Self-management

A stroke is a life-changing event that can affect your emotional well-being as much as your physical function. You may experience feelings of helplessness, frustration, depression and apathy. You may also have mood changes and less of a sex drive.

Maintaining your self-esteem, connections to others and interest in the world are essential parts of your recovery. Several strategies may help you and your caregivers, including:

  • Don't be hard on yourself. Accept that physical and emotional recovery will involve tough work and that it will take time. Aim for a "new normal," and celebrate your progress. Allow time for rest.
  • Get out of the house even if it's hard. Try not to be discouraged or self-conscious if you move slowly and need a cane, walker or wheelchair to get around. Getting out is good for you.
  • Join a support group. Meeting with others who are coping with a stroke lets you get out and share experiences, exchange information and forge new friendships.
  • Let friends and family know what you need. People may want to help, but they may not know what to do. Let them know how they can help, such as by bringing over a meal and staying to eat with you and talk, or attending social events or religious activities.
  • Know that you are not alone. Nearly 800,000 Americans have a stroke every year. Approximately every 40 seconds someone has a stroke in the United States.

Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a transient ischemic attack (TIA), these measures may help you avoid having another stroke. The follow-up care you receive in the hospital and afterward may play a role as well.

Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:

  • Controlling high blood pressure (hypertension). One of the most important things you can do to reduce your stroke risk is to keep your blood pressure under control. If you've had a stroke, lowering your blood pressure can help prevent a subsequent transient ischemic attack or stroke.

    Exercising, managing stress, maintaining a healthy weight, and limiting the amount of sodium and alcohol you eat and drink are all ways to keep high blood pressure in check.. In addition to recommending lifestyle changes, your doctor may prescribe medications to treat high blood pressure.

  • Lowering the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the fatty deposits (plaques) in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication.
  • Quitting tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting tobacco use reduces your risk of stroke.
  • Controlling diabetes. You can manage diabetes with diet, exercise, weight control and medication.
  • Maintaining a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Weight loss of as little as 10 pounds may lower your blood pressure and improve your cholesterol levels.
  • Eating a diet rich in fruits and vegetables. A diet containing five or more daily servings of fruits or vegetables may reduce your risk of stroke. Following the Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.
  • Exercising regularly. Aerobic or "cardio" exercise reduces your risk of stroke in many ways. Exercise can lower your blood pressure, increase your level of high-density lipoprotein cholesterol, and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to 30 minutes of activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week.
  • Drinking alcohol in moderation, if at all. Alcohol can be both a risk factor and a protective measure for stroke. Heavy alcohol consumption increases your risk of high blood pressure, ischemic strokes and hemorrhagic strokes. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent ischemic stroke and decrease your blood's clotting tendency. Alcohol may also interact with other drugs you're taking. Talk to your doctor about what's appropriate for you.
  • Treating obstructive sleep apnea, if present. Your doctor may recommend an overnight oxygen assessment to screen for obstructive sleep apnea (OSA). If OSA is detected, it may be treated by giving you oxygen at night or having you wear a small device in your mouth.
  • Avoiding illicit drugs. Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can cause narrowing of arteries.

