Ways to Prevent a Second Stroke, and the Risk of the Second Stroke

A stroke is a condition caused by a defect in the cardiovascular system, but it affects the nervous system. It can be a very disabling condition. Rehabilitation is slow and can be expensive, and even at that, a significant degree of recovery is not guaranteed.

Unfortunately, with one episode, the risk of a second one is increased. For this reason, it is important to do your best to prevent another one from occurring, as the effects are usually more severe.

What are the chances of having a second stroke after the first one? This article will answer that, as well as show you how to prevent a stroke.

Understanding Stroke

It’s important to understand what happens in the body during a stroke. Knowing the mechanism behind this condition makes it easier to grasp the forms of treatment, as well as the things to do to prevent a stroke.

Overview of Stroke and Its Impact

A stroke, or cerebrovascular accident (CVA), occurs when a section of brain tissue does not receive enough blood, and therefore oxygen, which leads to death of the tissue there. 

Two major types can occur:

  1. An ischemic stroke occurs when a vessel in the brain is blocked, usually by a blood clot. This is the more common type, accounting for close to 90% of them.
  2. A hemorrhagic stroke occurs when the wall of one of the arteries in the brain ruptures and leaks blood into the surrounding tissue.

When a segment of brain tissue dies or is damaged after a CVA, the functions that the segment is responsible for will be impaired. This is why speech, voluntary muscle control, and even memory, can be affected following an episode.

A CVA can commonly cause muscle paralysis that can prevent patients from carrying out tasks independently.

In the worst cases, patients who have experienced a CVA may lose independence and need to have a caretaker to handle daily activities for them. This emphasizes the importance of learning the ways to prevent stroke.

Explanation of the Risk of a Second Stroke

If you had a stroke will you have another” is a question that many patients ask themselves. It is not absolute, but the chances of having another CVA are greatly increased after one.

This is because the risk factors that predispose to the first episode are usually still present, and the damage caused by the first occurrence makes it more likely to happen again.

A study found that the 10-year risk of a second stroke was 39.2%, mostly accounting for ischemic strokes. When no measures are taken to prevent it, recurrence is likely.

But, what are the chances of a second brain hemorrhage? In the case of hemorrhagic CVA recurring, the 10-year risk was found to be 14.2%.  

Risk Factors for Stroke

There are several factors, which when present, increase your risk of having a CVA when compared to the average person. Being aware of these can better inform you of how to reduce the risk of a stroke.

These can be divided into modifiable (can be changed or managed) and non-modifiable (cannot be changed) risk factors. The modifiable ones include the following:

  • High blood pressure (hypertension)
  • Cardiovascular disease
  • Diabetes
  • Smoking
  • High blood cholesterol (hypercholesterolemia)
  • High blood lipids (hyperlipidemia)
  • Brain aneurysms
  • Obesity
  • Physical inactivity
  • Intravenous drug abuse
  • Excessive alcohol consumption

The non-modifiable risk factors include:

  • Older age
  • Male gender
  • History of stroke
  • Family history
  • African-American race

Prevention Strategies. 5 Ways to Prevent a Second Stroke

Learning how to prevent a stroke and the steps you can take becomes a priority for anyone who has had a previous episode. This can prevent you from suffering additional deficits in independent function.

So, what can you do to prevent strokes? Let’s talk about some of them.

Manage Underlying Medical Conditions

Many medical conditions can increase your chance of this disease. For instance, heart disease, diabetes, high blood pressure, or excessive lipids or cholesterol in your blood can predispose you to this. 

If you’re looking for how to stop a stroke, the only way is to prevent it from happening in the first place.

Visiting your doctor for regular check-ups and managing these diseases appropriately can reduce your risk significantly, especially in the case of high blood pressure, high cholesterol, and diabetes. Taking care of these usually just involves medication and that is worth preventing a recurrence or initial episode.

Exercise and Physical Activity

Physical inactivity is one of the risk factors. It’s been proven that increased physical activity, whether through work or exercise, is protective. Meanwhile, being sedentary, characterized by more than four hours of TV, video, or computer use a day, increased the risk.

