About every 40 seconds, someone in the U.S. suffers a stroke, and more than 77 percent are first events. In a new report available online at www.ConsumerReportsHealth.org, Consumer Reports Health identifies 11 strategies for stroke prevention.

“Many people don’t realize that by making healthier lifestyle changes, they can cut their risk of stroke dramatically,” says Orly Avitzur, M.D., medical adviser, Consumer Reports Health, and a board-certified neurologist. “American adults have their work cut out for them; only a very small fraction of people in their 40s and 50s have a handle on the major cardiovascular risk factors for stroke. Fortunately, many of those risk factors can be reduced or eliminated by controlling blood pressure, improving cholesterol levels, reining in diabetes, and quitting smoking.”

Stroke is caused by sudden loss of blood flow to the brain, or bleeding in or around the brain, either of which can cause brain cells to die. It is the number-three cause of death and the leading cause of disability in the U.S. “Hypertension is the most important and treatable risk factor for stroke, yet more than half of Americans with high blood pressure don’t have it under control,” said Avitzur.

The following medical and lifestyle changes can help prevent a stroke:

Medical changes
• Lower blood pressure. High blood pressure damages arteries so they clog or burst more easily, escalating the risk of both types of stroke: ischemic, and the less common but deadlier hemorrhagic.

Consumer Reports Health recommends having blood pressure checked regularly – at least once every two years, more often for adults 50 and older.

• Improve cholesterol levels. LDL (bad) cholesterol, a fatty substance in the blood, builds up plaque on artery walls, causing arteries to narrow. If plaque ruptures, a blood clot can form and block a blood vessel to the brain, causing a stroke. All men 35 and older and women 45 and over at high risk for heart disease should get a complete lipid profile at least every five years.

• Rein in diabetes. High blood sugar levels damage blood vessels over time. In addition, people with diabetes are likely to have hypertension, high cholesterol, and excess weight. Adults who are 45 or older should have their blood sugar measured at least once a year if they’re prediabetic (or every three years for those who aren’t).

• Consider low-dose aspirin.  Aspirin wards off heart attack and stroke by preventing artery-blocking blood clots. But it's not for everyone. For example, the benefit against heart attacks applies mainly to men 45 and older and the benefit against strokes applies mainly to women 55 and older. Consumer Reports Health notes that aspirin can cause dangerous gastrointestinal bleeding, but recommends that people of any age who are at very high risk of stroke (including those who have already had a stroke or mini-stroke or have heart disease or diabetes) should almost always take aspirin to protect their heart.

• Have pulse checked. Atrial fibrillation, a heart-rhythm disorder, can lead to blood clots that can travel to the brain, amplifying the risk of an ischemic stroke. It’s best to have a doctor check for irregular rhythms at every visit and follow up with an electrocardiogram or other heart monitoring if necessary.

• Neck surgery: Think twice – Surgery to remove blockages in neck arteries – or carotid arteries – can reduce stroke risk for those who have already had a stroke. But for those with a narrowed carotid artery that hasn’t triggered any symptoms, the risk of stroke is much lower, and the benefit of surgery is small. Screening for blockages in neck arteries is not recommended for people without stroke risk factors because it generates so many false-positive test results.

Lifestyle changes
Follow a brain-healthy diet– Diet has a strong influence on an individual’s risk of stroke. In a study that assessed people's consumption of fruits and vegetables, each extra daily serving reduced stroke risk by 6 percent. Other studies have linked high-potassium diets with lower stroke risk, while sodium-heavy diets are tied to greater risk. Consume a diet low in sodium and saturated fats, but high in potassium rich fruits and vegetables, and low-fat dairy

Be physically active–Do at least 30 minutes of moderate-intensity aerobic exercise five days a week or more. Adults should consult a doctor if they have a chronic health problem, chest pain or if they’re middle-aged and have been sedentary.

Trim your waist– If your waist measures more than 40 inches for men or 35 inches for women, commit to regular exercise and a weight-loss diet.

Drink moderately, if at all– Excessive drinking, associated with a 64 percent increased risk of stroke, raises blood pressure, promotes clot formation, and heightens the risk of atrial fibrillation. But light drinking appears to reduce stroke risk. Limit alcohol to no more than two drinks a day for men, one for women.

Quit smoking– Cigarette smoking raises blood pressure, decreases exercise tolerance, promotes plaque buildup in arteries, and makes blood more likely to clot. Smokers should talk to their doctor about options to help quit, including, counseling, nicotine replacement, and other medications.

Recognizing a stroke
If you think someone may be having a stroke, remember to act F.A.S.T. and do this simple test:

F – FACE - Ask the person to smile. Does one side of the face droop?

A – ARMS– Ask the person to raise both arms. Does one arm drift downward?

S – SPEECH– Ask the person to repeat a simple phrase. Is his or her speech slurred?

T – TIME– If you observe any of these signs, call 911 immediately.

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