“I had a stroke. Now what?” Learn How To Prevent the Next One

A typical stroke is basically a heart attack in the brain. To prevent strokes, follow the same healthy lifestyle that prevents heart attacks. Here are the key steps for preventing strokes and keeping your brain in good working order.

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Here is what you need to do if you've had a stroke.

One afternoon last summer, as Nancy Schwartz attempted to get up from her desk, she knew something was terribly wrong.
The 56-year-old financial advisor tried to pick up her phone, but her right hand couldn’t grab it. And she couldn’t speak. Frightened, she stumbled out to her intern, who called 911. Two hours later, after receiving drugs in the ER, she could speak again, but was completely dumbfounded. “I had a stroke?” she said to her doctor. “How could that be? There were no signs, no warnings.”

But the fact is, there were many warnings.

What many people do not realize is that the same lifestyle risks that lead to heart attacks also lead to strokes. Nancy had high blood pressure. She took medication for it, but her blood pressure still hovered around 140/90. She was also pre-diabetic. And she needed to lose about 25 pounds. She didn’t know it, but she was a prime candidate for both a heart attack and a stroke.

Bottom Line: A typical stroke, called an ischemic stroke, is basically a heart attack in the brain. To prevent ischemic strokes, you follow the same healthy lifestyle habits you would follow to prevent heart attacks.

During a stroke, every minute counts!

Acting F.A.S.T. can save lives. The most effective stroke treatments are only available if the stroke is treated within 3 hours of the first symptoms. If you think someone is having a stroke, do the following simple test:

Face:  Ask the person to smile. Does one side of the face droop?

Arms:  Ask the person to raise both arms. Does one arm drift downward?

Speech:  Ask the person to repeat a simple phrase. Is speech slurred or strange?

Time:  If you observe any of these signs, call 911 immediately.

Ischemic stroke

About 9 out of 10 strokes in America are ischemic. Here’s what happens. Arteries leading to the brain become inflamed and diseased, just as arteries leading to the heart can. Both are largely the result of lifestyle-related insults, particularly the typical modern diet, high in salt, sugar, refined (white) grains, and fats, especially saturated and trans fats. Plaque builds, clogging the arteries. Then a plaque ruptures, triggering a massive blood clot that chokes off blood flow to the heart, causing a heart attack, or to the brain, causing a stroke.

Two million brain cells

During a stroke, two million brain cells die every minute. The result can be brain damage, paralysis or other forms of disability, or death. Of those who survive, research1 reports, more than one-third can no longer walk on their own. One-quarter end up in nursing homes. In fact, stroke is the #1 reason Americans enter nursing homes.

And many Americans are hit. Though recent data2 indicate that stroke rates are starting to decline, stroke is still the fourth leading cause of death in the U.S. About 800,000 Americans suffer a stroke each year. One American dies from a stroke every four minutes.3

Hemorrhagic stroke

Roughly 1 out of 10 strokes is hemorrhagic, which means a blood vessel near or in the brain bursts.

“I had a stroke. Now what?”

If you’ve had a stroke, you are at high risk for another one. One of four survivors of strokes has another one within five years.

That’s why it’s so critical to treat the underlying causes of stroke, which include:

  • High blood pressure (hypertension)
  • Heart disease (coronary artery disease)
  • Atrial fibrillation (fast, irregular heartbeat)
  • High cholesterol levels
  • Diabetes or pre-diabetes
  • Smoking
  • Excess weight
  • Little or no exercise
  • Too much alcohol

Potassium (mg)
Banana 422
Spinach (1 cup cooked) 839
Zucchini (1 cup cooked, sliced) 475
Mushrooms (1 cup, sliced, raw) 416
Baked Potato 926
White Beans (1 cup cooked) 829
Nonfat Yogurt (1 cup) 625
Salmon (4 ounces, cooked) 534
Total 5,066

  • Lose excess weight.

    Being overweight puts a strain on the circulatory system. In addition to increasing your risk of blood pressure, excess body fat also makes it more likely you’ll develop high cholesterol, high blood sugar, and diabetes – all of which can increase the risk for stroke.

  • Get moving.

