Kseniya Ovchinnikova//Getty Images
About 795,000 people in the U.S. experience a stroke each year, which can be a life-altering experience. While you can’t influence some risk factors like your age or your genetics, there are lifestyle tweaks you can make to help. That includes making diet tweaks by adding foods that may help lower your risk of stroke. Overall, following a healthy eating pattern can help lower a slew of stroke risk factors, including your blood pressure, cholesterol, and blood sugar regulation, says Cheng-Han Chen, M.D.……..Continue reading….
By Korin Miller
Source: Prevention
.
Critics:
Stroke can be classified into two major categories: ischemic and hemorrhagic. Ischemic stroke is caused by interruption of the blood supply to the brain, while hemorrhagic stroke results from the rupture of a blood vessel or an abnormal vascular structure. About 87% of stroke is ischemic, with the rest being hemorrhagic. Bleeding can develop inside areas of ischemia, a condition known as “hemorrhagic transformation.”
It is unknown how many cases of hemorrhagic stroke actually start as ischemic stroke. Stroke may be preceded by premonitory symptoms, which may indicate a stroke is imminent. These symptoms may include dizziness, dysarthria (speech disorder), exhaustion, hemiparesis (weakness on one side of the body), paresthesia (tingling, pricking, chilling, burning, numbness of the skin), pathological laughter, seizure that turns into paralysis, “thunderclap” headache, or vomiting. Premonitory symptoms are not diagnostic of a stroke, and may be a sign of other illness.
Assessing onset (gradual or sudden), duration, and the presence of other associated symptoms are important, and premonitory symptoms may not appear at all or may vary depending on the type of stroke. Stroke symptoms typically start suddenly, over seconds to minutes, and in most cases do not progress further. The symptoms depend on the area of the brain affected. The more extensive the area of the brain affected, the more functions that are likely to be lost. Some forms of stroke can cause additional symptoms.
For example, in intracranial hemorrhage, the affected area may compress other structures. Most forms of stroke are not associated with a headache, apart from subarachnoid hemorrhage and cerebral venous thrombosis and occasionally intracerebral hemorrhage. Given the disease burden of stroke, prevention is an important public health concern. Primary prevention is less effective than secondary prevention (as judged by the number needed to treat to prevent one stroke per year).
Recent guidelines detail the evidence for primary prevention in stroke. About the use of aspirin as a preventive medication for stroke, in healthy people aspirin does not appear beneficial and thus is not recommended, but in people with high cardiovascular risk, or those who have had a myocardial infarction, it provides some protection against a first stroke. In those who have previously had stroke, treatment with medications such as aspirin, clopidogrel, and dipyridamole may be beneficial.
The U.S. Preventive Services Task Force (USPSTF) recommends against screening for carotid artery stenosis in those without symptoms. The most important modifiable risk factors for stroke are chronic uncontrolled hypertension and atrial fibrillation, although the size of the effect is small; 833 people have to be treated for 1 year to prevent one stroke.
Other modifiable risk factors include high blood cholesterol levels, diabetes mellitus, end-stage kidney disease, cigarette smoking (active and passive), heavy alcohol use, drug use, lack of physical activity, obesity, processed red meat consumption, and unhealthy diet. Smoking just one cigarette per day increases the risk more than 30%.
Alcohol use could predispose to ischemic stroke, as well as intracerebral and subarachnoid hemorrhage via multiple mechanisms (for example, via hypertension, atrial fibrillation, rebound thrombocytosis and platelet aggregation and clotting disturbances). Drugs, most commonly amphetamines and cocaine, can induce stroke through damage to the blood vessels in the brain and acute hypertension. Migraine with aura doubles a person’s risk for ischemic stroke.
Untreated, celiac disease regardless of the presence of symptoms can be an underlying cause of stroke, both in children and adults. According to a 2021 WHO study, working 55+ hours a week raises the risk of stroke by 35% and the risk of dying from heart conditions by 17%, when compared to a 35-40-hour week. High levels of physical activity reduce the risk of stroke by about 26%. There is a lack of high quality studies looking at promotional efforts to improve lifestyle factors.
