Stroke Overview

Prevention

You can help to prevent stroke by controlling risk factors, including high blood pressure, smoking, atrial fibrillation (an abnormal heart rhythm), high cholesterol or atherosclerosis, and diabetes. A healthy lifestyle and taking an aspirin once a day also can help to prevent stroke.

Several medicines used to treat high blood pressure have been shown to have an especially strong benefit in preventing stroke. These medicines include drugs called ACE inhibitors, including enalapril (Vasotec), ramipril (Altace), captopril (Capoten) or lisinopril (Prinivil, Zestril) and medicines called thiazide diuretics, including thiazide or chlorthalidone (Hygroton, Thalitone).

If you have atrial fibrillation, or if you have had it in the past, you can greatly reduce your risk of stroke by taking the blood-thinning medication warfarin (Coumadin). Most people who have atrial fibrillation can take this medication safely. Warfarin prevents clots from forming inside the left atrium of the heart that might later dislodge and cause a stroke.

People with diabetes can reduce their risk of atherosclerosis by keeping tight control over their blood sugar levels with aggressive treatment.

High cholesterol also should be treated aggressively. Cholesterol-lowering medications called statins can help to prevent stroke. If you do not have cholesterol problems, you should have your cholesterol checked every five years.

To help prevent stroke, you also should exercise regularly and eat a healthy diet that is rich in fruits and vegetables but low in saturated fats, trans fats (hydrogenated or partially hydrogenated oils) and cholesterol. Recent research has shown that eating two to four servings of fish weekly can lower the risk of stroke. One study demonstrated that people who eat fish frequently have about half the risk of stroke compared with people who eat fish one to three times a month. Also, avoid excessive use of alcohol and never take cocaine or amphetamines.

It is important that you discuss with your doctor the potential benefits of taking an aspirin daily. Aspirin in doses as low as 80 milligrams per day can reduce the risk of stroke overall, although one type of stroke, hemorrhagic stroke, occurs slightly more often when aspirin is taken regularly. Other medications that help to prevent clots from forming include ticlopidine (Ticlid) and clopidogrel (Plavix). Aspirin and these clot-preventing medicines are not safe for everyone.