Stop Stroke Before It Starts: Preventive Care Made Simple

The American Stroke Association and America Heart Association recently announced that up to 80% of the 610,000 first-time strokes that occur every year could be prevented through early screening and lifestyle changes. Shlee S. Song, MD, a board-certified vascular neurologist and medical director of the Cedars-Sinai Comprehensive Stroke Center, says the "2024 Guideline for the Primary Prevention of Stroke" article in the Stroke journal highlights the choices people can make, in addition to seeing a primary care team, to prevent stroke.

Can stroke be prevented?

The simplest answer is “yes, it can be.” Of course, it depends on the circumstances and factors such as genetics, and accidents and trauma are out of our control. But for most individuals, there are modifiable behaviors and lifestyle changes that can reduce the risk. What’s in our control is the American Heart Association’s "Life’s Essential 8": eat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood sugar and manage blood pressure.

What are the major risk factors for stroke?

The key risk factors include high blood pressure, elevated cholesterol, high blood sugar and obesity. When it comes to healthy weight, it’s more than just circumference—it is the distribution of weight. Extra pounds around the middle indicate higher risk of stroke. In addition, women’s stroke risk can change as they age. They need to have conversations with their OB-GYN regarding blood pressure and perimenopause, or early menopause, and the link to cardiovascular disease.

How can routine medical checkups and treatment reduce the risk of stroke?

Your care team—physician, physician assistant and nurse practitioner—will monitor existing and new health issues. When you go to your appointments, take any data you’ve collected at home, such as blood pressure or blood sugar trends, and tell them about any symptoms. Your team will keep track of patient history and bloodwork. They will check sugar trends and changes in blood pressure or cholesterol, and make recommendations for exercise and lifestyle changes. If you set goals for your health at your annual checkup, it’s a good idea to ask for a six-month follow-up visit for maintenance.

Which lifestyle choices can help prevent stroke?

Diet has an enormous impact on blood pressure, blood sugar, cholesterol and weight—four significant components of stroke risk. Your primary care team can give you guidance on eating habits, but the starter points are less red meat and processed foods, more fiber, and less sugar and simple carbohydrates.

Exercise also has a huge impact on these risk factors, so aim for at least 150 minutes a week of moderate-intensity aerobic activity such as brisk walking, water aerobics, gardening, tennis or biking; or at least 75 minutes a week of vigorous-intensity aerobic activity such as running, hiking uphill, swimming laps or jumping rope. Add muscle-strengthening activity on at least two days per week–resistance bands or weights.

We tend to forget the importance of social interaction on our health, especially after retirement. We really need to make an effort to stay connected with friends and have appointments that call us out of a sedentary lifestyle. That type of connection is essential.

What’s a simple step-by-step plan for individuals to protect themselves from stroke?

The key is tailoring a plan that is doable. It’s not about intensity; it’s about consistency. Start with small steps. See your primary care doctor at least once a year to talk about lifestyle changes possible for you. Small adjustments to diet and exercise can be made with the help of a personal trainer and nutritionist. Or begin on your own by adding a short daily walk and avoiding junk food. Build from there. And remember the social aspect: join a club, attend community events, and schedule visits or phone calls with friends and family.

Torrance Memorial Medical Center is a certified DNV-GL Healthcare Comprehensive Stroke Center, reflecting the highest level of competence for treatment of serious stroke events based on standards set forth by the Brain Attack Coalition and the American Stroke Association.

This affirms that the medical center addresses the full spectrum of stroke care—diagnosis, treatment, rehabilitation and education—and establishes clear metrics to evaluate outcomes. Comprehensive stroke centers are typically the largest and best-equipped hospitals, and a given geographical area that can treat any kind of stroke or stroke complication. In a growing number of states, stroke center certification determines to which facility a patient should be taken for the most appropriate, reimbursable care.