An aspirine a day, some statin, maybe more drugs (controlling BP, cholesterol, sugar) – we have a lot of ideas what to prescribe patients after their stroke. So what should they themselves do to prevent the next stroke?
I preach the five columns of stroke prevention behavior
- Lose weight
- Move around (5 times 30 minutes a week)
- Eat healthy (see recommendations by our German Nutritional Society)
- Don’t smoke
- Take your drugs (aka adherence)
This all sounds very well and we all suspect that properly following these instructions will reduce stroke risk in high risk situations (such as intracranial stenosis – see SAMMPRIS). Still, the evidence is scarce – as far as I know every attempt at showing that a particular diet is helpful for mortality failed. Studies for sports are rare. Even smoking studies are hard to come by.
We discuss the evidence and then develop a plan for a given patient.