Up to 80% of first-time strokes are preventable, says the American Stroke Association. New guidelines offer a better look at risk factors, including special considerations for women.
This Is the “Most Effective Way” to Prevent Stroke Death, Expert Doctor Says
Published on Oct. 29, 2024
The statistics can be sobering to read: Every 40 seconds, someone in the U.S. suffers a stroke—and someone dies from the condition about every three minutes. According to the Centers for Disease Control and Prevention (CDC), more than 795,000 Americans experience a stroke every year, with approximately half a million people having one for the first time.
A stroke occurs when a blood vessel ruptures (known as a hemorrhagic stroke) or becomes blocked by a blood clot (an ischemic stroke), thereby interrupting blood flow and oxygen to the brain. The CDC notes that because the brain needs oxygen and a stroke disrupts that process, “brain cells start to die within minutes.”
But the good news—and there is good news—is that this outcome is far from a foregone conclusion. The American Stroke Association (ASA), a division of the American Heart Association, suggests that up to 80% of strokes have the potential to be prevented—and they have a freshly updated plan of action to bring that hopeful possibility closer to reality. But how exactly?
In 2010, the American Heart Association (AHA) first released Life’s Essential 8, an evidence-based way of modifying cardiovascular risk. This campaign centered on eight recommendations which have been firmly established to reduce the likelihood of stroke:
- Eat better
- Be more active
- Quit tobacco
- Get healthy sleep
- Manage weight
- Control cholesterol
- Manage blood sugar
- Manage blood pressure
Cheryl D. Bushnell, MD, MHS, FAHA, professor and vice chair of research in the department of neurology at Wake Forest University School of Medicine, recently led the AHA’s guideline-writing group in penning the “2024 Guideline for the Primary Prevention of Stroke.” This document replaces the 2014 version as a resource for clinicians “in implementing a variety of prevention strategies for individuals with no prior history of stroke,” an October 21 news release explains.
“This guideline is important because new discoveries have been made since the last update 10 years ago. Understanding which people are at increased risk of a first stroke and providing support to preserve heart and brain health can help prevent a first stroke,” said Dr. Bushnell in the release. “The most effective way to reduce the occurrence of a stroke and stroke-related death is to prevent the first stroke—referred to as primary prevention,” she added.
The new 2024 guidelines continue to promote these science-backed measures, and add new emphasis on the importance of screening for stroke risk. “The new primary prevention of stroke guideline from the American Stroke Association (ASA) urges health care professionals to screen people for stroke risk factors, including high blood pressure, elevated cholesterol, high blood sugar, and obesity,” the AHA says.
The document also includes some new recommendations that could impact women in particular. “Health professionals should screen for conditions that can increase a woman’s risk of stroke, including use of oral contraceptives, high blood pressure during pregnancy, other pregnancy complications such as premature birth, endometriosis, premature ovarian failure and early onset menopause,” the guidelines state. They note that people taking estrogen as part of their gender-affirming care may also be at an increased risk of stroke.
The new guidelines also endorse the use of predictive tools which can help estimate risk for atherosclerotic cardiovascular disease and leave time for intervention. “The Association has recently developed a new Predicting Risk of Cardiovascular Disease Events (PREVENT) risk calculator as a screening tool that can help inform preventive treatment decisions. The PREVENT calculator can estimate 10-year and 30-year stroke and heart disease risk in individuals starting at age 30—a decade earlier than the Pooled Cohort Equations, another CVD risk calculator,” the AHA writes.
Recognizing the signs of a stroke is another crucial way to lower your risk of death. The American Stroke Association says that memorizing the acronym “F.A.S.T.” will help you remember those signs in an emergency:
- F: Facial droop or uneven smile
- A: Arm weakness or an inability to hold both arms up without one drifting down
- S: Speech difficulty, including slurred speech
- T: Time to call 9-1-1, and remember—every minute counts.
Other possible signs include confusion, vision problems, difficulty walking, or a severe headache with no known cause, and sudden numbness or weakness of the face, arm, or leg—especially on one side of the body.
With the help of a doctor, you can make a plan to manage and treat your risk factors. To get started, speak with your healthcare provider about screenings, questions, or concerns related to any medical conditions or factors that may make you more likely to have a stroke.
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