Stroke is a serious medical condition that occurs when blood flow to the brain is interrupted, resulting in damage to brain cells. While some risk factors for stroke, such as age and family history, are beyond our control, there are several lifestyle factors that can significantly reduce the risk of stroke.
That’s why we spoke with Ryan Cheung, D.O., a neurologist and physician on the medical staffs at Texas Health Dallas and Plano, to discuss lifestyle habits and choices that can help prevent stroke and promote overall brain health.
Understanding the Risk Factors
Similar to other medical conditions, the risk factors for stroke fall into two camps: controllable and uncontrollable factors. Uncontrollable risk factors are factors that increase your risk but are beyond your control, such as age, family history or a genetic predisposition, ethnic heritage, and a prior stroke history.
If you have any of these things, it would be extra important to manage your other modifiable risk factors, or the factors that are within your control.
“The American Heart Association (AHA) has what they call ‘Life’s Essential 8™,’ and they are key measures for improving and maintaining your cardiovascular health. Better cardiovascular health helps lower the risk of numerous things, stroke being one of them,” Cheung explains. “These are behaviors that are modifiable or controllable on your part, such as eating a healthy diet, being more active, quitting smoking, getting enough sleep, managing your weight, controlling cholesterol, managing blood sugar levels, and managing blood pressure.”
Healthy Diet
Eating a balanced diet rich in fruits, vegetables, whole grains, lean proteins, and healthy fats can lower the risk of stroke. Leafy greens, berries, and fatty fish are particularly beneficial for heart health and reducing stroke risk due to their high antioxidant content, fiber, and omega-3 fatty acids.
“The diet I recommend most to my patients and is recommended by the AHA is the Mediterranean diet which emphasizes these things, namely vegetables, fruits, whole grains, healthier fats (olive and avocado), lean animal proteins, legumes, and nuts,” Cheung adds.
Reducing sodium intake and limiting processed foods are also essential dietary strategies to lower stroke risk. High sodium intake is linked to increased blood pressure, a major risk factor for stroke, making it important to minimize processed and packaged foods. Instead, choosing fresh, whole foods and flavoring meals with herbs and spices can help maintain healthy blood pressure levels.
“Cooking at home leads to a greater awareness of what we consume and it is easier to enjoy fresh vegetables, fruits, leaner animal proteins, healthier oils, and limiting the amount of added sugars, sodium, and processed oils,” says Cheung.
Additionally, Cheung says moderating alcohol consumption is something that should also be top of mind. Heavy drinking, defined as 8 or more drinks per week for women and 15 or more drinks per week for men, can lead to high blood pressure, irregular heart rhythms (atrial fibrillation), cardiomyopathy (weakening of the heart muscle), and an increased risk of hemorrhagic stroke. Hemorrhagic stroke occurs when a weakened blood vessel ruptures and bleeds into the brain.
“Alcohol intake should be in moderation and if you don’t drink already, don’t start,” Cheung explains. “The AHA does not recommend drinking wine or any other alcohol for health benefits. You can speak to your doctor about the benefits and risks of alcohol consumption in moderation.”
Regular Exercise
Regular physical activity is essential for maintaining cardiovascular health and reducing the risk of stroke. In fact, everyone should aim for at least 150 minutes a week of moderate exercise or 75 minutes a week of high-intensity physical activity.
“Regular exercise and physical activity can have many positives to the body both physically and mentally. It improves cardiovascular and cerebrovascular health and can work positively towards treating hypertension (high blood pressure), elevated cholesterol, diabetes, and obesity, which all contribute toward stroke risk,” Cheung says.
While this may seem like a bit of an uphill battle, at first, the more physical activity becomes incorporated as a part of a daily routine, the more it is likely to be continued throughout the years. Build a habit by starting with achievable goals early on and add in strength training at least twice a week to build muscle strength.
“Even walking at a moderate pace has shown benefits,” Cheung adds. “Grab a family member, friend, or coworker and build healthy habits together as a community.”
Smoking Cessation
Smoking is incredibly harmful to your health and can have severe, long-term consequences. Smoking constricts blood vessels, raises blood pressure, and increases the risk of heart disease, stroke, and peripheral artery disease.
“Smoking significantly leads to stroke risk and causes many negative effects on the body due to inflammation within blood vessels and artery walls, which affects blood flow to important organs like the brain and heart,” Cheung explains. “Smokers are at higher risk for developing stroke, heart disease, hypertension and high cholesterol, in addition to lung and all types of cancer.”
While cigarette smoking has gone down significantly in the United States over the last few decades, vaping and electronic cigarette use has surged, especially among teens.
“Vaping of nicotine and various chemicals is likely more dangerous than we think and early research has shown this to increase inflammation and oxidative stress which is part of the pathophysiology of stroke and heart disease,” Cheung adds. “It's important to remember that it's never too late to quit smoking.”
One of the most important steps to reduce the risk of stroke is quitting smoking. You can seek guidance from your doctor to explore various options, such as pharmacologic interventions like gum, patches, or other medications. Additionally, behavioral therapy, counseling, support groups, and online resources have proven helpful for individuals looking to break the habit.
Getting Healthy Sleep
Most adults need 7-9 hours of sleep each night. While often easily overlooked, adequate sleep does more than set you up for the next day. Adequate sleep helps regulate blood pressure, control inflammation, and manage stress levels, all of which are significant contributors to cardiovascular health. During sleep, the body undergoes important physiological processes that support optimal brain function and overall well-being.
