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You can prevent the third-leading cause of death and the top cause of adult disability in the U.S.
By Sarah Baldauf
Posted May 12, 2009
Lifestyle counts, and in stroke prevention, the sum of one's efforts appears to be greater than singular prevention elements. A study in an August issue of the journal Circulation suggests that leading a low-risk lifestyle—including getting exercise, eating a healthful diet, and not smoking—reduces the risk of ischemic stroke, the most common from of stroke, in the general population by approximately 80 percent. It's essential to know what puts you at higher risk for stroke and to be able to immediately recognize the symptoms if you have a stroke, but much can be done to prevent such an event. Consider these elements of reducing your likelihood of having a stroke:

Quit smoking. Compared with nonsmokers, smokers on average have double the risk of ischemic stroke. And a study in an August issue of the journal Stroke found a dose-response in female subjects, meaning that the more cigarettes a woman smoked per day, the higher her odds of suffering a stroke. Two packs per day boosted risk of stroke to nine times that of nonsmokers. The same study found that when subjects quit smoking, their risk of stroke returned to normal within two years.

Get off the hormones, ladies. Hormone replacement therapy with estrogen, used to ease symptoms of menopause, have been found to significantly boost a woman's risk of stroke. And Tibolone, a synthetic HRT that mimics estrogen and the hormone progesterone, was found last year to increase the risk of stroke in women older than 60. Also, smokers who take birth control pills are at far greater risk of stroke, blood clots, and heart attack than women on the pill who don't smoke.

Eat your veggies. As if you need yet another reason to eat your vegetables, the American Heart Association recommends people at elevated risk of cardiovascular disease, which includes stroke, should make sure they get several servings a day. One reason is to increase intake of folic acid and vitamins B6 and B12, which have been associated with lower blood levels of homocysteine. Epidemiological studies suggest that high levels of this amino acid are associated with elevated rates of heart disease and stroke. Folic acid and vitamins B6 and B12 can also be found in fortified grains and cereals.

Take aspirin and a blood thinner, if your doctor recommends it. Low-dose aspirin is regularly prescribed to prevent a second heart attack, stroke, or "mini-stroke" and also is given to patients who are at high risk of having such a cardiovascular event. In those with abnormal heart rhythm known as atrial fibrillation, the blood thinner warfarin is often also prescribed to help prevent stroke. But some heart patients cannot safely take warfarin, which can cause dangerous bleeding and requires that the patient follow strict dietary limitations. A study published online in a March issue of the New England Journal of Medicine found that the incidence of stroke in those who cannot take warfarin went down by a third (from 3.4 percent to 2.4 percent per year) when they took Plavix along with aspirin.

Keep blood pressure and cholesterol under control. Making lifestyle changes, including eating a diet low in sodium and saturated fats, getting regular exercise, limiting alcohol intake, and staying trim, can help you lower your stroke risk. So can taking medications your doctor may prescribe to lower your blood pressure or cholesterol. Chronically uncontrolled blood pressure promotes hardening of arteries and buildup of plaque, and a temporary spike in blood pressure can raise the risk of hemorrhagic stroke, which is caused by bleeding in the brain. A study published in the May issue of Lancet Neurology analyzed existing research and concluded that taking statins to lower "bad," or LDL, cholesterol, if that level is initially too high, is associated with reduced rates of stroke.

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