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Stroke Stroke Prevention

Secondary Prevention: Stopping the Next Stroke


Author:

Jeffrey Saver, MD

UCLA School of Medicine

Medically Reviewed On: March 31, 2006

Introduction
Modifying Risk Factors
Atrial Fibrillation and Cardioembolic Stroke
Atherothrombotic Stroke and Antiplatelet Medications
Carotid Artery Disease and Carotid Endarterectomy
Conclusion

Introduction

Secondary prevention of stroke refers to preventing second, third, and additional strokes in individuals who have had a first stroke. If you have had a first stroke, there is bad news and good news with regard to secondary prevention. The bad news is that you are at increased risk for a second stroke. The good news is that there is a great deal you and your doctor can do to minimize this risk.

How much is the risk increased? The magnitude varies greatly from individual to individual. In general, however, individuals who have had a first ischemic stroke (stroke due to blockage or plugging of a blood vessel) have about a one-in-three chance of having another stroke during the next five years. Individuals who have had a transient ischemic attack (a blocked blood flow episode for which the symptoms last less than 24 hours) have about a one-in-four chance of having a stroke during the next five years. Clearly, everyone who has had a first stroke or a transient ischemic attack should take steps to reduce this substantial risk by adopting the risk-reducing strategies discussed below that apply to their particular condition.

Modifying Risk Factors

Major risk factors for stroke include high blood pressure, diabetes, cigarette smoking, heavy alcohol use, physical inactivity, and high cholesterol levels. Treating these risk factors can help prevent both first stroke and recurrent strokes. If you have had a transient ischemic attack or stroke, the time for action on these risk factors is now. There can be no more dilly-dallying. Use diet and exercise, and medications if needed, to control your blood pressure. Never smoke again. Drink alcohol only moderately, if at all-no more than one to two drinks per day. Perform a continuous physical activity, such as walking briskly, for 30 minutes a day, at least three days a week. Adopt a diet low in cholesterol and saturated fats and use cholesterol-lowering medicines if needed, to control your cholesterol levels.

Atrial Fibrillation and Cardioembolic Stroke

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