Derek Burnett
Derek Burnett is a Contributing Writer at Bottom Line Personal, where he writes frequently on health and wellness. He is also a contributing editor with Reader’s Digest magazine.
A stroke can be one of the most debilitating medical events of a person’s life…if they’re lucky enough to survive it. More than 20% of stroke victims die within a year. The good news: The majority survive, but merely surviving isn’t enough; survivors must regain their quality of life back.
Fortunately, while we don’t have control over whether or not we’ll have a stroke, there’s still a lot we can do to better our chances of preventing one. At its essence, a stroke is an injury to the brain caused by a problem with an artery that deprives part of the brain of oxygen and nutrients. It is, in other words, a failure within the circulatory system. Therefore, the best ways to prevent a stroke are those that contribute to the creation and maintenance of a healthy heart and blood vessels.
Let’s face it…age, sex, race, and genetics all contribute to stroke risk, and with regard to them there’s absolutely nothing we can do to improve the hand we’re dealt. But that still leaves an awful lot within our control. Two people of the exact same age, sex, race, and genetic makeup could have starkly different outcomes based on how they’ve lived their lives. So even if you feel the cards are stacked against you…perhaps even especially if you feel that way…you should do your best to improve the lifestyle factors within your control below that also contribute to risk:
A healthy diet: Following an eating pattern heavy on vegetables, fruits, whole grains, fish, and the healthy fats found in nuts, avocadoes, and olive oil is one of the best ways to lower your risk of stroke. If you’re uncertain about which foods to eat, consider following an established diet such as DASH (Dietary Approaches to Stop Hypertension), which not only helps manage blood pressure, but contributes to overall heart health. In one study published in the Journal of the American Heart Association, the highest adherence to the DASH diet was associated with a 38% lower risk of dying from a stroke.
Aerobic exercise: Guidelines from the US Department of Health and Human Services suggest that Americans get 2.5 to five hours of moderate physical activity each week, or 1.25 to 2.5 hours of vigorous activity. According to the World Stroke Organization, exercising for half an hour five days per week can slash stroke risk by 25%.
Quitting smoking: The stroke risk of smokers is two to four times higher than that of the general population. But the good news is that the risk begins to drop off as soon as you quit. Within five years after quitting, stroke risk falls to a level similar to that of nonsmokers.
Getting a good night’s sleep: Research links a decreased risk of stroke and heart attack to five healthy sleep characteristics:
If you aren’t doing well on this list, talk to your doctor to identify possible causes and solutions. It’s especially crucial that you address obstructive sleep apnea if you have it, since it is independently associated with elevated risk of stroke.
You may already have a physical condition that is known to increase the risk of stroke. But you can certainly mitigate that risk by treating or managing the problem. Even patients who have already had a stroke…who happen to be the most at-risk group for stroke…can lower their risk by up to 65% by following their doctors’ recommendations.
High blood pressure: Excess pressure on the arteries ages them, making them more likely to rupture and cause a hemorrhagic stroke. It also contributes to the accumulation of plaque, simultaneously increasing the risk of an ischemic stroke. You can lower your blood pressure by cutting salt from your diet, following the DASH diet, and taking blood pressure medications. According to the American Heart Association, you have high blood pressure if you get consistent readings above 130/80. An optimal pressure is 120/80.
High cholesterol: This waxy substance damages the cells that line the blood vessels, contributing to the formation of plaque that can burst and cause a blockage to the brain. Having a level of LDL (“bad”) cholesterol of 100 milligrams per deciliter (mg/dL) or higher puts you at significantly increased risk of stroke. In fact, more than a quarter of patients hospitalized for stroke have cholesterol above that level. To some degree, you can manage your cholesterol level through diet and exercise, but if you try and fall short, a statin drug can help get you the rest of the way there. In a 2017 meta-analysis covering more than 700,000 patients, adherence to a statin regimen was associated with a 17% reduced risk of ischemic stroke and 25% lower risk of hemorrhagic stroke. If you struggle with side effects from statins, talk to your doctor about alternatives, several of which are highly effective.
Diabetes: There are plenty of good reasons to carefully manage your type 2 diabetes, and you can add stroke risk to the list. Patients with this disease face up to eight times the stroke risk of the rest of the population, and this effect is especially strong for women. It’s crucial that diabetes patients get their blood sugar under control, through diet, exercise, and medication. When it comes to the risk of stroke, high blood pressure is particularly dangerous for people with diabetes, so even if your diabetes is well controlled, addressing your high blood pressure with your doctor is an absolute must.
Atherosclerosis: Commonly referred to as “clogged arteries,” this condition is marked by the narrowing and hardening of blood vessels. It is often a precursor to stroke. People with atherosclerosis should follow a heart-healthy diet and engage in a level of physical activity deemed appropriate by their doctors. Numerous medications may be prescribed for atherosclerosis and the conditions which often accompany it such as high blood pressure and cholesterol. These can include ACE inhibitors, beta blockers, statins, anti-clotting medications, nitrates, calcium channel blockers, and metformin. In some cases, doctors will suggest surgery to open blocked arteries, sometimes placing stents inside to keep them from re-narrowing. One surgical solution involves bypassing the coronary arteries completely by grafting blood vessels from elsewhere in the body.
Obesity: Being morbidly obese, which means carrying at least 100 pounds more than your ideal weight if you’re a man and 80 pounds if you’re a woman, increases risk for every type of cardiovascular disease and event, including stroke. Even if you’re more modestly overweight, you should execute a weight-loss plan that includes a healthy eating pattern like the Mediterranean or DASH diet and plenty of exercise. If you have tried and failed to lose weight through these natural methods, talk to your doctor about the new GLP-1 weight loss drugs, or about weight-loss surgery. In a large 2021 study, people who underwent bariatric surgery saw a reduced stroke risk of 64% in the first year and 49% after five years.
Atrial fibrillation (A-fib): If left untreated, this heart-rhythm disorder can increase a person’s risk of ischemic stroke by 500%. That’s because the heart fails to pump enough blood as it beats, allowing blood to pool in the left atrium, where it can form a clot that can then move to the brain, causing stroke. While there are A-fib medications, the first line of treatment is now a surgical procedure called ablation, which can permanently correct the faulty electrical signals that cause the fibrillation.
