Neurology-Online

How can you prevent a stroke?

introduction

There are risk factors for stroke that cannot be influenced. This includes age and a certain genetic disposition.

In addition, there are a number of risk factors that can be eliminated to prevent a stroke.
The most important risk factor for a stroke is untreated or poorly controlled high blood pressure. In addition, lack of exercise is one of the risk factors. Overweight and an unhealthy diet are also among the controllable risk factors; likewise smoking and increased blood sugar and blood lipid values.

These risk factors are not only important for the development of a stroke. They generally lead to one in the body Atherosclerosis, i.e. calcification of the arteries. In addition, this is also the most common cause of a heart attack. For this reason, it is worthwhile to eliminate or minimize these risk factors for health reasons.

What options are there?

There are various ways to eliminate the risk factors mentioned above.

The most important risk factor is still high blood pressure (arterial hypertension). In addition to weight loss, increased physical activity and a low-salt diet, drugs play an important role in lowering blood pressure. After consulting the family doctor or the cardiologist, the appropriate medication can be determined individually for each patient.
If one drug is not sufficient to lower blood pressure, a combination therapy can be used. This also applies to increased blood lipid levels (Hypercholesterolemia)which are also a risk factor. Diet can often only marginally influence the LDL cholesterol level. Medicines (e.g. statins) often have to be taken.

It is also important to suggest a lifestyle change to the patient. More exercise and a balanced diet are the basis for permanent weight loss. This does not, for example, have a positive effect on the blood sugar level.
Last but not least, one should also pay attention to nicotine consumption. In the best case scenario, smoking cessation should be sought. However, a reduction in the daily amount of cigarettes should also be emphasized as positive.

Sonography of the carotid artery

Through a sonography of the carotid artery (Carotid artery) the risk of a stroke can be assessed. An ultrasound examination is used to determine what the walls of the carotid artery look like.
For example, are there vasoconstrictions (Stenoses) or you can get small debris (Plaques) detect. In addition, the speed of blood flow through the blood vessel can be assessed.

When should this examination be carried out?

Doctors recommend this examination to be carried out on patients who have suspected hardening of the arteries. Special risk groups are smokers, diabetics, overweight people and people who have already suffered a heart attack or stroke.
If the examination shows more serious deposits in the area of the carotid artery, there is an urgent need for action. The risk factors for arteriosclerosis present in the patient must be minimized or eliminated. This is the only way to prevent a stroke.

However, it is already a narrowing of the carotid artery (Stenosis) a presentation to a vascular surgeon should take place. There are different treatment options depending on the severity of the vascular narrowing.

Stent

A narrowing of the carotid artery (Carotid stenosis) is responsible for around 20% of all strokes.

Due to the slowly progressing process of hardening of the arteries (Arteriosclerosis) the blood flow through the blood vessel becomes more and more restricted. However, it only becomes really dangerous for the patient when parts of these arteriosclerotic calcifications develop (Plaques) peel off the wall of the blood vessel and be washed into the brain. Here they can block smaller blood vessels and the patient can suffer a stroke in this way.

In order to prevent this, the carotid artery should be examined regularly with selected risk groups using ultrasound.
In the case of severe constrictions, an operation usually had to be performed to remove the calcifications. Nowadays, a narrowing of the carotid artery can also be treated in a minimally invasive manner using a stent.

A stent is a small wire tube that supports the blood vessel wall. Similar to the heart, it is introduced into the bloodstream via a catheter from the groin. The study results for this procedure are superior to other results. In this way, a stroke can be prevented, especially in patients with a high risk of surgery.

Find out more about the topic here arteriosclerosis

Atrial fibrillation

Atrial fibrillation is a cardiac arrhythmia that can cause blood clots to form in the heart. These blood clots (Thrombi) are then washed away with the bloodstream and clog other smaller blood vessels (mostly in the brain). If this happens in the brain, then one develops from a stroke.

The risk of developing atrial fibrillation increases with age. Almost 10% of those over 70 are affected by the cardiac arrhythmia. Based on the patient's individual risk profile, the doctor will then decide whether to thin the blood (Anticoagulation) necessary is.
This protects patients with atrial fibrillation from a stroke. In many cases, atrial fibrillation is only temporary (so-called. paroxysmal atrial fibrillation). The heart always returns to the right rhythm. This can often make diagnosis difficult. It cannot be seen in the standard resting ECG. Usually a 24-hour long-term ECG is then carried out. This increases the chances of uncovering any arrhythmias.

