Prevention

You can help prevent a stroke if you control risk factors and treat other medical conditions that can lead to a stroke.

And if you have already had a stroke or a transient ischemic attack (TIA), you can prevent another stroke in the same way, by controlling risk factors and treating medical conditions that can lead to stroke.

A transient ischemic attack (TIA) is a warning sign that a stroke may soon occur. Prompt medical attention for a TIA may help prevent a stroke.

Seek emergency medical help immediately if you have symptoms of a TIA, which are similar to those of a stroke. Symptoms include problems with vision, speech, behavior, and thought processes. A TIA may cause loss of consciousness, seizure, dizziness (vertigo), and weakness or numbness on one side of the body. But symptoms of a TIA are temporary and usually disappear after 10 to 20 minutes, although they may last longer.

Treating other medical conditions can help prevent a stroke.

• Hardened arteries. If you have been told that you have hardening of the arteries (atherosclerosis), check with your doctor about whether you should take an aspirin each day and/or a medicine to lower your cholesterol. Taking an aspirin daily can also reduce the risk of stroke in a person who has already had an ischemic stroke, a TIA, or carotid endarterectomy surgery.
• Blocked carotid artery. If your doctor hears a swishing sound—a bruit (say "broo-E")—when listening to blood flow through the large blood vessels in your neck (carotid arteries), ask whether you need further testing (usually carotid ultrasound). Surgery to reopen a blocked carotid artery may be appropriate. For more information on this surgery, see:

  Should I have carotid endarterectomy?

A procedure called carotid artery stenting is another option for some people at high risk for stroke. This procedure is much like coronary angioplasty, which is commonly used to open blocked arteries in the heart. During this procedure, a doctor inserts a metal tube called a stent inside your carotid artery to increase blood flow in areas blocked by plaque. The doctor may use a stent that is coated with medicine to help prevent future blockage.

Control your risk factors for stroke by:

• Having regular medical checkups.
• Controlling your high blood pressure by working with your doctor.
• If you have diabetes, keeping your blood sugar levels as close to normal as possible.
• Controlling high cholesterol, heart disease (especially atrial fibrillation), diabetes, or disorders that affect your blood vessels, such as coronary artery disease.
• Taking cholesterol-lowering medicines called statins if you have high cholesterol or have had a heart attack, TIA, or stroke.^{5, 6}
• Not smoking and staying away from secondhand smoke. If you do smoke, quit. (For tips, see the topic Quitting Smoking.) Daily cigarette smoking increases the risk of stroke by more than 2 times.
• Limiting alcohol. Low to moderate alcohol consumption may decrease the risk of ischemic stroke. Moderate drinking is 2 drinks a day for men, and 1 drink a day for women. Excessive use of alcohol (more than 2 drinks a day) can raise your risk of stroke.
• Staying at a healthy weight. Being overweight increases your risk of developing high blood pressure, heart problems, and diabetes, which are risk factors for TIA and stroke.
• Becoming more active. Do activities that raise your heart rate. Try to do moderate activity at least 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.⁷ A large study showed that physical activity lowers your risk of stroke, partly by reducing the two greatest risk factors for stroke: high blood pressure and heart disease. The more physically active you are, the lower your risk. Moderately active people had a 20% lower risk of stroke than inactive people. Highly active people had about a 30% reduction of risk.⁸Exercise can also help raise HDL ("good") cholesterol levels in your body, which also lowers the risk of stroke.

Lower your risk for stroke by:

• Taking aspirin if you have had a heart attack. For more information, see:

  Should I take daily aspirin to prevent a heart attack or a stroke?

• Taking anticoagulants, as prescribed by your doctor, if you have atrial fibrillation or have had a heart attack with other complications.
• Eating a nutritious, balanced diet that is low in cholesterol, saturated fats, and salt. Foods high in saturated fat and cholesterol can make hardening of the arteries worse. Eat more fruits and vegetables to increase your intake of potassium and vitamins B, C, E, and riboflavin. Add whole grains to your diet. Eating fish one or more times a month may also reduce your risk of stroke. Limit the amount of salt you eat too. For more information, see:

  Heart disease: Eating a heart-healthy diet.

  High blood pressure: Using the DASH diet.

• Avoiding illegal drugs (such as a stimulant, like cocaine). Cocaine can increase blood pressure and cause the heart to beat more rapidly, thereby increasing your risk of stroke.
• Avoiding birth control pills if you have other risk factors. If you smoke or have high cholesterol or a history of blood clots, taking birth control pills increases your risk of having a stroke.
• Avoiding hormone replacement therapy. In women who have gone through menopause, hormone replacement therapy has been shown to slightly increase the risk of stroke.³
• Avoid getting sick from the flu. Get a flu shot every year.