Additionally, consistent, restorative sleep promotes healthy lifestyle choices, such as maintaining a balanced diet, engaging in regular physical activity, and avoiding excessive alcohol consumption. These lifestyle factors collectively lower the risk of stroke and other cardiovascular diseases.
Prioritizing good sleep hygiene, including establishing a consistent sleep schedule, creating a comfortable sleep environment, and practicing relaxation techniques, is crucial for stroke prevention and maintaining overall cardiovascular health.
Managing Weight
Maintaining a healthy weight is crucial for reducing stroke risk. It helps regulate blood pressure, manage cholesterol levels, and prevent conditions like diabetes, all of which are significant contributors to stroke risk.
Excess weight, especially around the abdomen, is closely linked to high blood pressure, a major risk factor for stroke. When you carry extra weight, your heart has to work harder to pump blood throughout your body, which can lead to hypertension. By managing a healthy weight, you can help keep your blood pressure within a normal range, reducing the strain on your cardiovascular system and lowering your risk of stroke.
Understanding how many calories you take in and your activity level can help you identify changes you want to make. To lose weight, you need to burn more calories than you eat.
Reduce Calories In: Keeping track of what and how much you’re eating can help you know whether you’re eating out of habit, stress or boredom instead of real hunger.
Increase Calories Out: An activity tracker can help you track how much physical activity you get.
Learn about portion sizes and how much you might really be eating, get active and shake up your diet with lots of vegetables, fruits, whole grains, beans, legumes, nuts, plant-based proteins, and lean animal proteins like fish and seafood. Limit sugary foods and drinks, red or processed meats, salty foods, refined carbohydrates and highly processed foods.
If you aren’t able to lose weight successfully on your own, chat with your doctor to create a plan to help you reach your goal.
Control Cholesterol Levels
High levels of LDL cholesterol (commonly known as "bad" cholesterol) can lead to the buildup of plaque in the arteries, a condition called atherosclerosis. This plaque narrows the arteries and restricts blood flow to the brain. If a plaque ruptures, it can cause a blood clot to form, blocking blood flow completely and resulting in an ischemic stroke.
Elevated levels of LDL cholesterol and triglycerides increase the likelihood of blood clot formation. Blood clots can form in the arteries supplying blood to the brain, leading to an ischemic stroke. Additionally, if a blood clot travels from another part of the body, such as the heart, to the brain, it can cause a stroke.
But not all cholesterol is bad. HDL cholesterol (commonly known as “good” cholesterol) can help prevent some of the bad cholesterols from accumulating in your arteries and blood vessel walls, and even helps to pull some of that bad cholesterol away.
Your doctor can measure blood cholesterol and help you understand what the levels mean. Getting active can help improve cholesterol levels, as well as replacing saturated fats with unsaturated fats.
Manage Blood Sugar Levels
Diabetes is a significant risk factor for stroke, as it can damage blood vessels and increase the likelihood of blood clots. Over time, uncontrolled diabetes can damage blood vessels throughout the body, including those in the brain, raising the risk of stroke. Maintaining optimal blood sugar levels is crucial for individuals with diabetes to reduce their stroke risk. This can be achieved through various strategies, including healthy eating, regular exercise, medication management, and monitoring blood glucose levels.
It's essential for individuals with diabetes to work closely with their healthcare team, including doctors, dietitians, and diabetes educators, to develop a personalized management plan tailored to their needs.
Blood Pressure Management
High blood pressure is a leading cause of stroke, so it's essential to monitor blood pressure regularly and take steps to keep it within a healthy range. High blood pressure contributes to stroke risk by damaging blood vessels and promoting the formation of plaque and blood clots.
“High blood pressure is often referred to as the ‘silent killer’ in medicine because it can start in your 20s and 30s and the effects may not be found until decades later, and it can lead to serious consequences,” says Cheung.
Keeping your blood pressure within acceptable ranges can keep you healthier longer. Levels less than 120/80 mm Hg are optimal. High blood pressure is defined as greater than 130 mm Hg systolic pressure (the top number in a reading) or above 80 mm Hg diastolic pressure (bottom number).
Managing blood pressure through lifestyle modifications, such as adopting a healthy diet, engaging in regular physical activity, and, if necessary, taking medication, is crucial for reducing the risk of stroke and maintaining overall cardiovascular health. While not always top of mind when it comes to high blood pressure, stress can also play a big role in elevated blood pressure levels.
Stress triggers the body's "fight or flight" response, which can cause a temporary increase in blood pressure. Chronic stress can lead to sustained high blood pressure, a significant risk factor for stroke.
“Stress is something that's more probably of an indirect cause, but certainly in this world where it's very hard to get disconnected and unplugged from the rest of the world, stress can easily creep in,” Cheung adds. “It can influence the way we live and the way we eat. If we're really busy and overworked and overtired, then some of those healthier habits we do day-to-day can fall by the wayside. Things like getting enough sleep, proper eating, exercise, and even just simple things like remembering to take your medications.”
The Takeaway
While some factors like age and family history are beyond our control, lifestyle choices play a crucial role in stroke prevention. By adopting healthy lifestyle habits and making proactive choices, you can significantly reduce your risk of stroke and promote overall brain health.
It's important to work closely with your doctors to develop personalized strategies for stroke prevention. Knowing the symptoms of stroke can also help keep you safe. If you experience sudden one-sided weakness, difficulty seeing or speaking, dizziness, trouble walking, or intense headache, call 911 immediately.
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Physicians on the medical staff practice independently and are not employees or agents of the hospital or Texas Health Resources.