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Lifestyle Changes Reduce Stroke Risk

New guidelines issued by the American Heart Association/American Stroke Association say that people who make healthy lifestyle choices can significantly reduce stroke risk by 80 percent.

“Between 1999 and 2006, there’s been over a 30 percent reduction in stroke death rates in the United States and we think the majority of the reduction is coming from better prevention,” said Larry B. Goldstein, MD, chairman of the statement writing committee and director of the Duke Stroke Center in Durham, NC.

Before this, the incidence of stroke may have been increasing, according to the statement that cites a 39 percent rise in hospitalizations between 1988 and 1997. As the population continues to age, the total number of Americans having a stroke is expected to rise.

Of the 795,000 strokes occurring in Americans each year, 77 percent are first events. Stroke is the third leading cause of death in the United States after heart disease and cancer and one of the major causes of disability in adults.
For the first time, the stroke prevention guidelines address all types of strokes. For prevention, there is often little difference along the stroke spectrum, said Dr. Goldstein, who is also a professor of medicine and director of Duke’s ASA-Bugher Foundation Center for Stroke Prevention Research.

Stroke types are:

• Ischemic stroke. These account for 87 percent of all strokes and occur when a blood vessel in or leading to the brain is blocked.
• Hemorrhagic stroke. A blood vessel rupture causes a non-ischemic or bleeding stroke.
• Transient ischemic attack or TIA. This occurs when the blockage is temporary, but is considered a major risk factor for a later, larger stroke.

The new guidelines feature several key prevention updates based on recent research and say that making healthy lifestyle choices can lower risk of a first stroke as much as 80 percent compared with those who don’t make such changes. The preventive benefit increases with each positive change you make.

You can reduce stroke risk by:

• Not smoking
• Eating a low-fat diet high in fruits and vegetables
• Drinking in moderation
• Exercising regularly
• Maintaining a normal body weight

Other findings include:

• Emergency room doctors should attempt to identify patients at high risk for stroke and consider making referrals, conducting screenings or beginning preventive therapy.
• Although genetic screening for stroke among the general population isn’t recommended, it may be appropriate in certain circumstances, depending on family history and other factors.
• General population screening for carotid artery narrowing isn’t recommended.
• The usefulness of stenting in people with a narrowing of a carotid artery in the neck compared to surgery (endarterectomy) is still uncertain. Because of advances in standard medical therapies (including a change in lifestyle factors, treating high blood pressure and using antiplatelet and cholesterol lowering drugs) the usefulness of either procedure in people who have not had symptoms is unclear. Doctors must decide whether to perform either procedure on a case-by-case basis.
• Aspirin doesn’t prevent a first stroke in low-risk people or those with diabetes or asymptomatic peripheral artery disease. However, it’s recommended for those whose risk is high enough for the reduction in stroke risk to outweigh the bleeding risks of aspirin.

Talk to your doctor about how to make the lifestyle changes that will lower your stroke risk.