Can strokes be prevented?

Can strokes be prevented?

Prevention is always the best treatment, especially when the illness can be life-threatening or life-altering. Ischemic strokes are most often caused by atherosclerosis, or hardening of the arteries, and carry the same risk factors as do heart attacks (myocardial infarction, coronary artery disease) and peripheral vascular disease. These include high blood pressure, high cholesterol, diabetes, and smoking. Stopping smoking and keeping the other three under lifelong control greatly minimizes the risk of ischemic stroke.

Patients who have had a transient ischemic attack (TIA) are often prescribed medications to decrease their risk of a subsequent stroke. These include medications to lower blood cholesterol levels and control blood pressure. In addition, antiplatelet medications may be prescribed to make platelets less likely to promote blood clot formation. These include aspirin, clopidogrel (Plavix), and dipyridamole/aspirin (Aggrenox).

Patients with a TIA are usually evaluated for carotid stenosis or narrowing of the carotid artery. Surgery to open critically narrowed arteries may decrease stroke risk.

Lifelong control of high blood pressure decreases the risk of hemorrhagic stroke.

Atrial fibrillation is the most common cause of embolic stroke. Ideally the heart rhythm can be converted to normal sinus rhythm but in those patients whose hearts are chronically in atrial fibrillation, anticoagulation or “blood thinning” minimizes the risk of blood clot formation in the heart and subsequent embolization and stroke. Which drug that is used to “thin” the blood depends upon the specific patient and their individual situation. Patients who are prescribed warfarin (Coumadin), dabigatran (Pradaxa), and rivaroxaban (Xarelto) decrease the chance of a stroke but are at risk for bleeding complications.