Stroke and TIA: Key Facts and Prevention Strategies

Stroke or brain attack is a serious medical condition that can result in significant disability or death. Prevention and early recognition are essential for effective treatment.

A transient ischaemic attack (TIA) presents temporary stroke symptoms but shares the same underlying causes as a full stroke. Without intervention, up to 20% of TIA patients may experience a major stroke within 90 days, with the highest risk in the first week. Immediate medical attention is critical.

Understanding Stroke 

A stroke occurs when blood supply to part of the brain is interrupted, either by a blockage (ischaemic stroke) or bleeding (haemorrhagic stroke). This deprives brain cells of oxygen and nutrients, potentially causing lasting damage. This damage can impair parts of the brain that control our thoughts, speech, muscle movements and mobility. The blockage is caused by a blood clot within small arteries, narrowed by deposition of cholesterol called atherosclerosis, much like the furring of kitchen pipes with grease and debris.

Recognising Stroke: FAST

Facial weakness - cannot smile
Arm weakness - cannot lift arms
Speech problems - cannot articulate
Time to call emergency services (999)

Risk Factors

• Advancing age and arterial hardening.
• High blood pressure, high cholesterol, and diabetes.
• Lifestyle factors: poor diet, excessive alcohol, drug use, smoking, and inactivity.
• Atrial fibrillation increases stroke risk fivefold.
• Women using hormonal medications including HRT and contraception.
• Obesity.
• Genetic diseases like factor V Leiden mutation, Bechet’s disease.

Stroke Prevention Strategies

Control Blood Pressure: Keep blood pressure below 140/90 mmHg through medication and lifestyle changes. Ideally blood pressure should be 120/80.

Manage Cholesterol: Maintain cholesterol under 5 mmol/L with a healthy, low-saturated-fat diet and regular check-ups. Lipid lowering medications help in reducing cholesterol and control triglycerides, by enclosing harmful fats like an envelope and preventing clotting of blood, inside blood vessels.

Monitor Diabetes: Control blood sugar levels to prevent arterial damage leading to blood clots. Blood sugar reducing medications help reduce complications of diabetes.

Treat Atrial Fibrillation: Seek medical management for irregular heartbeat to reduce clot risk. These can be medications to reduce heart rate and medications to reduce blood clotting.

Stop Smoking: Quitting smoking significantly lowers stroke risk; support is available via GP services and nicotine replacement therapies.

Eat More Fibre: Choose whole grains, brown rice, wholewheat bread, pasta, and couscous to help lower cholesterol.

Reduce Salt and Processed Foods: Minimises risk factors like high blood pressure and obesity.

Maintain a Healthy Weight: Reduces risk of high blood pressure, heart disease, and type 2 diabetes.

Exercise Regularly: Aim for at least 30 minutes of physical activity, five days a week, to halve stroke risk. Consistent exercise lowers blood pressure and reduces risk of stroke, type 2 diabetes and heart disease.

If over 40, the NHS recommends an annual health check for the above risks, so please see your GP or practice nurse regularly.

Dr Suparna Behura
GP Partner & Trainer
Diabetes Lead

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