sleep. A minimum of 7 hours of uninterrupted sleep is best for overall cardio and cerebrovascular outcomes.

“Collaborative teamwork between neurologists and cardiologists is important. We also need a stronger push in the lifestyle space, which neurologists and cardiologists don’t teach us. But it’s an amazing, powerful way to minimize costs and side effects, and to increase results,” Freeman said.

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