Prevention of stroke

Recurrent strokes make up almost 25% of the nearly 800,000 strokes that occur annually in the United States. Risk factors for ischemic stroke include hypertension, diabetes mellitus, hyperlipidemia, sleep apnea, and obesity. Lifestyle modifications, including tobacco cessation, decreased alcohol use, and increased physical activity, are also important in the management of patients with a history of stroke or transient ischemic attack. Antiplatelet therapy is recommended to reduce the risk of recurrent ischemic stroke. The selection of antiplatelet therapy should be based on timing, safety, effectiveness, cost, patient characteristics, and patient preference. Aspirin is recommended as initial treatment to prevent recurrent ischemic stroke. Clopidogrel is recommended as an alternative monotherapy and in patients allergic to aspirin. The combination of clopidogrel and aspirin is not recommended for long-term use (more than two to three years) because of increased bleeding risk. Aspirin/dipyridamole is at least as effective as aspirin alone, but it is not as well tolerated. Warfarin should not be used for prevention of recurrent ischemic stroke. Clinical recommendation Evidence rating References Antihypertensive therapy should be initiated in untreated patients with a recurrent ischemic stroke or TIA who have systolic blood pressure of more than 140 mm Hg or diastolic blood pressure of more than 90 mm Hg several days after the event. B – All patients with ischemic stroke or TI...

I'm Dr. Robert Brown, neurologist at Mayo Clinic. In this video, we'll cover the basics of a stroke. What is it, who it happens to, the symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. You've likely heard the term stroke before. They affect about 800,000 people in the United States each year. Strokes happen in two ways. In the first, a blocked artery can cut off blood to an area of the brain. And this is known as an ischemic stroke. 85% of strokes are of this type. The second type of stroke happens when a blood vessel can leak or burst. So the blood spills into the brain tissue or surrounding the brain. And this is called a hemorrhagic stroke. Prompt treatment can reduce brain damage and the likelihood of death or disability. So if you or someone you know is experiencing a stroke, you should call 911 and seek emergency medical care right away. Anyone can have a stroke, but some things put you at higher risk. And some things can lower your risk. If you're 55 and older, if you're African-American, if you're a man, or if you have a family history of strokes or heart attacks, your chances of having a stroke are higher. Being overweight, physically inactive, drinking alcohol heavily, recreational drug use. Those who smoke, have high blood pressure or high cholesterol, have poorly controlled diabetes, suffer from obstructive sleep apnea, or have certain forms of heart d...

Should you take aspirin to prevent stroke? AHA Recommendation Key takeaways from the 2019 American College of Cardiology/American Heart Association (ACC/AHA) Guidelines on the Primary Prevention of Cardiovascular Disease include a thorough assessment of your risk and a shared decision on preventive strategy with your health care provider. You shouldn’t take daily low-dose aspirin on your own without talking to your doctor. In some cases, there are serious risks that outweigh the benefits of aspirin. You should not start aspirin on your own. Because of the risk of bleeding, aspirin therapy is not recommended if you have never had a heart attack or stroke, except for certain carefully selected patients. If you’re over 70, taking aspirin to prevent a first heart attack or stroke could do more harm than good. If you have had a stroke, your doctor may recommend medications, including aspirin, to help prevent another one. Aspirin is part of a well-established treatment plan for patients with a history of stroke. Take the recommended medications and talk to your doctor before making any changes. Know the risks Because aspirin thins the blood, it can cause several complications. You should not take daily low-dose aspirin if you: • Have an aspirin allergy or intolerance • Are at risk for gastrointestinal bleeding or hemorrhagic stroke • Drink alcohol regularly • Are undergoing any simple medical or dental procedures • Are over the age of 70 There is a risk of stomach problems, incl...

Stroke Prevention and Management The main primary preventive approaches for stroke are the promotion and maintenance of healthy lifestyle and blood pressure control. A healthy lifestyle includes not smoking (and smoking cessation for smokers), no binge drinking, being physically active, and a healthy diet characterized by adequate fruit and vegetable intake, reduced dietary trans fat intake, and reduced sodium intake. Primary prevention High blood pressure prevention and control Reducing blood pressure has been demonstrated to reduce the risk of stroke effectively. In a meta-analysis of 11 clinical trials on blood pressure reduction and stroke among Asian populations, a 10mmHg reduction in systolic blood pressure was associated with a 30% reduction in risk of stroke, regardless of the anti-hypertensive agents used (renin–angiotensin blockers, calcium-channel blockers, or diuretics). Tobacco control Tobacco control was ranked number one among the top five priority interventions for non-communicable diseases (NCDs), according to a group of experts. According to a micro-simulation model based on Indian data, smoke-free legislation and tobacco taxation in combination could avert 25% (95% CI: 17%–34%) of myocardial infarctions and strokes if the effects of the interventions are additive. Sodium reduction Reduction of sodium intake has been ranked as the second most cost-effective intervention, after tobacco control, for addressing the NCD crisis. Achievement of actual and susta...

Brief Summary: Primary Aim: To determine if apixaban is superior to aspirin for prevention of the composite outcome of any stroke (hemorrhagic or ischemic) or death from any cause in patients with recent ICH and atrial fibrillation (AF). Secondary Aim: To determine if apixaban, compared with aspirin, results in better functional outcomes as measured by the modified Rankin Scale. • Adam de Havenon, MD, MSCI • Adam Jasne, MD • Emily J. Gilmore, MD, FNCS, FACNS • Hardik P Amin, MD • Jaehan Park • James A. Giles, MD, PhD, MPHS, MRCP • Jennifer Ahjin Kim, MD/PhD • Jessica Magid-Bernstein, MD, PhD • Joseph Schindler, MD • Kasun Navarathna, MD • Kevin Sheth, MD • Kun He Lee, MD, BS • Lauren Hachmann Sansing, MD, MS, FAHA, FANA • Neeharika Thottempudi • Nils Petersen, MD/PhD, MSc • Nishant K. Mishra, MBBS, PhD, MD, FAHA • Rachel Beekman, MD • Rachel Forman, MD • Reshma Narula, MD • Richa Sharma, MD, MPH • Ruth Arnold • Safa Abdelhakim, MD • Stefanie Cappucci • Yee Kuang Cheng, MD Your browser is antiquated and no longer supported on this website. Please update your browser or switch to Chrome, Firefox or Safari. You can update your IE here: [5,26,25,93]

It's never too late to strike out against a potentially devastating brain attack. Like close cousins, heart disease and stroke share a common lineage. Both emerge from a mix of nature (genes), nurture (upbringing and environment), and personal choice (smoking, exercise, etc). For most of us, personal choice largely determines whether a stroke lies ahead. Guidelines on the prevention of stroke suggest that a healthy lifestyle can cut the risk of having one by 80%. No drug, device, or other intervention can come close to doing that. As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Thanks for visiting. Don't miss your FREE gift. The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, andmore. Close Health Alerts from Harvard Medical School Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss...from exercises to build a stronger core to...