Nonetheless, given the large body of circumstantial evidence, best medical management for stroke includes advice on diet, exercise, smoking and alcohol use. Medication is the most common method of stroke prevention; carotid endarterectomy can be a useful surgical method of preventing stroke. A recent 2025 reports that women under 50 with a history of pregnancy complications face a higher risk of ischemic stroke.
Conditions such as hypertensive disorders of pregnancy, gestational diabetes, preterm birth, small-for-gestational-age infants, stillbirth, and miscarriage were more common among stroke patients than those without stroke. The risk was especially elevated for strokes linked to large artery disease in women with prior hypertensive disorders, preterm births or small-for-gestational-age deliveries. High blood pressure accounts for 35–50% of stroke risk.
Blood pressure reduction of 10 mmHg systolic or 5 mmHg diastolic reduces the risk of stroke by ~40%. Lowering blood pressure has been conclusively shown to prevent both ischemic and hemorrhagic stroke. It is equally important in secondary prevention. Even people older than 80 years and those with isolated systolic hypertension benefit from antihypertensive therapy.
The available evidence does not show large differences in stroke prevention between antihypertensive drugs—therefore, other factors such as protection against other forms of cardiovascular disease and cost should be considered. The routine use of beta-blockers following stroke or TIA has not been shown to result in benefits. High cholesterol levels have been inconsistently associated with (ischemic) stroke.
Statins have been shown to reduce the risk of stroke by about 15%. Since earlier meta-analyses of other lipid-lowering drugs did not show a decreased risk, statins might exert their effect through mechanisms other than their lipid-lowering effects. Diabetes mellitus increases the risk of stroke by 2 to 3 times. While intensive blood sugar control has been shown to reduce small blood vessel complications such as kidney damage and damage to the retina of the eye it has not been shown to reduce large blood vessel complications such as stroke.
Physical and occupational therapy have overlapping areas of expertise; however, physical therapy focuses on joint range of motion and strength by performing exercises and relearning functional tasks such as bed mobility, transferring, walking and other gross motor functions. Physiotherapists can also work with people who have had stroke to improve awareness and use of the hemiplegic side.
Rehabilitation involves working on the ability to produce strong movements or the ability to perform tasks using normal patterns. Emphasis is often concentrated on functional tasks and people’s goals. One example physiotherapists employ to promote motor learning involves constraint-induced movement therapy. Through continuous practice the person relearns to use and adapt the hemiplegic limb during functional activities to create lasting permanent changes.
Physical therapy is effective for recovery of function and mobility after stroke. Occupational therapy is involved in training to help relearn everyday activities known as the activities of daily living (ADLs) such as eating, drinking, dressing, bathing, cooking, reading and writing, and toileting. Approaches to helping people with urinary incontinence include physical therapy, cognitive therapy, and specialized interventions with experienced medical professionals, however, it is not clear how effective these approaches are at improving urinary incontinence following stroke.
Treatment of spasticity related to stroke often involves early mobilizations, commonly performed by a physiotherapist, combined with elongation of spastic muscles and sustained stretching through different positions.[45] Gaining initial improvement in range of motion is often achieved through rhythmic rotational patterns associated with the affected limb.
After full range has been achieved by the therapist, the limb should be positioned in the lengthened positions to prevent against further contractures, skin breakdown, and disuse of the limb with the use of splints or other tools to stabilize the joint. Cold ice wraps or ice packs may briefly relieve spasticity by temporarily reducing neural firing rates. Electrical stimulation to the antagonist muscles or vibrations has also been used with some success.
Physical therapy is sometimes suggested for people who experience sexual dysfunction following stroke. Stroke can affect the ability to live independently and with quality. Self-management programs are a special training that educates stroke survivors about stroke and its consequences, helps them acquire skills to cope with their challenges, and helps them set and meet their own goals during their recovery process.
These programs are tailored to the target audience, and led by someone trained and expert in stroke and its consequences (most commonly professionals, but also stroke survivors and peers). A 2016 review reported that these programs improve the quality of life after stroke, without negative effects. People with stroke felt more empowered, happy and satisfied with life after participating in this training.
Leave a Reply