Preventing stroke

A risk factor is something that increases your chance of having a stroke. You cannot change some risk factors for stroke. But some, you can.

Changing risk factors that you can control will help you live a longer, healthier life. This is called preventive care.

An important way to help prevent stroke is to see your health care provider for regular checkups. Your provider will want to see you at least once a year. Ask your provider when you should come in for a checkup.

You can't change some risk factors or causes of stroke:

• Age. Your risk of stroke increases as you get older.
• Sex. Men have a higher risk of stroke than women. But more women than men die from stroke.
• Genetic characteristics. If one of your parents had a stroke, you are at higher risk.
• Race. African Americans have a higher risk of stroke than all other races. Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk of stroke.
• Diseases such as cancer, chronic kidney disease, and some autoimmune diseases.
• Weak areas in an artery wall or abnormal arteries and veins.
• Pregnancy, both during and in the weeks right after pregnancy.

Blood clots from the heart may travel to the brain and cause a stroke. This may happen in people with:

• Man-made or infected heart valves
• Certain heart defects with which you were born

You can change some risk factors for stroke, by taking the following steps:

• Do not smoke. If you do smoke, quit.
• Control high blood pressure through diet, exercise, and medicines, if needed.
• Exercise at least 30 minutes a day for at least 5 days every week.
• Maintain a healthy weight by eating healthy foods, eating smaller portions, and joining a weight loss program if needed.
• Limit how much alcohol you drink. This means 1 drink a day or less for women and 2 drinks a day or less for men.
• Do not use cocaine and other illegal drugs.
• Get regular check-ups to screen for high blood pressure, diabetes, high cholesterol, and other health problems.

Eating healthy is good for your heart and can help lower your risk of stroke.

• Eat plenty of fruits, vegetables, and whole grains.
• Choose lean proteins, such as chicken, fish, beans, and legumes.
• Choose nonfat or low-fat dairy products, such as 1% milk and other low-fat items.
• Avoid fried foods, processed foods, and baked goods.
• Eat fewer foods that contain cheese, cream, or eggs.
• Avoid foods with a lot of sodium (salt).

Read labels and stay away from unhealthy fats. Avoid foods with:

• Saturated fat
• Partially-hydrogenated or hydrogenated fats

Work with your provider to control your cholesterol and diabetes with a healthy diet, exercise, and medicines if needed.

If you have high blood pressure:

• Your provider may ask you to keep track of your blood pressure at home.
• You should lower it and control it with a healthy diet, exercise, and by taking medicines your provider prescribes.

If you have hardening of the arteries, your provider may want to monitor your carotid arteries for blockages.

If you take blood thinners, it is important to not miss any doses, as blood clots can form and cause stroke.

Talk to your provider about the risks of taking birth control pills.

• Birth control pills can increase the chance of blood clots, which can lead to stroke.
• Clots are more likely in women taking birth control pills who also smoke and who are older than 35.

Your provider may suggest taking aspirin or another medicine to help prevent blood clots from forming. Do not take aspirin without talking to your provider first.

Stroke - prevention; CVA - prevention; Cerebral vascular accident - prevention; TIA - prevention, Transient ischemic attack - prevention

Alberts MJ. Prevention and management of ischemic stroke. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 45.

Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley's and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 65.

January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2019;74(1):104-132. PMID: 30703431 pubmed.ncbi.nlm.nih.gov/30703431/.

Riegel B, Moser DK, Buck HG, et al; American Heart Association Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Quality of Care and Outcomes Research. Self-care for the prevention and management of cardiovascular disease and stroke: a scientific statement for healthcare professionals from the American Heart Association. J Am Heart Assoc. 2017;6(9). pii: e006997. PMID: 28860232 pubmed.ncbi.nlm.nih.gov/28860232/.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71(19):e127-e248. PMID: 29146535 pubmed.ncbi.nlm.nih.gov/29146535/.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School at Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.