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What lifestyle changes can reduce your risk of stroke?
Every year in the UK, around 120,000 people have their first stroke and about 30,000 have a recurrent stroke. You're probably aware that strokes can cause serious and life-altering damage, but did you know that up to 90% of them could be prevented by making healthier lifestyle choices?
"Not all strokes are avoidable, but as many as nine out of 10 strokes could be prevented because they are linked to factors you can change or manage," explains Juliet Bouverie OBE, chief executive at the Stroke Association.
Contrary to popular belief, it's not just older people who need to know how to reduce the risk of stroke. While most cases occur in people aged over 65 years, a stroke can occur at any age: "Many people think that strokes only happen to older people, but stroke can strike anyone, at any time," says Bouverie.
What happens during a stroke?
There are two main types of stroke. A minority (2-3 out of 20 strokes) involves a bleed into the brain: this happens when a blood vessel in the brain bursts. The rest are caused by a clot, which cuts off the blood flow through an artery in the brain.
In both of these, the blood supply that provides essential oxygen to your brain cells is suddenly cut off to a part of your brain. As a result, the affected cells become damaged or die. Bouverie explains how serious this can be:
"The brain is the control centre for who we are and what we can do. The effects of a stroke can be life-changing for you and your family."
The potential outcomes following a stroke are extremely varied depending on the extent of brain damage. They range from the relatively less serious and temporary effects to life-altering disabilities and even death. Stroke is the leading cause of adult disability and the fourth biggest cause of death in the UK.
Stroke survivors speak out
Unfortunately, many people don't realise they're high-risk. In fact, according to a new UK survey of stroke survivors by the Stroke Association in December 2021, more than four out of five said they hadn't realised that they were at risk of a stroke.
What's more, nine out of 10 stroke survivors would go back in time and urge their younger self to make lifestyle changes that may have prevented their stroke.
"When we asked stroke survivors what advice they would have given to their younger self and what changes they had made since their stroke, we were overwhelmed by the response, with more than 5,300 people contributing," adds Bouverie.
The top changes that stroke survivors would have urged their younger selves to make include:
- Reduce stress levels - 46%.
- Monitoring blood pressure - 37%.
- Eat a more balanced diet - 32%.
- Exercise more frequently - 32%.
- Lose a set amount of weight - 28%.
- Stop smoking - 25%.
- Drink less alcohol - 24%.
- Monitor high cholesterol - 22%.
- Reduce salt intake - 17%.
How to reduce the risk of stroke
Blood supply to the brain can be cut off in two ways: ischaemic strokes are caused by a blood clot, whereas haemorrhagic strokes are caused by bleeding on the brain.
There are several conditions affecting the heart and blood vessels (arteries), known as risk factors, that increase the likelihood of these events.
- High blood pressure - the biggest single risk factor for stroke. High blood pressure can cause blood vessels in your brain to restrict and harden which can lead to a blood clot and can also cause a weakened blood vessel to burst.
- High cholesterol - too much cholesterol in your blood can cause fatty deposits to build up which can restrict blood flow and cause clots.
- Diabetes - raised blood sugar (glucose) levels can damage and block blood vessels in the brain. However, it's important to note that only type 2 diabetes can be prevented through lifestyle changes.
- Atrial fibrillation - this condition can disrupt the blood flow in the heart chambers which sometimes leads to a small clot that gets lodged in a brain blood vessel.
The good news is these can usually be prevented, managed, and improved through your lifestyle choices to reduce your risk of having a stroke. Reema Patel, a dietitian at Dietitian Fit, says: "Working on reducing the risk factor of certain conditions associated with stroke can help, such as obtaining optimal cholesterol levels and blood pressure."
"It's crucial that everyone knows that with some simple lifestyle changes the risk could be reduced," adds Bouverie. "The bonus is that these changes not only reduce your risk of stroke but also bring a wide range of other health benefits."
Addressing stress levels
There is a growing body of evidence linking high levels of stress to stroke, as well as other diseases relating to the heart and blood vessels (cardiovascular diseases). In some severe cases, stress may place extra strain on your heart, resulting in raised blood pressure and blood sugar (glucose). Unfortunately, feeling highly stressed and following an unhealthy lifestyle often go hand in hand, further exacerbating poor physical and mental health.
Altering your diet is one of the most effective methods of stroke prevention. This not only involves cutting back on high-risk foods but making sure you're eating a nutritious and well-balanced diet. Patel says, "Choose to eat a diet high in fibre that is found in fruits, vegetables, beans, pulses nuts, and seeds."
Reducing salt intake
Reducing your salt intake should be a top priority. According to the World Health Organization (WHO), most people consume 9-12 grams a day of salt - twice the recommended maximum intake of 6 grams per day. This statistic is worrying, as salt is the main source of sodium which significantly contributes to high blood pressure. Bouverie suggests switching to a reduced-sodium alternative such as LoSalt, while Patel cautions against hidden salt in processed foods.
Limiting saturated fat
Saturated fats can raise your cholesterol levels and cause excess weight gain (a risk factor for stroke, type 2 diabetes, and other cardiovascular diseases). One study suggests that cutting back on saturated fats for at least two years can significantly lower your chances of cardiovascular diseases like stroke.
Drinking less alcohol
Following the UK Alcohol Guidelines of up to 14 units per week is also important for stroke prevention. What's more, sensible drinking can benefit your health in many other ways, from treating anxiety to reducing your risk of serious diseases like liver disease and cancer. There are many tips for reducing your intake. For example, the Stroke Association recommends introducing a number of alcohol-free days each week.
Reaching and maintaining a healthy weight can also reduce the risk of stroke. BMI calculators can help to indicate if you're carrying a dangerous amount of excess weight. If so, your chances of developing the main risk factors associated with stroke increase. Being overweight or obese can lead to a multitude of issues to do with your heart, respiratory system, immune response, cartilage and bones, and mental health.
There is a lot of strong evidence linking smoking, which transfers harmful chemicals into your bloodstream, to strokes. One study found that smokers were six times more likely to have a stroke than non-smokers who had never been exposed to second-hand smoke. Smoking also makes you twice as likely to die from a stroke.
"Keeping active and taking part in regular physical exercise provides a multitude of benefits, including helping to lower cholesterol and blood pressure, which can be risk factors of a stroke," says Patel.
You can participate in the Stroke Association's Stride for Stroke challenge - one step for each of the 1.3 million stroke survivors in the UK.
Monitoring your cholesterol and blood pressure
The Stroke Association recommends having your cholesterol and blood pressure checked regularly. This means a blood pressure check at least once a year (ait's and a cholesterol check at least every five years, or more frequently if advised by your healthcare professional. Check-ups are important as these health issues typically cause no symptoms. Being aware of them will enable your doctor to recommend the appropriate treatment.