For some people, stroke prevention may begin after a transient ischemic attack, or TIA. A TIA is a warning sign that a stroke may soon occur. Prompt medical attention may help prevent a stroke.
Seek emergency medical help immediately if you have symptoms of a TIA, which are similar to those of a stroke and include problems with vision, speech, behavior and thought processes. A TIA may cause loss of consciousness, seizure, dizziness, vertigo and weakness or numbness on one side of the body. Symptoms of a TIA are temporary and usually disappear after 10 to 20 minutes, although they may last up to 24 hours.
Many strokes can be prevented by controlling risk factors and treating other medical conditions that can lead to a stroke.
- If you have been told that you have hardening of the arteries or atherosclerosis, check with your doctor about whether you should take an aspirin each day and/or a medication to lower your cholesterol. Taking an aspirin daily also can reduce the risk of stroke in a person who has already had an ischemic stroke, a TIA, or carotid endarterectomy surgery.
- If your doctor hears a swishing sound - a bruit - when listening to blood flow through the large blood vessels in your neck (carotid arteries), ask whether you need further testing (usually carotid ultrasonography). Taking an aspirin daily or considering surgery to reopen a blocked carotid artery may be appropriate.
A relatively new procedure called carotid artery stenting is another option for some people at high risk of stroke. This procedure is much like coronary angioplasty, which is commonly used to open blocked arteries in the heart. During this procedure, a vascular surgeon inserts a metal tube called a stent inside your carotid artery to increase blood flow in areas blocked by plaque. The surgeon may use a stent that is coated with medication to help prevent future blockage.
Other ways you can control your risk factors include:
- Have regular medical checkups. Work with your doctor to control your high blood pressure. This is important if you also have diabetes.
- Become more active. A new large study shows that physical activity significantly lowers your risk of stroke, partly by reducing the two greatest risk factors for stroke: high blood pressure and heart disease. The more physically active you are, the greater the reduction in risk. Exercise also can help raise HDL, or good cholesterol levels in your body, reducing the risk of stroke.
- Control high cholesterol, heart disease (atrial fibrillation), diabetes or disorders that affect your blood vessels, such as coronary artery disease.
- Do not smoke. If you do smoke, quit. Daily cigarette smoking increases the risk of stroke by 2½ times.
- Take cholesterol-lowering medications called statins if you have high cholesterol or have had a heart attack, TIA or stroke.
Other ways you may be able to decrease your risk for stroke include:
- Take daily aspirin if you have had a heart attack.
- Take anticoagulants, as prescribed by your doctor, if you have atrial fibrillation or have had a heart attack with other complications.
- Maintain a healthy weight. Being overweight increases your risk of developing high blood pressure, heart problems and diabetes, which are risk factors for TIA and stroke.
- Eat a nutritious, balanced diet low in cholesterol, saturated fats and salt. Foods high in saturated fat and cholesterol can worsen hardening of the arteries. Eating more fruits and vegetables increases your intake of potassium and vitamins B, C, E and riboflavin. Adding whole grains to your diet may greatly reduce the risk of ischemic stroke (particularly in women). Eating fish once a month or more may also reduce your risk of stroke.
- Limit your alcohol. Low to moderate alcohol consumption (from one drink per week to less than two drinks per day) may decrease the risk of ischemic stroke. Excessive use of alcohol (more than two drinks per day) increases a person's risk of stroke.
- Avoid cocaine and other illegal drugs. Cocaine can increase blood pressure and cause the heart to beat more rapidly, thereby increasing your risk of stroke.
- Avoid birth control pills if you have other risk factors. If you smoke or have high cholesterol or a history of blood clots, taking birth control pills increases your risk of having a stroke.
- Avoid hormone replacement therapy. In women who have gone through menopause, hormone replacement therapy has been shown to slightly increase the risk of stroke.