How can monitoring blood pressure and diabetes help in preventing stroke?

Various arteries to the brain, which supply blood to specific areas of the brain. (American Stroke Association)

Small improvements in BP (10 mm Hg systolic and 5 mm Hg diastolic) are associated with a 41 percent reduction in stroke, seemingly small interventions can achieve significant population-wide positive impacts.

Having diabetes constitutes a distinct and separate risk factor for the occurrence of strokes. Compared with nondiabetic patients, diabetic patients have at least twice the risk for stroke and approximately 20 percent of diabetic patients will die from stroke, making it one of the leading causes of death in this population.

Diabetes duration has also been shown to increase the risk of stroke, with every year of diabetes duration increasing the risk by 3 percent.

The likelihood of experiencing a stroke is notably higher during the winter season, particularly when there is a sudden and substantial drop in temperature. The reason is a cold-induced increase in blood pressure and hypercoagulation — blood tends to thicken and become stickier during extreme cold.

Looking at the above facts, it is clear that regular monitoring of BP and sugar levels will help in the prevention of stroke, especially more so during the winter season.

Also Read: India leads in WHO’s Southeast Asia stroke chart

Prevention of stroke

Controlling blood pressure

• Achieving optimal blood pressure control involves aiming for a target of keeping blood pressure below 120/80 mmHg. If needed, take doctor-prescribed blood pressure medicines.
• Limit your daily salt intake to a maximum of 1,500 mg, approximately equivalent to half a teaspoon, to promote a reduction in salt in your diet.
• Steer clear of foods rich in cholesterol, such as burgers, cheese, and ice cream, to maintain a healthy diet.
• Consume a daily intake of 4 to 5 cups of fruits and vegetables, incorporate one serving of fish into your diet two to three times a week, and include multiple daily servings of whole grains and low-fat dairy for a balanced and nutritious eating routine.
• Get more exercise. Engage in a minimum of 30 minutes of daily physical activity and, if feasible, extend the duration for even greater health benefits.
• Quit smoking, if you smoke.

Lose weight

Obesity, along with associated complications like high blood pressure and diabetes, increases the likelihood of experiencing a stroke. Shedding even a modest amount of weight, such as 5 kg, can significantly reduce your risk.

Your goal: While aiming for an ideal body mass index (BMI) of 25 or less is beneficial, it’s essential to collaborate with your doctor to develop a personalised weight loss plan. Craft a weight loss strategy that aligns with your health objectives and individual needs.

How to achieve it:

• Strive to keep your daily calorie intake within the range of 1,500 to 2,000 calories, considering your activity level and current BMI.
• Boost your physical activity by incorporating exercises such as walking, golf, or tennis into your routine, making a conscious effort to integrate activity into your daily life.

Exercise more

Physical activity not only aids in weight loss and the reduction of blood pressure but also functions independently as a significant factor in lowering the risk of strokes.

Your goal: Engage in moderate-intensity exercise for a minimum of five days per week.

How to achieve it:

• Incorporate a morning stroll around your neighborhood following breakfast into your routine.
• Initiate a fitness club with friends for shared exercise.
• Aim for a workout intensity where you’re breathing noticeably but still able to hold a conversation.
• Choose stairs instead of elevators whenever the opportunity arises.
• If a continuous 30-minute exercise session is challenging, consider breaking it into 10-15-minute sessions multiple times throughout the day.

Also Read: This study in Kerala sheds light on ways to prevent stroke recurrence

Limit alcohol consumption

Having approximately one drink per day is considered within a reasonable limit. However, exceeding two drinks per day significantly increases the associated health risks.

Your goal: Abstain from alcohol consumption or if you choose to drink, do so in moderation.

How to achieve it:

• Restrict the amount of alcohol you consume to one glass per day.
• When opting for an alcoholic beverage, consider red wine as your preferred choice, as certain studies propose its potential to prevent heart disease and strokes.
• Watch your portion sizes. A standard drink is equivalent to a 5-ounce glass of wine, a 12-ounce beer, or a 1.5-ounce serving of hard liquor.

Treat atrial fibrillation

Atrial fibrillation, characterised by irregular heartbeats, leads to the formation of clots in the heart, posing the risk of strokes as these clots can migrate to the brain. Atrial fibrillation significantly elevates the risk of strokes, nearly fivefold, emphasising the need for serious attention. If you are diagnosed with atrial fibrillation, it is crucial to pursue appropriate treatment.

Your goal: Seek treatment if you are diagnosed with atrial fibrillation.

How to achieve it:

• If you experience symptoms like heart palpitations or shortness of breath, consult your doctor for a thorough examination.
• Your healthcare provider might recommend the use of anticoagulant medication, such as direct-acting anticoagulants, to mitigate the risk of stroke associated with atrial fibrillation. Trust your medical professionals to guide you through this treatment.

Also Read: Study links keto diet to risk of heart disease and strokes

Treat diabetes

Elevated blood sugar levels cause gradual damage to blood vessels, increasing the likelihood of clot formation within them.

Your goal: It is essential to manage and maintain control of your blood sugar to mitigate these risks.

How to achieve it:

• Follow your doctor’s guidance for regular monitoring of your blood sugar levels.
• Employ a combination of a balanced diet, regular exercise, and prescribed medications to ensure your blood sugar remains within the recommended range.

Quit smoking

Smoking expedites the formation of clots through dual mechanisms—it thickens the blood and promotes the accumulation of plaque in the arteries. Quitting smoking, alongside adopting a healthy diet and engaging in regular exercise, stands as one of the most impactful lifestyle changes to significantly decrease the risk of stroke.

Your goal: Quit smoking.

How to achieve it:

• Seek guidance from your doctor regarding the most suitable method for you to quit smoking.
• Utilise quit-smoking aids like nicotine pills or patches, counseling, or prescribed medications to support your efforts in breaking the habit.
• Don’t give up. Most smokers need several tries to quit. View each effort to quit smoking as a positive stride toward successfully overcoming the habit.

Also Read: Brain stroke awareness very low in Hyderabad, Bengaluru: Survey

(The author Dr Kumar Kenchappa is a Consultant – Interventional Cardiologist with Manipal Hospital in Hebbal, Bengaluru.)