Up to 80% of strokes are preventable with lifestyle changes, new guidelines suggest

The American Stroke Association, a part of the American Heart Association, released updated guidelines on Monday, indicating that up to 80% of strokes can be prevented through healthy lifestyle choices, better blood pressure management, and other medical interventions.

The recommendations emphasize a Mediterranean diet, regular physical activity, and closer monitoring of high-risk groups, including women and transgender individuals.

Stroke, the third leading cause of death in Israel, impacts around 20,000 people annually, often resulting in severe disability or death. According to the updated guidelines, which are the first major revision in a decade, most strokes can be avoided with preventive actions.

A stroke occurs when blood flow to the brain is suddenly interrupted, usually due to a blood clot or hemorrhage. This lack of oxygen and nutrients causes rapid brain cell death, making immediate medical attention crucial.

Symptoms include sudden weakness or paralysis, often on one side of the body, difficulty speaking, vision loss, loss of balance, and severe headaches. In such cases, it's vital to contact Magen David Adom at 101 and rush to the hospital for a CT scan and urgent treatment.

The new guidelines stress that most strokes are preventable through lifestyle changes. "These guidelines are a crucial update based on recent studies that identified key factors for reducing stroke risk," says Prof. Ronen Leker, Chair of the Israeli Stroke Society and Director of the Stroke Center at Hadassah Medical Center.

They recommend adopting a Mediterranean diet rich in nuts and olive oil, shown to lower stroke risk, along with regular physical activity to counteract sedentary lifestyles common in Western countries.

The silent killer

Managing high blood pressure is another critical factor. Studies indicate that a single blood pressure medication only helps about 30% of patients reach their target. Most patients require a combination of two or three medications to achieve the desired results. Based on this data, the guidelines recommend using at least two drugs for most patients needing hypertension treatment.

Specific recommendations are also made for women, particularly those who are pregnant, have experienced early menopause, or suffer from endometriosis, as these conditions increase the risk of stroke. For transgender women, the guidelines highlight that hormone therapy containing estrogen increases stroke risk, warranting close medical supervision.

"Rapid treatment, such as performing a CT scan within 25 minutes of the patient’s arrival, followed by clot-dissolving medication or brain catheterization, has been proven to save lives and reduce disability," Prof. Leker adds. "However, these new guidelines focus on prevention, aiming to prevent strokes altogether through proactive care that family physicians need to prioritize."