Things you can do to prevent a stroke

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Regardless of your age or family history, a stroke doesn’t have to be inevitable. You can’t reverse the years or change your family history, but there are many other stroke risk factors that you can control—provided that you’re aware of them. “Knowledge is power,” says Dr. Natalia Rost, associate professor of neurology at Harvard Medical School and associate director of the Acute Stroke Service at Massachusetts General Hospital. “If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk.”

Here are eight ways to reduce your stroke risks:

1. LOWER BLOOD PRESSURE:

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. “High blood pressure is the biggest contributor to the risk of stroke in both men and women,” Dr. Rost says. “Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference women can make to their vascular health.”

Your goal:

Maintain a blood pressure of less than 120 (top number) over less than 80 (bottom number).

How to achieve it:

• Reduce the salt in your diet to no more than 1,500 milligrams a day (about a half teaspoon).
• Avoid high-cholesterol foods, such as burgers, cheese, and ice cream.
• Eat 4 to 5 cups of fruits and vegetables every day; fish two to three times a week, and several daily servings of whole grains and low-fat dairy.
• Get more exercise—at least 30 minutes of activity a day, and more, if possible.
• Quit smoking, if you smoke.
• If needed, take blood pressure medicines.

2. LOSE WEIGHT:

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you’re overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

Your goal:

Keep your body mass index (BMI) at 25 or less.

How to achieve it:

• Limit or avoid saturated and trans fats.
• Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current body mass index).
• Increase the amount of exercise you do with such activities as walking, golfing, or playing tennis, and by making activity part of every single day.

3. EXERCISE MORE

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer. One 2012 study found that women who walked three hours a week were less likely to have a stroke than women who didn’t walk.

Your goal:

Exercise at a moderate intensity at least five days a week.

How to achieve it:

• Take a walk around your neighborhood every morning after breakfast.
• Start a fitness club with friends.
• When you exercise, reach the level at which you’re breathing hard, but you can still talk.
• Take the stairs instead of an elevator when you can.
• If you don’t have 30 consecutive minutes to exercise, break it up into 10- to 15-minute sessions a few times each day.

4. DRINK—IN MODERATION

What you’ve heard is true. Drinking can make you less likely to have a stroke—up to a point. “Studies show that if you have about one drink per day, your risk may be lower,” according to Dr. Rost. “Once you start drinking more than two drinks per day, your risk goes up very sharply.”

Your goal:

Drink alcohol in moderation.

How to achieve it:

• Have one glass of alcohol a day.
• Make red wine your first choice, because it contains resveratrol, which is thought to protect the heart and brain.
• Watch your portion sizes. A standard-sized drink is a 5-ounce glass of wine, 12-ounce beer, or 1.5-ounce glass of hard liquor.

5. TAKE A BABY ASPIRIN:

The landmark Women’s Health Initiative study found that women over age 65 who take a daily baby aspirin lower their stroke risk. Aspirin helps by preventing blood clots from forming.

Your goal:

Take a baby aspirin every day (if it’s appropriate for you).

How to achieve it:

• First talk to your doctor to make sure aspirin is safe and appropriate for you to take. If you have a bleeding disorder, you may need to reduce your dose to every other day or avoid this regimen altogether.

6. TREAT ATRIAL FIBRILLATION:

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. “Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously,” Dr. Rost says.

Your goal:

If you have atrial fibrillation, get it treated.

How to achieve it:

• If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.
• You may need to take blood thinners such as high-dose aspirin or warfarin (Coumadin) to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.

7. TREAT DIABETES:

Having high blood sugar over time damages blood vessels, making clots more likely to form inside them.

Your goal:

Keep your blood sugar under control.

How to achieve it:

• Monitor your blood sugar as directed by your doctor.
• Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

8. QUIT SMOKING:

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. “Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly,” Dr. Rost says.

Your goal:

Quit smoking.

How to achieve it:

• Ask your doctor for advice on the most appropriate way for you to quit.
• Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.
• Don’t give up. Most smokers take several tries to quit. See each failed attempt as bringing you one step closer to successfully beating the habit.