Increasing your weekly physical activity can prevent a stroke, but it also has several other benefits for your health.

As a result, exercising regularly can serve as one of the ways to prevent stroke. It also helps out secondarily since it can be used to tackle obesity or overweight, lower blood cholesterol, and control hypertension.

Healthy Diet and Nutrition

How to reduce the risk of a stroke is sometimes as easy as eating better. A diet full of salt or unhealthy fats can make high blood pressure and hypercholesterolemia more likely, which in turn, makes a CVA more likely.

Attempt to cut down salt intake, reduce fried and fatty foods in your diet, and include more fresh fruit, vegetables, and fiber.

Weight Management

Being obese has been well-proven to be a major factor contributing to the development of cerebrovascular accidents in many patients. It’s been shown that a BMI over 30 kg/m2 increases risk by about 70% when compared to a person with a BMI under 25 kg/m2.

With such high levels of risk, it becomes evident why weight management should be taken seriously as one of the ways to prevent stroke. Fortunately, maintaining a healthy diet and adequate physical activity can help reduce weight, in addition to being preventive measures on their own.

Smoking Cessation

Smoking makes it more likely to have an ischemic CVA because it can cause the narrowing of the arteries in the body and also increases the chance of random blood clots.

It can be hard to quit smoking, but it can provide a lot of general health benefits, not just reducing the risk of a CVA. It might be more practical to attempt to taper down how many cigarettes you smoke daily, rather than quitting cold turkey.

Medications and Medical Treatments for Stroke

You can always learn how to prevent a stroke, but if it occurs anyway, it is important to get appropriate treatment to combat the chance of recurrence.

There are multiple established medical treatments used for this. Many of these can be used as ways to prevent stroke, when appropriate.

Anticoagulants and Antiplatelet Agents

Since ischemic CVAs are typically caused by blood clots, discouraging unnecessary clotting of blood is one way to manage this condition.

Aspirin is perhaps the most popular antiplatelet medication and many patients are placed on this after a cerebrovascular accident or when risk factors like hypertension are present. Anticoagulants like warfarin might also be used.

To treat an ischemic CVA though, medication that dissolves clots can be administered. One great example of this is alteplase, and it can be very effective when used within 4 hours of the onset of symptoms.

Blood Pressure Management

Hypertension is the most important risk factor, so if you’re looking for how to reduce the risk of a stroke, managing blood pressure should be the first step when possible.

Anti-hypertensives can be used to treat a cerebrovascular accident or for prevention. These include diuretics, ACE inhibitors, calcium channel blockers, beta-blockers, and other medications.

Cholesterol-Lowering Drugs

Drugs that reduce cholesterol are known as statins. They can’t be used to acutely treat a CVA, but instead, are used as one of the ways to prevent stroke.

Note that these are not only used for people with high cholesterol. They are occasionally given to patients simply as a preventive measure.

Carotid Endarterectomy or Stenting

Carotid endarterectomy is a surgery used to remove fatty deposits that have built up on the inside of the carotid artery. This is used when this artery has been severely narrowed by plaques.

Another surgical option is called stenting. This is less invasive, and it involves passing a tube into the carotid artery to hold it open and stop it from narrowing.

Either of these methods serves as an option for how to avoid a stroke, as they can prevent clots or other occlusive materials from passing through the carotid into the brain.

Post-Stroke Rehabilitation

If you learn how to prevent a stroke, it can help you avoid the major loss of functionality that can sometimes occur with this condition. However, if it happens anyway, rehabilitation serves as one of the major means to restore independence and combat disability.

Physical Therapy

Movement is affected in many cases, frequently on one side of the body. Physical therapy can help restore strength and coordination in the muscles.

Occupational Therapy

Occupational therapy is similar to physical therapy in that it relies on improving muscle coordination and strength to a degree, but the focus here is on restoring independence and getting patients to be able to perform activities of daily living on their own again.

