- If you've never had a stroke
you probably don't wanna have a first one.
If you had a stroke, chances are pretty good
that you don't want to have another one.
So, what you can do to help prevent strokes?
How can you lower your risk?
After all, the vast majority that happen of strokes
that happen are preventable.
So, let's actually thinks about this
in terms of categories.
So, there's ways to help prevent stroke
by making some lifestyle changes.
There's ways to prevent stroke involving
taking certain medications,
and there are ways involving surgery.
So, we'll look at how each of these categories
can help you to reduce your risk of stroke.
And I won't be covering every possible thing you could do.
I'll just cover some of the more important ones
for each of our categories here.
So with lifestyle, we just gotta start
with blood pressure control,
so lower blood pressure.
Because high blood pressure
is the biggest risk factor for stroke
because what it does is it causes damage
to your blood vessel walls which can
eventually lead to a stroke.
And in terms of lifestyles,
there's a few ways to reduce your blood pressure.
For example, daily exercise which will strengthen
your cardiovascular system
and lower your blood pressure that way.
And there's reducing your salt intake
because lots of salt in your diet
can cause you to retain more water in your blood vessels.
And by default, that would increase your blood pressure.
And limiting the amount of alcohol you drink
because high alcohol intake in known
to increase blood pressure.
So, if you have a glass of wine with dinner
that's not really a problem.
It's when you start having more
than two standard drinks a day
that your stroke risk goes up pretty sharply.
And next in our lifestyle column here we have smoking.
And really, not smoking is crucial.
In fact, smoking and blood pressure control
are probably the two most important
risk factors for a stroke
because for one, smoking damages your blood vessels.
And for two, smoking increases your blood pressure.
So smoking, no good.
Keeping a healthy body weight is important.
So, that means that you're being physically active
whether that's going for a walk everyday
or taking the dog to the beach
or maybe playing with the grand kids.
Any physical activity that's safe for you to undertake.
And diet as well, so eating healthily.
Lots of fruit and vegetables, no trans fat,
not too much saturated fat and so on.
Studies have actually shown time and time again
that maintaining a healthy body weight
and having a healthy waist circumference
is really important in preventing diseases
of the arteries and that includes strokes and heart attacks.
So, a healthy diet and exercise are really helpful
in keeping your cholesterol levels
and your blood pressure under control.
And then last here, we'll put managing
any current medical conditions
because some of them can independently increase
your risk of stroke.
So for example, if you have diabetes
then it's super important to keep
those blood sugar levels under control
whether that's through diet and exercise
or those PLUS medications.
Because poorly controlled diabetes can cause some imbalances
to happen with the lipids in your blood
and can damage your arteries
which increases your risk of stroke.
So, let's hop over to our medications category now.
So there's really four broad categories of medication
that we'll talk about that you might be taking
to prevent or rather lower your risk
of having a stroke.
So, we've got blood pressure lowering meds.
Of course, we'd start with that one.
And you know, the plan would be
to have your blood pressure controlled
by lifestyle measures alone
because who likes taking extra pills, right?
But if that's not possible
then your doctor might prescribe a medication
to help lower your blood pressure that way
and that will reduce your risk of both
ischemic and hemorrhagic strokes.
And a group of anti-hypertensives you might have heard of
are the ACE inhibitors which work
by relaxing your blood vessels
and reducing your blood volume.
And that in turn lowers your blood pressure.
Next, we've got anti-platelet medications like aspirin.
And these anti-platelets, they sort of prevent
blood clots from forming inappropriately
within your blood stream.
Because drugs like aspirin stop platelets in your blood
from sticking together and forming
these little precursors to full-blown blood clots.
So, the fewer the precursors,
platelet plugs as they're called.
These little precursor clots,
the fewer blood clots that are able to be created.
And of course, the fewer the blood clots
you have in your bloodstream,
the less likely you are to have one
get stuck up in the arteries of your brain, right?
Now, anti-coagulants are a similar story to anti-platelets.
And you probably heard of the most commonly used
anti-coagulant called Warfarin.
And how these work is they sort of interfere with
and reduce production of certain proteins
that are required to form blood clots.
So, the result is that any existing clots
just can't really grow any bigger
because the proteins aren't there
that allow that to happen.
And also, new clots generally won't form very easily.
So, the last major group of medications you might
take to reduce your risk of stroke
that we'll talk about
is the group of lipid-lowering drugs.
So, you've probably heard of these
as drugs to lower your blood cholesterol.
And there's a few different types
that each work in a bit of a different way.
So, for example one type, the statins
they work by preventing your liver
for making cholesterol.
And you might have heard
of a drug called Lipitor.
That's actually the most commonly prescribed statin.
Another type of lipid-lowering drug
is called ezetimibe.
And that one works by hanging out in your gut,
in your small intestine and then kind of
grabbing on to cholesterol that you eat.
Not letting you absorb it.
So, these lipid-lowering drugs are good
for helping you maintain a nice healthy
lipid profile within your bloodstream
and that lowers your risk of stroke.
And I'll just add on to this
that sometimes you need medication
to manage any ongoing medical conditions
that could cause a stroke.
So for example, if you have atrial fibrillation
which is a condition known to cause clots
to form in the atria that sometimes then travel
up to brain and cause strokes,
it would be really important that you took
the necessary medications to manage
the atrial fibrillation, right?
So that your risk of clot formation in the atria
and thus, your risk of stroke would be lowered, right?
So here, you'd usually have a combination
of drugs to control your hear rhythm or your heart rate
plus an anti-coagulant such as Warfarin
to make sure that clots don't pop up unexpectedly.
So really, the bottom line is that you need
to treat ongoing medical conditions
that could cause a stroke.
Now, for our last major category
and that's stroke risk reduction
by surgery, by surgical means.
So, clots can come from collections of cholesterol
from atherosclerotic build up that happens commonly
in your carotid arteries, right?
So, you get build up of cholesterol and necrotic debris
in your arteries here as part of carotid atherosclerosis.
And then bits can break off and just travel
a short distance up into your brain
and get stuck and cause a stroke.
Or the build up can just totally block off
your carotid artery itself
and that would cause a stroke, too.
Because it's preventing blood from
from heading up into your brain.
So, to prevent this from causing a stroke
either a first stroke or a subsequent stroke,
a surgeon can access this build up and get rid of it.
So, there'd be a little incision made here.
A little cut in the carotid artery here
that has all the atherosclerotic build up.
And this whole sort of thick necrotic gunk
would be removed and that will reduce the risk
of further strokes happening in a pretty big way.
So, this procedure is called the carotid endarterectomy.
And there's another procedure,
I'll talk about that.
It helps to lower your stroke risk.
And again, it has to do with these carotid plaques.
You can just see that these carotid plaques
are pretty big risk factor for stroke.
So, if you have a significant
plaque build up in your carotids,
as surgeon might insert a stent.
This little mesh expandable tube within the artery,
within the carotid to push open the walls
and allow more blood flow through it
up to the brain.
So, it kinda squishes this atherosclerotic plaque
against the sides of the artery here
and allows you to get better blood flow going
through your carotids up to your brain
and that lowers your risk
for at least ischemic strokes.
So there, there's a few ways to try
to prevent strokes from happening
by some lifestyle changes like blood pressure reduction
and quitting smoking and keeping a healthy weight.
Some medications like anti-coagulants
and anti-platelets and a few surgeries.