Your guide to stroke prevention

How common are strokes?

Stroke is the largest cause of disability in the UK. While most strokes affect over-65s, they can strike at any age. However, the vast majority of strokes could be prevented if we all took simple steps to identify and reduce our risk factors.

Stroke survivors

A survey from the Stroke Association shows that nine in ten stroke survivors would go back in time and urge their younger self to make lifestyle changes which may have prevented their stroke. More than eight in ten of these people said they hadn’t realised that they were at risk of a stroke.

All the changes these stroke survivors would have made are based on strong science - they're changes all of us can make to cut our chance of stroke.

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Gut microbes can predict the rate of recovery from stroke and may improve stroke prevention. An expert and a stroke survivor explain why this discovery matters.

by Ellie Broughton

Brain and nerves

Transient ischaemic attack

A transient ischaemic attack (TIA) causes symptoms similar to a stroke. Some people call a TIA a mini-stroke. With a TIA, the symptoms go completely within 24 hours (whilst with a stroke, the symptoms are usually more permanent). The most common cause is a tiny blood clot in a blood vessel in the brain. Call 999/112/911 if you have symptoms of a stroke or TIA - act FAST. Unless the symptoms get better within a few minutes you need emergency treatment, as the cause might be a stroke rather than a TIA. It is important that you don't wait too long to see if the symptoms get better on their own. If your symptoms have got better quickly and completely, you need to arrange to see your GP urgently for further investigations and treatment.

by Dr Colin Tidy, MRCGP

Can stress cause a stroke?

Almost half said they would have taken steps to reduce their stress levels. Stress itself can raise your blood pressure - a recurring theme, because high blood pressure is perhaps the single biggest risk factor for stroke.

But if you're stressed, you're also less likely to look after yourself. That means you're more likely to indulge in all the unhealthy behaviours that can increase your chance of stroke.

What's the link between high blood pressure and stroke?

Two in five stroke survivors in the survey said they would have monitored their blood pressure. High blood pressure affects more than one in four UK adults. It's often known as 'the silent killer' because it rarely causes symptoms and therefore often isn't diagnosed. In fact, it's estimated that 5.5 million people in England alone have untreated high blood pressure.

High blood pressure contributes to about half of strokes - it can damage your blood vessels, causing them to become harder and narrower. It can also cause weakened blood vessels to burst, leading to bleeding in the brain. Lifestyle changes - and, if these aren't enough, medications - are highly effective at lowering blood pressure.

How to lower blood pressure

Making lifestyle changes

Lifestyle changes, including minor tweaks to your diet, can significantly reduce your blood pressure and with it your risk of stroke. The DASH diet has many similarities with the Mediterranean diet, but is specifically designed to help tackle high blood pressure.

Lowering your salt intake

Public Health England (now known as the UK Health Security Agency) reminds us that where blood pressure is concerned, excess salt in your diet is one of the most important risk factors you can change. A high salt diet disrupts the natural sodium balance in the body. This causes fluid retention, which increases the pressure exerted by the blood against blood vessel walls. If we all reduced our salt intake by just one gram a day, we could save more than 4,000 early deaths a year in the UK.

To reduce the salt in your diet, you can stop adding salt to your food. It's also important to remember that three quarters of the salt in your diet comes from salt in prepared foods you eat. Preserved foods - salamis, hams, bacon and pickles, along with salted peanuts and crisps, are all high in salt. Cooking from scratch means you know exactly how much salt is in your food. Using herbs, spices and lemon juice allows you to keep the flavour without ramping up the salt.

Can salt substitutes cut my risk of stroke?

It's the sodium in normal salt which increases your blood pressure, and it's possible to buy reduced sodium alternatives such as LoSalt in most supermarkets. Here, two thirds of the sodium is replaced by potassium.

In recent years there has been much interest in reduced sodium alternatives for people who still want the taste of salt. A study of more than 20,000 over-60s showed that switching to a reduced sodium salt substitute:

• Cut the risk of stroke by 14%, and of heart attack, stroke or heart failure by 13%.

• Reduced the chance of dying by 12%.

What's the link between exercise and stroke?

One in three people surveyed would also have exercised more. Many people with high blood pressure are concerned that intense physical exertion might do more harm than good. In fact, the opposite is true. While your blood pressure might rise briefly when you're exercising, your blood pressure is likely to be lower overall if you exercise regularly.

In addition, regular exercise also strengthens your muscles - reducing the risk of falls - and helps you maintain mobility.

Does high cholesterol increase my risk of stroke?

More than one in five stroke survivors wish they had monitored their blood cholesterol. Well known as a major risk factor for heart attack, high cholesterol can also increase your stroke risk.

A heart-healthy diet, low in saturated fat and higher in vegetables, fruit, unrefined carbohydrates and heart-healthy oils, can help protect against both heart attack and stroke. The Mediterranean diet and the Portfolio diet are excellent examples

If you're over 40 and haven't had your cholesterol checked recently, speak to your community pharmacist, practice nurse or GP - they can arrange a simple blood test.

Why do abnormal heart rhythms increase the risk of stroke?

Atrial fibrillation, or AF, is the commonest type of abnormal heart rhythm among people in the UK. AF increases the risk of a clot forming in your heart. Part of this clot can break off and travel to your brain, leading to a stroke.

Without treatment, people with AF are up to five times more likely than other people to have a stroke. What's more, because the area of the brain affected by AF-related strokes is often larger than other strokes, they're often more severe. However, this risk is very greatly reduced by taking anticoagulants - blood thinning medications.

With thanks to 'My Weekly' magazine where this article was originally published.