Having a stroke can be a life-changing experience. Nobody wants to go through it twice. Upon recovery, one of the first things we do is try to help patients reduce their risk through education about secondary stroke prevention. These are the steps patients can take to potentially avoid having another stroke and to reduce the symptoms of a previous stroke.
Key risk factors for stroke have been identified over the years that have resulted in patients receiving better preventative and post-stroke treatment. For example, when I became a doctor in the mid ‘90s, stroke was the third most common cause of death. Now, it’s the fifth most common.
Because a patient’s risk for stroke increases after their first (or primary) stroke, it’s important that doctors and patients work together to reduce the risk of a secondary stroke. The doctors in our Comprehensive Stroke Center typically begin with education and recommendations around three specific steps.
3 steps to prevent a secondary stroke
- Take an antithrombotic medication, if appropriate
Antithrombotic medications can reduce the formation of blood clots, which cause the majority of strokes. Antithrombotic agents include anticoagulants and antiplatelets.
- Consider taking a statin
Many patients who have had a stroke can benefit from statin agents. These medications have many positive effects, such as decreasing bad cholesterol (LDL), increasing good cholesterol (HDL), neuro-protection, and in some instances, regressing athero-sclerotic plaque.
- Learn about and manage personal risk factors
We categorize the risk factors for stroke into modifiable and non-modifiable risk factors to help patients better understand how much they can affect their stroke risk.
Modifiable risk factors:
These are risk factors that can be controlled through behavior and lifestyle. We often discuss the following modifiable risk factors with patients:
- Hypertension: This is by far the most common risk factor for stroke. Patients usually get treated first by taking antihypertensives, and then we offer them lifestyle suggestions, such as exercise and incorporating a Mediterranean diet to help ensure they have a healthier blood pressure down the road.
- Lack of exercise: If you compare people who are the same age and have the same risk factors, those who exercise have a decreased risk in having a stroke.
- Diabetes: Patients with diabetes are two to four times more likely to have a stroke than those who don’t.
- Heavy alcohol consumption: Excessive drinking can lead to conditions that increase the risk of stroke, such as high blood pressure, diabetes, and obesity.
- Obesity: Carrying too much body fat can contribute to high blood pressure and often is associated with decreased exercise and a poor diet.
Non-modifiable risk factors:
These are risk factors we cannot change or reverse. However, patients can benefit from understanding them, as this education often encourages patients to more seriously adopt healthy behavioral changes. Non-modifiable risk factors include:
- Age: After the age 65, stroke risk goes up one percent each year.
- Gender: Strokes are more common in men. But prevalence, or the number of survivors, is higher in women because they tend to live longer.
- Race/ethnicity: Studies show that African-Americans and Latinos are much more likely to have strokes than patients of other ethnic backgrounds.
- Socioeconomic status: For a variety of reasons, the lower someone’s financial or education status, the higher their risk of stroke.
Expert stroke prevention and care in the District
A unique thing about MedStar Washington Hospital Center is that about 50 to 70 percent of our patients are African-American. This is important because African-Americans are at increased risk for strokes—in fact, about two times more than Caucasians. This allows us the opportunity to help educate our patients on their individual risk factors.
When it comes to stroke prevention and treatment, where a patient receives care can make a huge difference in their outcomes and recovery. MedStar Washington Hospital Center received the Washington, D.C., region’s first comprehensive stroke center certification from the Joint Commission for caring for patients with complex stroke cases, demonstrating our level of commitment in caring for patients with complex stroke conditions.
Due to our expertise and exceptional care, we get referrals from 9 MedStar Health hospitals. We’re also a regional referral center, which means approximately another 35 hospitals send patients to us for advanced stroke care. Patients can feel safe, as complex stroke cases are treated here through services, such as:
- A state-of-the-art neurological intensive care unit.
- Nurses who specialize in stroke care.
- Vascular cardiology.
Additionally, we’re affiliated with the National Institutes of Health, meaning we’re one of the select medical facilities in the U.S. where patients who we suspect have had strokes are screened with magnetic resonance imaging (MRI) right away. This process allows us to clearly visualize and confirm the signs of a stroke and implement the most appropriate course of care.
We are also one of the select sites in the U.S. that provides embolectomy, or thrombectomy, procedures in the early research stages, which is an incredibly effective intervention for clot-related strokes. With these procedures, we can restore blood flow to the brains of patients who suffer strokes, even up to 24 hours after the stroke began.
A stroke can be life-changing. If you or a loved one have had a stroke, you can significantly reduce the risk of having another by understanding personal risk factors. Take control of your health future by managing your overall health together with your doctor.
