Stroke

Alternative Names

Cerebrovascular disease; CVA; Cerebral infarction; Cerebral hemorrhage; Ischemic stroke; Stroke - ischemic

Prevention

To help prevent a stroke:

• Get screened for high blood pressure every 1 - 2 years, especially if you have a family history of high blood pressure.
• Have your cholesterol checked. If you are high risk, your LDL "bad" cholesterol should be lower than 100 mg/dL. Your doctor may recommend you try to reduce your LDL cholesterol to as low as 70 mg/dL.
• If you have high blood pressure, diabetes, high cholesterol, and heart disease, make sure you follow your doctor's treatment recommendations.
• Follow a low-fat diet.
• Quit smoking.
• Exercise regularly -- 30 minutes a day if you are not overweight; 60 - 90 minutes a day if you are overweight.
• Do not drink more than 1 to 2 alcoholic drinks a day.

Aspirin therapy (81mg a day or 100mg every other day) is now recommended for stroke prevention in women under 65 as long as the benefits outweigh the risks. It should be considered for women over age 65 only if their blood pressure is controlled and the benefit is greater than the risk of gastrointestinal bleeding and brain hemorrhage. Ask your doctor if aspirin is right for you.

Your doctor may also recommend that you take aspirin or another blood thinner if you have had a TIA or stroke in the past, or if you currently have a heart arrhythmia (like atrial fibrillation), mechanical heart valve, congestive heart failure, or risk factors for stroke.

Carotid endarterectomy (removal of plaque from the carotid arteries) may help prevent new strokes from occurring in people with large blockage in their blood vessels.

References

American Heart Association. Heart Disease and Stroke Statistics -- 2005 Update. Dallas, Texas: American Heart Association; 2005.

Goldman L, Ausiello D, eds. Cecil Textbook of Medicine, 22nd ed. Philadelphia, Pa: Saunders; 2004.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th ed. St. Louis, Mo: Mosby; 2002.

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007; Published online before print February 19, 2007.

Wolff T, Miller T. Evidence for the reaffirmation of the U.S. Preventive Services Task Force recommendation on screening for high blood pressure. Ann Intern Med. 2007;147(11): 787-91.