Speech Therapy

The muscles responsible for speech can be paralyzed or weakened by a cerebrovascular accident. Additionally, speech centers in the brain can be impaired by the disease, which can result in difficulty forming sentences and recognizing words. Speech therapy can make it possible to recover these deficits.

Stem Cells Therapy

When it comes to treating this condition, stem cells provide a potentially revolutionary option. They are yet to be approved as a treatment, but many studies have been done to show their efficacy.

One study was able to show that stem cell therapy was not only safe for the treatment of ischemic CVA but was also able to show positive effects on motor function. Another study used neuroimaging to show that stem cells had a protective effect against the degeneration of certain tracts in the nervous system.

Stem cell therapy can improve motor function in patients after a CVA and is also shown to have a protective effect on neuronal cells.

While stem cell therapy has only been observed for the treatment of this disease, its natural mechanisms may potentially equip them as a novel means of how to avoid a stroke from recurring.

Support and Resources for Stroke Survivors

As a stroke survivor, life can be very tough. Fortunately, there are many resources and groups available that can make things easier to cope with.

Support Groups

A support group can be an invaluable outlet for the stress and problems of living that come after a cerebrovascular accident. You can interact with others in similar positions, and even learn from others on what they’ve learned about how to prevent a stroke.

This tool has made it easy to find a group near you.

Caregiver Resources

Taking care of someone who has had a stroke is a whole job in itself. It can be very draining, mentally, but fortunately, there are many resources available to show you the way when you are feeling lost.

Community Programs

Depending on where you live, you might be able to join community programs centered around educating people about CVAs or engaging survivors with various activities.

Get a free online consultation

Please contact us to learn about treatment options for post-stroke condition, including stem cell therapy.

Dr. Aleksandra Fetyukhina
Dr. Aleksandra Fetyukhina, MD

Medical Advisor, Swiss Medica doctor

List of References

  1. Mohan, K. M., Wolfe, C. D., Rudd, A. G., Heuschmann, P. U., Kolominsky-Rabas, P. L., & Grieve, A. P. (2011). Risk and cumulative risk of stroke recurrence: a systematic review and meta-analysis. Stroke, 42(5), 1489–1494.

  2. Huhtakangas, J., Löppönen, P., Tetri, S., Juvela, S., Saloheimo, P., Bode, M. K., & Hillbom, M. (2013). Predictors for recurrent primary intracerebral hemorrhage: a retrospective population-based study. Stroke, 44(3), 585–590.

  3. Ghozy, S., Zayan, A. H., El-Qushayri, A. E., Parker, K. E., Varney, J., Kallmes, K. M., Morsy, S., Abbas, A. S., Diestro, J. D. B., Dmytriw, A. A., Shah, J., Hassan, A. E., & Islam, S. M. S. (2022). Physical activity level and stroke risk in US population: A matched case-control study of 102,578 individuals. Annals of clinical and translational neurology, 9(3), 264–275.

  4. Mitchell, A. B., Cole, J. W., McArdle, P. F., Cheng, Y. C., Ryan, K. A., Sparks, M. J., Mitchell, B. D., & Kittner, S. J. (2015). Obesity increases risk of ischemic stroke in young adults. Stroke, 46(6), 1690–1692.

  5. Jaillard, A., Hommel, M., Moisan, A., Zeffiro, T. A., Favre-Wiki, I. M., Barbieux-Guillot, M., Vadot, W., Marcel, S., Lamalle, L., Grand, S., Detante, O., & (for the ISIS-HERMES Study Group) (2020). Autologous Mesenchymal Stem Cells Improve Motor Recovery in Subacute Ischemic Stroke: a Randomized Clinical Trial. Translational stroke research, 11(5), 910–923.

  6. Lee, J., Chang, W. H., Chung, J. W., Kim, S. J., Kim, S. K., Lee, J. S., Sohn, S. I., Kim, Y. H., Bang, O. Y., & STARTING-2 Collaborators (2022). Efficacy of Intravenous Mesenchymal Stem Cells for Motor Recovery After Ischemic Stroke: A Neuroimaging Study. Stroke, 53(1), 20–28.

More sources

Medical Advisor, Swiss Medica doctor

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