What Steps Can You Take to Reduce Your Risk of Having Another Stroke?
Those who have already experienced a stroke are at a higher risk for a recurrent stroke or heart attack. The good news is that you can reduce your chances of this occurring by controlling your risk factors through life-style changes and medical treatment.
Reduce High Blood Pressure
The most important risk factor for stroke is high blood pressure (also called hypertension). Blood pressure is high if it is regularly above 140/90. High blood pressure is a modifiable risk factor meaning if you can control your blood pressure, you can reduce your risk of stroke. There are several studies showing that lowering your blood pressure by as little as 5-10 mm Hg will significantly reduce your risk of having a stroke. 
Lifestyle changes can significantly improve a person’s blood pressure. There are several changes that will help to reduce your blood pressure.
1. Modify your diet
Too much salt (sodium) in your diet may lead to high blood pressure and make it more difficult to control. If you have high blood pressure, you should cut down on the salt that you use in cooking and not add salt to foods. Your doctor may also tell you to use no salt at all. Begin to read food labels so that you will know which foods are high in salt. You can also begin to use a salt substitute or other herbs instead of salt.
Research has also shown that a diet that is high in fruits, vegetables, low-fat dairy products, whole grains, poultry, fish and nuts and low in fat, red meat, and sweets can help to reduce blood pressure. Changing cooking habits to include baking and broiling rather than frying will also cut down on fat. When you change to this type of a diet along with a reduction in salt intake, the benefits are additive and blood pressure is lowered even more. Ask your nurse or doctor about the DASH (Dietary Approaches to Stop Hypertension) Diet. This diet has been shown to lead to important reductions in blood pressure and it also appears to lower cholesterol levels.
2. Participate in regular physical activity
Exercising at least three to four times per week is helpful for regulating high blood pressure. It also seems to slow down or stop the clogging of blood vessels by fatty plaque deposits. Exercise also helps to control your weight, helps you relax, and can improve your mood.
It is important to keep in mind that exercising regularly is more important than the intensity of the workout. For example, studies have shown that Tai Chi (an ancient Chinese workout involving slow relaxing movements) may lower blood pressure almost as well as moderately intense exercise. You should consult with your nurse or physician before starting an exercise program.
3. Limit alcohol intake
Limit alcohol use to one drink per day for women and two drinks per day for men. One drink is defined as one 6-ounce glass of wine per day, one 12-ounce beer or one 1-ounce shot of distilled spirits.
4. Quit smoking
Smoking is a major risk factor for high blood pressure as well as many other illnesses including lung cancer, breast cancer, and heart disease. If you smoke, stopping smoking is perhaps the most important thing you can do to promote your own good health.
5. Reduce the stress in your life
The body reacts to a perceived threat (stress) with a complex “fight or flight” reaction. This reaction involves a faster heart rate, higher blood pressure, and increased work for the body as it prepares to deal with this stressful situation. Frequent or chronic episodes of stress can increase the risk of heart-related problems such as high blood pressure. Although it may be impossible to reduce all sources of stress in your life, everyone can learn ways to control their reactions to these stressful situations.
6. Take high blood pressure (anti-hypertensive) medications as prescribed
In addition to making lifestyle changes to lower your blood pressure, the doctor may need to prescribe medications to control your blood pressure. It is important that you take these medications exactly as prescribed.
The following table from the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (2003) lists health behavior changes and the approximate reductions in systolic blood pressure (the top number) that may be achieved with each health change.
| Modification |
Recommendation |
Approx Systolic BP Reduction, Range |
|
Weight reduction |
Maintain normal body weight (BMI, 18.5-24.9) |
5-20 mm Hg per 10 kg / 22 lb weight loss |
|
Adopt DASH eating plan |
Consume a diet rich in fruits, vegetables, and low fat dairy products with a reduced content of saturated and total fat |
8-14 mm Hg |
|
Dietary sodium reduction |
Reduce dietary sodium intake to no more than 100mEq/L (2.4 g sodium or 6 g sodium chloride) |
2-8 mm Hg |
|
Physical activity |
Engage in regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of week) |
4-9 mm Hg |
|
Moderation of alcohol consumption |
Limit consumption to no more than 2 drinks per day (1 oz or 30mL ethanol; e.g. 24 oz beer, 10 oz wine, or 3 oz 80-proof whiskey) in most men and no more than 1 drink per day in women and lighter-weight persons |
2-4 mm Hg |
Take Antiplatelet Medications As Prescribed by Your Doctor
Antiplatelet agents are medications that help prevent the formation of blood clots by keeping platelets (the body’s natural blood-clotters) from clumping together. Platelets play an essential role in blood clotting and group together to stop the bleeding when the body has been cut. At times, however, the formation of clots may be harmful. Depending on the size and location of these blood clots, they may increase a person’s risk of heart attack or stroke. Therefore, antiplatelets are prescribed to reduce the chance that the platelets will clump together and form potentially harmful blood clots. Aspirin is the most commonly prescribed antiplatelet medication. Although a stroke can happen even when you are taking aspirin, we know that taking aspirin regularly will reduce the risk of having a stroke. There are also other medications that are prescribed to present stroke and heart attack and these include Plavix, Aggrenox, or Coumadin (warfarin). Your personal physician will recommend the antiplatelet medication(s) that is right for you.
Lower Your Cholesterol
Elevated blood levels of total cholesterol and LDL (bad) cholesterol are risk factors for stroke and heart attack. Current guidelines recommend total cholesterol of < 200, and LDL < 100 for all patients with coronary artery disease and most patients with stroke. To lower cholesterol, the right diet is important as well as daily exercise. Medications called ‘statins’ are used to treat high cholesterol.
If You Have Diabetes, Keep it Well Controlled
While diabetes is treatable, it increases your risk for having a stroke. If you have diabetes, the best way to reduce the impact it can have on your health is by controlling your other risk factors.
Work with your doctor and a dietician to manage your diabetes.
