year about 600,000 Americans suffer from their first stroke, with nearly three-quarters of these occurring in people
over the age of 65. Strokes are the fourth leading cause of death
in this country, accounting for more than 133,000 deaths in 2008 (the last year
for which data are available). Sadly, as many as 30 percent of stroke victims
remain permanently disabled. Moreover, a first stroke greatly increases the
risk of a second one, and the likelihood of a stroke grows steadily with
increasing age. With strokes, prevention is the best option.
What can you do to prevent a stroke?
high blood pressure is the most important preventive measure. Hypertension
raises the danger of both hemorrhagic (bleeding) strokes and ischemic strokes. For hemorrhagic strokes this is due to the rupture of a blood vessel. The much
more common ischemic strokes result from the complete blockage of an artery
narrowed by plaque.
good news is that you can make lifestyle changes that can help lower blood
Lower intake of
moderately – no more than one drink a day for women and two drinks a day for
Reach and maintain a normal body weight
these measures do not bring your blood pressure lower than 140 mm Hg,
antihypertensive medications--often two or even three combined--will be needed
to control hypertension.
and other prevention measures
older Americans are taking a daily aspirin, either on their own or on their
doctor’s advice, in an effort to prevent a heart attack or stroke. This
practice is appropriate for those with either a previous cardiovascular event
or with multiple risk factors for such an event. However, new stroke prevention guidelines from the
American Heart Association and the American Stroke Association recommend that
you take a daily aspirin only if your risk factors indicate that your ten-year risk of a heart attack or stroke is ten percent or more. Those at a lower
risk should ask their doctors whether they should be taking aspirin because it
raises the danger of serious gastrointestinal bleeding and even a hemorrhagic
addition, atrial fibrillation, the most common heart rhythm abnormality among
older individuals, greatly increases the risk of stroke. A blood clot that
forms in the left atrium can break off and travel through the bloodstream to
block off an artery in the brain and cause a stroke. Such blood clots must be
prevented in people with atrial fibrillation. Treatment would include either
aspirin or the blood thinner warfarin (Coumadin) in those with valvular heart
disease, or people with additional risk factors such as hypertension, or those
older than age 75.
stroke prevention measures include smoking cessation and lowering blood cholesterol
levels. Lower cholesterol can be accomplished with a diet low in
saturated fats and treatment with one of the statin drugs if the LDL
cholesterol exceeds 100 mg/dL.