Some patients are completely symptom-free despite atrial fibrillation. However, if the arrhythmia is not recognized and the patient is not given a blood thinner, the risk of stroke increases. For this reason, in old age you should regularly (once a year) come to your doctor for a routine EKG check.

Read more on the subject here Atrial fibrillation

Blood thinning

As already mentioned, blood thinning can reduce the risk of stroke.
Even with atrial fibrillation, blood clots can no longer form so easily in the heart while taking blood-thinning medication. If there are other risk factors for a stroke in addition to atrial fibrillation, such as age over 65 years, a previous stroke, high blood pressure, diabetes or coronary heart disease, blood thinning is strongly recommended.

This blood-thinning effect can be achieved by taking so-called vitamin K antagonists (the most prominent example Marcumar®). Newer oral anticoagulants (blood thinners, NOAC for short) such as Xarelto® or Eliquis® are also used.

You can read more about this here: blood thinner

Aspirin®

ASA or acetylsalicylic acid is also known to many under the trade name Aspirin® and also has a blood thinning effect. However, it is no longer used to prevent strokes caused by atrial fibrillation. Numerous studies have been able to clearly demonstrate that the bleeding complications are just as frequent and severe as with vitamin K antagonists (e.g. Marcumar®). However, the number of strokes prevented was significantly lower.

Nevertheless, ASA is still often used in medicine to thin the blood. For example, it becomes after a heart attack or when the carotid artery is narrowed (Carotid stenosis) used.

Read more here: Aspirin and its application

Prevention through sport

Exercise is essential to preventing a stroke. It doesn't always have to be exercise in the gym. Even more exercise in everyday life leads to a significant reduction in the risk of stroke. This is mainly due to the fact that increased physical activity has a positive effect on blood pressure, blood sugar and blood lipid values. Exercise also helps you lose weight and thus eliminates another risk factor - obesity.

Basically, however, it makes sense to see your family doctor for further advice. Especially if there are chronic illnesses, medication is taken regularly or simply no sport has been performed for a long time. The doctor can perform an exercise ECG as a supplementary diagnosis and check how the heart rate and blood pressure behave. Building on this, he can give a qualified recommendation and assess the reasonable burden.

Another very important stroke prevention is integration into everyday life. Try to get more exercise, ride your bike more often, or get off a tram stop earlier and walk home. Even small measures reduce the risk of stroke.

Prevention through a healthy diet

You can also take action yourself to reduce your individual risk of stroke.
A healthy diet has a positive effect on the cardiovascular system. For the blood vessels, the so-called Mediterranean diet is particularly desirable. This means a diet with lots of vegetables, olive oil, fish and nuts. Of course, it's okay to treat yourself to a piece of cake every now and then.
Basically, however, you should make sure you eat a balanced diet.

Excessive alcohol consumption is also not good for the blood vessels. However, the famous glass of red wine during the day is allowed.
When it comes to nutrition, it also makes sense to think about weight loss. Obesity is a far greater risk factor than an unhealthy diet. A change in diet to a Mediterranean diet is particularly useful for overweight people

Prevention through naturopathy

While naturopathy does not play a role in acute stroke therapy, it can be used in aftercare or to prevent a stroke.
A well-known dietary supplement is, for example, Ginkgo biloba. It is used to improve the blood circulation in circulatory disorders.
Garlic is also recommended for stroke prevention.If you are bothered by the smell, it is advised to take dietary supplements with garlic extract.

Homeopathic medicines are also used to prevent a stroke. These include Acidum hydrocyanicum and hydrofluoricum, as well as Glonoinum, various potassium compounds (chloratum, nitricum, phosphoricum) and Xanthocylum fraxineum.
For homeopathic remedies that you have chosen yourself, the potencies D6 and D12 are recommended. However, a consultation with a homeopath is useful.

Prevention through home remedies

There are also various home remedies that can be used to reduce the risk of stroke. For example, teas made from birch leaves, lady's mantle, nettle, arnica, field horsetail, yarrow, silverware and lavender are recommended
One teaspoon of a mixture should be boiled in a cup of water. After 15 minutes of steeping time, the tea can be drunk before eating. There is also a herbal wine mix that can be drunk three times a day. Angelica root, sage, bertram root, hyssop, rosemary, clove root and marjoram are mixed here. Take an amount of this mixture that is about three fingers wide and boil it up with a cup of apple cider.
Another recommendation is to regularly take alternating baths.