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Over 10,000 strokes are experienced by New Zealanders every year. This equates to over 27 every day.1 According to the American Stroke Association, up to 80% of strokes may be preventable through recommended risk reduction strategies. The American Stroke Association (ASA) has recently released its updated guidelines on stroke risk reduction. In this article we will look at the updated guidelines and set out the key findings on how you can reduce your risk of a stroke and avoid the life changing effects.
2024 Guideline for the Primary Prevention of Stroke provides recommendations based on current evidence on strategies to reduce risk or prevent stroke throughout life. This guideline replaces the previous 2014 guideline.
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The 2024 Guideline by the ASA states that by optimising a few behaviours and using evidence-based preventative care you can reduce your risk of stroke. These recommendations align with the American Health Association’s Life’s Essential 8, which identifies the key measures for improving and maintaining cardiovascular health. The 8 components include 4 health behaviours and 4 health factors.
A healthy balanced diet is essential for cardiovascular health. The study identifies the Mediterranean diet and sodium substitution with potassium as beneficial for stroke reduction. It also states some benefits were seen with folic acid and B-complex vitamins.
The guideline identifies an association between physical activity and a lower risk for stroke. The AHA recommends adults get 2.5 hours of moderate physical activity (e.g., brisk walking) or 75 minutes of vigorous physical activity (e.g., running or jogging) per week.
Tobacco use is identified as a major modifiable risk factor for stroke. The use of inhaled nicotine products i.e., cigarettes, e-cigarettes, and vaping is a leading cause of preventable deaths, including heart disease. It can significantly increase the chance of stroke.
Obstructive sleep apnoea is an independent risk factor for stroke and increases risk of stroke through its indirect effects on hypertension. If you are not getting enough quality sleep (most adults 7-9 hours per night) you could be at higher risk of cardiovascular disease.
Being overweight or obese is associated with a 22% and 64% increased risk of stoke respectively.2 The guideline observes that recent meta-analyses provide strong evidence that pharmacological treatments for diabetes that lower both blood glucose and weight, and bariatric surgery procedures are associated with a reduced risk of cardiovascular events, including stroke, in selected patients.
Poorly managed blood cholesterol levels can lead to atherosclerosis. High blood cholesterol levels lead to a build-up of plaque in the arteries, causing them to thicken and harden. Most ischemic strokes are caused by atherosclerosis. Making diet and lifestyle changes to improve cholesterol levels is therefore recommended.
Diabetes, prediabetes, and type 1 diabetes are identified in the guideline as independent risk factors for stroke. Adults with higher cumulative hyperglycaemia (high blood sugar) levels are associated with higher stroke risk.
The guideline identifies a strong, continuous and progressive association between blood pressure and risk of stroke. High blood pressure associated with a higher risk of stroke, along with other forms of cardiovascular disease. It is identified as the number one modifiable risk factor for stroke, as it can be managed or treated with lifestyle changes and/or medicines.
The acronym BE FAST is used to help recognise the warning signs of a stroke, so you can act quickly to call 111 if you suspect a stroke.
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B – Balance: sudden loss of balance or coordination.
E – Eyes: changes in vision, or vision loss in one or both eyes.
F – Face: face drooping and numbness, particularly to one side (ask person to smile).
A – Arm weakness: sudden weakness or numbness in one arm (ask person to lift both arms).
S – Speech: slurring of words or garbled speech, difficulty speaking or understanding.
T – Take Action: time to call 111 if you suspect a stroke based on these symptoms.
