• Information
• Publications
  • Brain and Spine Booklets
  • Forthcoming titles
  • Get involved publications
  • Case studies
• Glossary
• Neurological centres
• Headstrong
• Information Access toolkit
• Communication skills project

|

There are several things you can do to reduce the chances of having a stroke:

Diet
A healthy diet, low in fat and high in fibre, will help keep your weight down and cholesterol low. By avoiding too much salt and excessive alcohol you can reduce your blood pressure, which might reduce the need for blood pressure drugs and will help prevent a stroke. If your cholesterol level is very high or remains high despite dieting your doctor may prescribe a drug to lower your cholesterol level.

Smoking
This increases the risk of strokes as well as other health problems, so you should give up smoking if at all possible. Nicotine patches or gum used in consultation with your doctor will improve your chances of successfully giving up. It may help if you can avoid the situations in which you normally “light up” (e.g. sitting down after a meal). If possible, anyone else who smokes in your home should try to give up at the same time.

Blood pressure
If your blood pressure is consistently high after a mild stroke or TIA, lowering it by taking tablets will reduce the risk of a stroke. Losing weight, exercising regularly and avoiding excessive alcohol and salt in your food will all help keep your blood pressure low.

Antiplatelets
These are a group of drugs that can reduce the risk of a stroke by making the blood less sticky. It is important to keep taking these tablets if they have been
prescribed or recommended by your doctor.

Aspirin: An aspirin tablet (75mg, 150mg or 300mg) each day reduces the risk of a further stroke or heart attack by making the blood less sticky. It probably does not make much difference which dose your doctor prescribes, although a lower dose may cause less indigestion. Most people will remain on aspirin indefinitely unless they develop side effects.

Dipyridamole (also known as Persantin Retard): This drug acts in a similar way to aspirin and can be taken in addition to aspirin. It is sometimes recommended for those people who have had a stroke or heart attack whilst on aspirin alone or who for some reason cannot take aspirin.

Clopidogrel (also known as Plavix): This drug acts in a similar way to aspirin and is often used when patients are allergic to aspirin or cannot tolerate it because of stomach problems.

Anticoagulants
For people who have a blocked blood vessel in the brain or who have had a recent heart attack, or have an abnormal heart rhythm or an artificial heart valve, anticoagulants (usually Warfarin) are recommended to prevent future strokes. Except in unusual circumstances, it is usually best to avoid taking aspirin and Warfarin together. Your doctor will advise you about this.

Surgery
A small number of people who have had a transient ischaemic attack will have a very narrow (but not completely blocked) artery in the neck. Removing the narrowing in the artery with an operation called a carotid endarterectomy may reduce the risk of further strokes. The operation is quite a simple one and patients are not usually in hospital for more than five or six days. Unfortunately, there is a small risk that the surgery itself will cause a stroke - you will have to balance the benefits of surgery against this small risk.

The operation is not suitable for everyone and is usually only offered to those with severe narrowing of the artery (where its diameter is reduced by more than 70 or 80 per cent) within six months of an attack. If you have a narrowed artery in your neck you need to discuss this option with the specialist looking after you.

A recently developed alternative is to stretch the narrowed artery with a balloon (percutaneous transluminal angioplasty and stent insertion). This is still being tested and is not yet in routine use.

Research
In recent years there has been a lot of research to develop new treatments for transient ischaemic attacks and stroke and to test whether they are safe and effective. You may be asked whether you would be willing to take part in a research project or clinical trial. The most common type of research is called a 
randomised controlled trial where two or more kinds of treatment are given to different people and then compared to find out which is most effective. If you agree to take part, those running the trial will treat you using a specific drug or treatment and then monitor your progress. Your progress, along with that of all the other people who have received the same treatment, will then be compared with that of people receiving the alternative treatment(s). This will tell the doctors if one treatment is better than another.