How to reduce your risk of another stroke - Newcastle Hospitals NHS Foundation Trust

Changes in diet and lifestyle can lower the risk of a stroke. However, some people are more at risk of stroke than others depending on their risk factors.

There are several risk factors that cannot be modified such as:

Age – risk increases with age
Ethnicity – people of African, Caribbean and Asian ethnicity are more likely to have a stroke than people in other ethnic groups. This is linked to high blood pressure and diabetes.
Family history – stroke is not hereditary but some risk factors may be hereditary such as high blood pressure, diabetes and high cholesterol

And some risk factors that can be modified such as:

Diet
Salt
Cholesterol
Alcohol
High blood pressure
Atrial fibrillation (AF)
Smoking
Exercise
Stress
Illicit drug use

Diet

A healthy balanced diet of fruit, vegetables, wholegrains and plant-based food, which are low in fat, sugar and salt can help reduce your risk of a stroke.

Eating at least 5 portions of fruit and vegetables in your daily diet can reduce the risk of stroke. Fruit and vegetables contain a range of vitamins, minerals and nutrients which can prevent high blood pressure, prevent damage to your arteries and lower your cholesterol.

Tips to improve your diet to avoid stroke:

Eat two portions of oily fish per week.
Reduce the amount of saturated fat and replace with polyunsaturated or monounsaturated fats (unsaturated fats).

Saturated fats can raise the cholesterol level in the blood which can lead to blocked arteries and heart disease. Saturated fats are mainly found in red meat, especially fatty cuts and processed meat, dairy products, butter and pastry.
Unsaturated fats can reduce the risk of blood clots and clogged arteries. They are mainly found in fish and in plant based foods like nuts and seeds and tend to be oils not solid fats.

Health eating guide – Stroke Association

Salt

Eating a lot of salt can increase your blood pressure. By reducing the amount of salt you eat, you can lower your blood pressure and your risk of stroke.

Salt intake can be reduced by not adding salt to food or in cooking, with no more than 6 grams of salt a day (about a teaspoon). Avoid high-salt foods e.g processed meat, cheese, stock cubes and pre-prepared meals. Salt can be listed in the ingredients as salt or sodium.

Simple swaps – Cutting back on salt – Stroke Association

Cholesterol

Fat in our diet is a valuable source of energy and it helps the body absorb certain nutrients. Cholesterol is a fat (lipid) in your blood which plays an important role in repairing damaged tissue however having too much saturated fat can lead to heart disease and stroke due to the build-up of fatty deposits in the arteries.

Lipid lowering treatment (statins) can be used to lower the LDL cholesterol and prevent the risk of stroke.

Eating too much saturated fat can lead to high cholesterol. This causes a build up of fatty deposits in your arteries causing them to become narrowed and stiff. There are two types of cholesterol LDL (low density protein) and HDL (high density protein). Each have a role to play however it is important that there is a balance.

LDL ‘Bad’ cholesterol carries the cholesterol to where it is needed, too much cholesterol will cause the fatty deposits increasing your risk of stroke.

HDL ‘good’ cholesterol absorbs cholesterol in the blood and carries it back to the liver where it is destroyed.

High cholesterol levels can be caused by having too much saturated fat and not enough unsaturated fats. Smoking, drinking too much alcohol, being overweight can all be linked to high cholesterol levels.

Healthy eating and stroke – Stroke Association

Alcohol

Regularly drinking too much alcohol can raise your risk of stroke.

It is important that the UK government guidelines for men and women are followed. The recommendations are no more than 14 units of alcohol with several drink free days a week.

Drinking alcohol can result in a number of conditions that can increase the risk factors of stroke, including high blood pressure, type 2 diabetes and being overweight.

Alcohol and stroke – Stroke Association
Unit and calorie calculator – Drink Aware

High blood pressure

Over time, high blood pressure can lead to cardiovascular disease including stroke and heart disease.

High blood pressure (Hypertension) is the most treatable risk factor of stroke, it can affect 50-80% of people, but usually has no obvious symptoms.

Blood pressure is a measure of how strongly the blood presses against the walls of the arteries. If the pressure is too high it will put a strain on the arteries and heart. This strain can damage the blood vessels causing them to become harder and narrower (atherosclerosis). This makes a clot more likely to occur, which could cause a stroke. It is important to check your blood pressure regularly.

