Did you know that there are preventative measures you can take to reduce your risk for a stroke? Zachary Bulwa, MD, NorthShore Neurological Institute, who specializes in stroke, answers questions. 

What are preventative measures I can take to avoid having a stroke? 
When we discuss measures to prevent a 'first' stroke we consider that primary prevention. Primary prevention is generally guided by healthy lifestyle choices, such as regular exercise, healthy food choices, maintenance of healthy weight, no smoking, and regular doctor visits. Some patients have certain risk factors, such as elevated blood pressure (hypertension), elevated blood cholesterol (hyperlipidemia), elevated blood glucose (diabetes), abnormal heart rhythms (atrial fibrillation), and sleep apnea that may increase their likelihood of experiencing a stroke. Health maintenance under the guidance of a primary care physician (internal medicine, family medicine, or geriatric medicine) is the key to identifying these conditions and treating them accordingly.

How common is it for younger people to have a stroke? 
Stroke in younger patients is less common than stroke in older patients. As we age, risks factors like hypertension, hyperlipidemia, diabetes start to demonstrate cumulative effects on our blood vessels. Atrial fibrillation, an abnormal heart rhythm that predisposes blood clot formation in the heart and increases the risk of stroke, increases in incidence as we age.

What’s the best way for this age group to prevent stroke?
As it is for any patient of any age, a healthy lifestyle and regular doctor visits are the pillars to stroke prevention. The American Heart Association created a campaign called "Life's Simple 7," which helps us organize our prevention measures. Maintenance of (1) normal blood pressure, (2) blood cholesterol, and (3) blood glucose ranges, (4) no smoking, (5) regular moderate intensity exercise, (6) healthy weight, and (7) healthy diet (food choices). Specifically with regard to food choices, the most well studied diet for cardiovascular and cerebrovascular prevention is the Mediterranean diet, however there are other dietary recommendations that may be beneficial. There are certain conditions, such as connective tissue disorders, that may predispose younger patients for stroke and it is important for patients who have a family history of stroke below the age of 55 to be evaluated for genetic conditions that may increase their risks beyond those discussed above.   

What are some risk factors or comorbid conditions for stroke?
The most common comorbid conditions for stroke are hypertension, hyperlipidemia, diabetes, smoking, heart disease (specifically coronary artery disease and atrial fibrillation), obesity, sleep apnea, and kidney disease. Less common risk factors include conditions such as malignancy and other hypercoagulable conditions, which may cause blood clots in regions outside the central nervous system that can travel and cause stroke, and connective tissue disorders, which may cause arterial dissections. We frequently work with specialty colleagues in cardiology, vascular medicine, and neurosurgery, amongst a variety of other specialties, to comprehensively address each patient's risk factors to reduce their likelihood of stroke.
 
To someone who has already received a diagnosis of stroke and is wondering how to go forward and prevent additional incidents of stroke, what would you say?
I believe the most important aspect of post-stroke care is to establish a relationship, an open line of communication, with a vascular (stroke) neurologist. Our goal is two-fold, first is to prevent that patient from having a second stroke. We do this by evaluating all the patient's risk factors, starting with the appearance of the blood vessels in the head and neck, and the structure and function of the heart. Our goal is to tailor 'secondary' prevention to the cause of the first stroke while simultaneously reducing any risk factor that could precipitate another stroke. Second, we promote rehabilitation for any residual deficits from the first stroke. We are grateful to have an excellent system of skilled physical, occupational, and speech therapists, and physical medicine and rehabilitation physicians (physiatrists) that specialize in stroke recovery. We collaborate daily with these specialists to provide comprehensive recovery care. We all care deeply about secondary prevention and stroke recovery. We all make it very clear that they can use any communication platform, including NorthShore Connect, to use us as a resource at any time.

To learn more about the NorthShore Stroke Program, click here.