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You may not have to have a stroke. You've heard it before – control your blood pressure, control your cholesterol, stop smoking and keep your body to a healthy weight. You can dramatically reduce the risk of having a stroke, along with preventing a heart attack, Type 2 diabetes and many other diseases.
In general, to prevent stroke you shold:
- Know your risk factors and develop a plan, with your doctor, to reduce them;
- Control high blood pressure, high cholesterol, diabetes, and heart disease with lifestyle changes and medicines prescribed by your doctor.
High blood pressure is the leading risk factor for stroke. But you can reduce your blood pressure by making some simple lifestyle changes.
- Stop smoking.
- Don't abuse alcohol (no more than 1 to 2 drinks per day).
- Eat a low-fat diet.
- Minimize the amount of sodium in your diet.
- Sodium is found in table salt (chemical name, sodium chloride), so minimize the amount of salt you eat; avoid salty snacks.
- Exercise often, on a regular schedule.
- Lose weight if you're overweight.
- Reduce and manage stress by changing your lifestyle and simplifying your life, exercising and using relaxation techniques.
There are also prescription medicines that help reduce blood pressure, such as:
- Diuretics
- ACE (angiotensin-converting enzyme) inhibitors
- Angiotensin receptor blockers
- Beta-blockers
- Calcium channel blockers
You should discuss these medicines with your doctor, who will prescribe what's appropriate for you. You can get more information about them at Medline Plus, an on-line service of the National Library of Medicine, the National Institutes of Health, and other government agencies and health-related organizations.
Most strokes are caused by a blood clot or atherosclerosis (fatty build-up) blocking the flow of blood through arteries leading to the brain. Atherosclerosis is the same condition that can also cause a heart attack. High levels of LDL-cholesterol (commonly called "bad cholesterol") are a major cause of atherosclerosis. Therefore, two other types of stroke preventing medicines are those that:
- reduce blood clotting
- reduce LDL-cholesterol, plaque and atherosclerosis
The first type, prescription anti-clotting medicines, include anticoagulants, antiplatelet agents, and thrombolytics. Like all prescription medicines, they must be used properly, following all of your doctor's recommendations and precautions.
- Anticoagulants decrease the blood's ability to form clots. They're often called "blood thinners," though they don't actually thin the blood, nor do they dissolve clots already present.
- Antiplatelets stop blood platelets (substances in blood that promote clotting) from clumping together to form clots.
- Thrombolytics are often called "clot busters" because they break up or dissolve already existing blood clots. For information about them, go to Key Point 1.
Aspirin is a non-prescription antiplatelet medicine. But even though it is available over-the-counter, it may not be appropriate because it increases the risk of bleeding. Do not "self-medicate" yourself with aspirin. Instead, talk to your doctor about its risks and benefits.
The second type of medicine, prescription LDL-cholesterol reducing drugs, include statins, bile acid sequestrants, and fibrates.
- Statins are currently considered the most important and effective group of LDL-cholesterol reducing medicines. They slow cholesterol production and increase the liver's ability to remove the LDL-cholesterol already there. Because the body makes more cholesterol at night, these drugs are usually taken in the evening, at dinner or before bed. Side effects appear to be minimal and studies show that people using statins have reported 20 to 60 percent lower LDL-cholesterol levels. As of this writing, five statin drugs are available in the U. S.:
- lovastatin
- simvastatin
- pravastatin
- fluvastatin
- atorvastatin
- Bile acid sequestrants bind with bile acids in the intestines that contain cholesterol. Then they are eliminated during defecation, reducing the amount of cholesterol in the blood. Often, these drugs are prescribed in combination with statins. As of this writing, three main bile acid sequestrants are available here:
- cholestyramine,
- colestipol
- colesevelam
- Fibrates lower the level of triglycerides (the main component of fat and therefore another major cause of atherosclerosis) in the blood.
Nicotinic acid is a non-prescription cholesterol lowering substance. It's a form of niacin, the water-soluble B vitamin. When taken in high doses, well above the suggested daily amount, it can be effective in lowering LDL-cholesterol and triglyceride levels. Note that there's another form of niacin, nicotinamide, that doesn't lower cholesterol and shouldn't be used instead of nicotinic acid. Further, high doses of nicotinic acid can have side effects. Do not "self-medicate" yourself with Vitamin B. Instead, talk to your doctor about its risks and benefits.
In addition to all these preventative measures, there are also physical ways to unblock an artery, including surgery and a procedure called "stenting." For information about them, go to Key Point 2.
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