The current NICE (The National Institute for Health and Care Excellence) recommendations for blood pressure control for under 80 years old is lower than 135/85 mmHg and over 80 years old lower than 145/85 mmHg.

One or more risk factors can lead to high blood pressure. Making lifestyle changes such as reducing alcohol intake, being more active, stop smoking, eat more fruit and vegetables and limit process food, having at least 6 hours of sleep and taking time to relax will all help to lower the blood pressure.

Using antihypertensive medication and regular monitoring is highly effective as a treatment to lower blood pressure.

High blood pressure – Stroke Association

Atrial Fibrillation

Atrial Fibrillation (AF) is a heart condition that causes an irregular and fast heartbeat which raises the risk of stroke.

Normally the blood flows into the heart and gets pumped out with each beat. With the irregular and fast rhythm, the heart may not have time to empty fully before refilling with blood. The blood can pool inside the heart and can cause a clot to form and increase the risk of a stroke.

There are often no symptoms with AF however some people may have palpitations, chest pain, breathlessness or fatigue. Atrial Fibrillation can happen to anyone, more commonly in men and people with conditions such as heart disease, diabetes, obesity and high blood pressure.

Taking anticoagulant medication will slow down the clotting process, making it less likely for a clot to form and reduce your risk of a stroke.

The Stroke Association offer further information on AF.
Atrial Fibrillation (AF) – Stroke Association

Diabetes

Diabetes nearly doubles your risk of stroke and other cardiovascular diseases. Having too much sugar in your blood damages the blood vessels and increasing the risk of them becoming blocked. Making lifestyle changes and managing your diabetes can reduce these risks.

Diabetes – Stroke Association

Smoking

Smoking can increase the risk of stroke.

Chemicals from smoking enter your bloodstream causing changes within your body by:

reducing the oxygen in the blood
increasing blood pressure
can trigger atrial fibrillation (irregular heartbeat)
making the blood more likely to clot

Smoking – Stroke Association

Quit Smoking – NHS

Exercise

Exercise can improve your health and reduce the risk of a stroke.

30 minutes of moderate exercise, 5 days a week can reduce the risk of stroke and improve physical and mental health.

Exercise can help reduce blood pressure, lower cholesterol level, reduce the risk of type 2 diabetes, increase muscle strength and flexibility, and increase energy levels.
Moderate exercise will raise the heart rate, make you breathe faster and feel warmer.

It is important to reduce the time spent sitting for long periods.

Getting active after a stroke – Stroke Association

Stress

Although stress does not cause a stroke it may have an effect on blood pressure which can lead to a stroke.

Take time to relax, seek support from local services and monitor blood pressure.

Illicit drug use

Misuse of illegal drugs can increase the risk of a stroke by causing damage to the blood vessels and raising the blood pressure abruptly.

Medication

Some medications may be prescribed following a stroke.
Antiplatelets such as Aspirin or Clopidogrel help to prevent blood clots which can block blood vessels and cause a stroke.

Anticoagulants may be prescribed to treat Atrial Fibrillation (AF) e.g. Warfarin, Apixaban, Rivaroxaban, Edoxaban or Dabigatran.

Anti-hypertensive medication helps to lower blood pressure (the biggest single risk factor for stroke). They all work differently and a combination may be required e.g. Perindopril, Amlodipine.

Statins help lower cholesterol levels e.g. Atorvastatin, Simvastatin.

Contact your community pharmacy for advice on taking any medications or herbal remedies alongside your prescribed medications.
It is not recommended to take ibuprofen alongside anticoagulants or antiplatelets.
Some herbal supplements can cause increased risk of bleeding.
The pharmacist may be able to provide advice on suitable alternatives.
Community pharmacies offer a service called the “New Medicine Service” which involves three appointments with the pharmacist over several weeks (over the phone or in the pharmacy’s private consultation area). At these appointments, you can discuss any concerns or issues with the pharmacist, and they can help you with any problems linked to your medicine. If needed, the pharmacist can refer you back to your doctor.
You may want to discuss the risks and benefits of hormone replacement therapy (HRT) and/or contraceptives with your GP.

Further Information

Your feedback: We would be grateful if you could take a few minutes to complete this online survey to give us some feedback on your experience of this website. Your responses will help us to make improvements to website content. The information you provide will be kept anonymous and will stored securely on our hospital system.