Stroke prevention is a subject of much debate. Approximately 25 percent of people who recover from a first stroke will have a second within five years. While the chance of death and disability increases with each stroke, risk of another stroke appears to be greatest within the first year (National Stroke Association 2005).
Using measurements such as the degree of artery occlusion (how much of the carotid artery is blocked by atherosclerotic plaques), medical experts have sought to establish firm guidelines to help physicians choose between the various options, including medication, angioplasty, and surgery. Common prescription drugs used to help prevent stroke include antihypertensive agents (Gorelick PB et al 1999; Goldstein LB et al 2001), cholesterol lowering agents (statins), and antiarrhythmics to help control irregular heartbeats that might contribute to stroke risk. Angioplasty is a procedure in which a balloon is threaded into the artery and inflated rapidly, crushing the plaque against the arterial wall and opening the artery. The most common surgery used to prevent stroke is called carotid endarterectomy, in which the surgeon opens the arteries in the neck and strips away the inner lining of the artery.
While these strategies have been shown to work in specific circumstances, a common flaw also unites them: they are often used only after stroke risk has reached an unacceptable level. We prefer a much more proactive approach. By using advanced early screening tests to determine risk, then taking action to improve endothelial function and reduce blood risk factors (such as homocysteine and fibrinogen) and blood pressure, our practice seeks to maintain the lowest possible risk profile.
Multiple studies have found that a diet high in fruits and vegetables lowers risk of cerebrovascular disease and both ischemic and hemorrhagic stroke (Gariballa SE 2000; Sauvaget C et al 2003). Two major reviews recommended that public health policy promote increased dietary intake of antioxidant vitamin C, beta-carotene, vitamin E, B vitamins (including folate), potassium, calcium, magnesium, vitamin D, fiber, and omega-3 fatty acids to reduce risk of stroke (Gariballa SE 2000; Johnsen SP 2004). These vital nutrients can also be obtained through dietary supplements in conjunction with a healthy diet.