Four Steps to Heart Health

Aug. 15, 2017
References
  1. Stroke: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/stroke/stroke.htm. Accessed Nov. 9, 2013.
  2. Oliveira-Filho J. Initial assessment and management of acute stroke. http://www.uptodate.com/home. Accessed Nov. 9, 2013.
  3. Know stroke brochure. National Institute of Neurological Disorders and Stroke. http://stroke.nih.gov/materials/actintime.htm. Accessed Nov. 9, 2013.
  4. Go AS, et al. Heart disease and stroke statistics — 2013 update: A report from the American Heart Association. Circulation. 2013;127:e6.
  5. Warning signs of a stroke. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=SYMP. Accessed Nov. 9, 2013.
  6. Caplan LR. Overview of the evaluation of stroke. http://www.uptodate.com/home. Accessed Nov. 9, 2013.
  7. Caplan LR. Etiology and classification of stroke. http://www.uptodate.com/home. Accessed Nov. 9, 2013.
  8. Ischemic stroke (clots). American Stroke Association. http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots_UCM_310939_Article.jsp. Accessed Nov. 9, 2013.
  9. Cerebral aneurysms fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/cerebral_aneurysm/cerebral_aneurysms.htm. Accessed Nov. 9, 2013.
  10. Furie KL, et al. Etiology and clinical manifestations of transient ischemic attack. http://www.uptodate.com/home. Accessed Nov. 9, 2013.
  11. Effects of stroke. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=EFFECT. Accessed Nov. 9, 2013.
  12. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm?css=print. Accessed Nov. 9, 2013.
  13. What is echocardiography? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/echo/. Accessed Nov. 9, 2013.
  14. Samuels OB. Intravenous fibrinolytic (thrombolytic) therapy in acute ischemic stroke: Therapeutic use. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  15. Oliveira-Filho J, et al. Reperfusion therapy for acute ischemic stroke. http://www.uptodate.com/home. Accessed Nov. 9, 2013.
  16. Cucchiara BL, et al. Antiplatelet therapy for secondary prevention of stroke. http://www.uptodate.com/home. Accessed Nov. 9, 2013.
  17. Questions and answers about carotid endarterectomy. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/stroke/carotid_endarterectomy_backgrounder.htm. Accessed Nov. 10, 2013.
  18. Mohler ER, et al. Carotid endarterectomy. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  19. Greelish JP, et al. Carotid artery stenting and its complications. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  20. Rordorf G, et al. Spontaneous intracerebral hemorrhage: Prognosis and treatment. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  21. Arteriovenous malformations and other vascular lesions of the central nervous system fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/avms/avms.htm. Accessed Nov. 9, 2013.
  22. Recovery and rehabilitation. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=REHABT. Accessed Nov. 9, 2013.
  23. Recovery after stroke — Coping with emotions. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=Recov_factsheets. Accessed Nov. 9, 2013.
  24. Recovery after stroke — Social support. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=Recov_factsheets. Accessed Nov. 9, 2013.
  25. Recovery after stroke — Thinking and cognition. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=Recov_factsheets. Accessed Nov. 9, 2013.
  26. Controllable risk factors — High blood pressure (hypertension). National Stroke Association. http://www.stroke.org/site/PageServer?pagename=HighBloodPressure. Accessed Nov. 9, 2013.
  27. STARS — Steps against recurrent stroke. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=STARS. Accessed Nov. 9, 2013.
  28. Physical activity and healthy diet. National Stroke Association. http://www.stroke.org/site/PageServer?pagename=eathealthy. Accessed Nov. 9, 2013.
  29. Furie KL, et al. Secondary prevention of stroke: Risk factor reduction. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  30. Oliveira-Filho J, et al. Antithrombotic treatment of acute ischemic stroke. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  31. Brown RD (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 11, 2013.
  32. Singer RJ, et al. Treatment of aneurysmal subarachnoid hemorrhage. http://www.uptodate.com/home. Accessed Nov. 10, 2012.
  33. Quality check. The Joint Commission. http://www.qualitycheck.org/consumer/searchresults.aspx?nm=Mayo+Clinic&ddstatelist=&st_nm=-1&st=. Accessed Nov. 10, 2013.
  34. U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings/neurology-and-neurosurgery. Accessed Nov. 9, 2013.
  35. U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings/rehabilitation. Accessed Nov. 9, 2013.
  36. Anderson CS, et al. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage. New England Journal of Medicine. 2013;368:2355.
  37. Life after stroke. National Stroke Association. http://strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/PhysicalChallenges/Post-Stroke-Rehabilitation_UCM_310447_Article.jsp. Accessed Nov. 10, 2013.
  38. Post-stroke rehabilitation fact sheet. National Institute of Neurological Disorders and Stroke. http://stroke.nih.gov/materials/rehabilitation.htm. Accessed Nov. 10, 2013.
  39. Broderick JP, et al. Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. New England Journal of Medicine. 2013;368:893.
  40. Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Nov. 9, 2013.
  41. Brott TG, et al. Stenting versus endarterectomy for treatment of carotid-artery stenosis. New England Journal of Medicine. 2010;363:11.
  42. Daroff RB, et al. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012. https://www.clinicalkey.com. Accessed Nov. 10, 2013.
  43. Rordorf G, et al. Spontaneous intracerebral hemorrhage: Pathogenesis, clinical features and diagnosis. http://www.uptodate.com/home. Accessed Nov. 10, 2013.
  44. Jauch EC, et al. Guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013;44:870.
  45. Estruch R, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. New England Journal of Medicine. 2013;368:1279.
  46. Ovbiagele B, et al. Level of systolic blood pressure within the normal range and risk of recurrent stroke. JAMA. 2011;306:2137.
  47. Flemming KD, et al. Utility of a post-hospitalization stroke prevention program managed by nurses. Hospital Practice. 2013;41:70.
  48. Saver JL, et al. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke. JAMA. 2013;309:2480.
  49. Ciccone A, et al. Endovascular treatment for acute ischemic stroke. New England Journal of Medicine. 2013;368:904.
  50. Xian Y, et al. Risks of intracranial hemorrhage among patients with acute ischemic stroke receiving warfarin and treated with intravenous tissue plasminogen activator. JAMA. 2012;307:2600.
  51. Singh B, et al. Endovascular therapy for acute ischemic stroke: A systematic review and meta-analysis. Mayo Clinic Proceedings. 2013;88:1056.
  52. Controllable risk factors — Alcohol use. National Stroke Association.  http://www.stroke.org/site/PageServer?pagename=alcohol. Assessed Sept. 24, 2014.
  53. Stroke treatments. American Stroke Association. Accessed Oct. 6, 2014. http://www.strokeassociation.org/STROKEORG/AboutStroke/Treatment/Stroke-Treatments_UCM_310892_Article.jsp