    Regular exercise can help you maintain a healthy weight and lower your blood pressure. “It’s incredible how quickly people’s blood pressures fall here at Pritikin,” observes Jamie Costello, MSC, Pritikin’s Director of Exercise. “The Pritikin diet, low in salt and rich in fruits, vegetables, whole grains, and beans, really helps, but our fitness program plays a vital role, too.”

    “In fact, by day three, we need to keep a close watch on our guests’ blood pressures,” smiles physician and Medical Director Danine Fruge, MD. “Many people’s blood pressures have dropped so dramatically that we’re taking them off their medications or reducing their dosages so that their blood pressures don’t go too low.”

  • Limit alcohol.

    Drinking too much alcohol can raise your blood pressure. Pritikin recommendations, similar to those of many public health organizations, are not drinking or limiting intake to no more than 4 drinks weekly for women (not more than ½ to 1 drink per day) and no more than 7 drinks weekly for men (not more than 1 to 2 drinks per day).

  • “I had a stroke. Now what?”
    Additional Lifestyle Steps For Preventing The Next One…

    In addition to lowering your blood pressure by cutting down on salt, eating more potassium-rich foods, losing excess weight, exercising regularly, and limiting alcohol, the following guidelines can greatly help in keeping strokes – and heart attacks – at bay.

    • Lower LDL (bad) cholesterol. Prevent/control heart disease.

      Cholesterol is a complex molecule found in our cell walls and several hormones. Our livers produce enough cholesterol for the body’s needs, but we often get more from the foods we eat, particularly saturated-fat-rich foods like meat and full-fat dairy foods. If we take in more cholesterol than we need, the extra cholesterol can build up in our arteries, leading to both heart attacks and strokes.

      Medications like statins can help lower LDL cholesterol, but so can a healthy lifestyle. In research, for example, on more than 4,500 men and women who began the Pritikin Program, LDL cholesterol levels fell on average 23% within three weeks.9

    • Lower blood sugar (glucose). Prevent/control diabetes.

      People who have type 2 diabetes are two to four times more likely to have a stroke compared to people without the disease. High blood sugar, in and of itself, increases the risk of stroke, but so do other health problems common among diabetics, including high blood pressure, excess weight, high LDL cholesterol, heart disease (coronary artery disease, or atherosclerosis) as well as atrial fibrillation (a type of irregular heart beat).

      Once again, a healthy lifestyle can have major benefits in lowering blood sugar and curbing both type 2 diabetes (a fasting glucose of 126 mg/dL or higher) and pre-diabetes (a fasting glucose between 100 and 125 mg/dL).

      And the sooner you get started, the better your results. A study10 published on type 2 diabetics coming to the Pritikin Center followed 243 people in the early stages of diabetes (not yet on medications). Within three weeks, their fasting glucose plummeted on average from 160 to 124.

    • Stop smoking.

      Compared to nonsmokers, being a smoker doubles your risk for a stroke. It increases the amount of plaque build-up in the arteries. It also reduces oxygen amounts in the blood, which causes the heart to work harder and makes blood clots form more easily. If you don’t smoke, that’s wonderful, but also make sure that others around you don’t smoke.

    • Treat atrial fibrillation.

      Having atrial fibrillation or AFib, an irregular heartbeat that leads to the formation of clots within the heart, increases the risk of stroke five-fold. Often, unfortunately, people don’t know they have AFib because many do not experience its symptoms, which are fluttering, racing, or pounding sensations in the chest.

      To find out if you have AFib, make an appointment with your physician. Medications and/or the use of electrical stimulation can often restore normal heart rhythms.

    “I had a stroke, and I’m doing really well.”

    Since her stroke last summer, Nancy has worked hard to turn her life around. She got a lot of help from her 84-year-old-father, who had starting living Pritikin-style 30 years ago after having a heart attack. He’s never had another heart problem. And he’s in great shape, walking five miles daily.

    “We often walk to farmers’ markets together,” smiles Nancy, who has shed 25 pounds, is off all blood pressure medications (“I don’t need them anymore”), and has blood sugar readings in the normal range.

    “I honestly had no idea how much a healthy lifestyle could benefit my life. In our society, we’re so used to taking a pill for this problem and another pill for that problem, but all too often, we’ve still got the problems.

    “That’s not the case with a healthy lifestyle like Pritikin. I’m free of high blood pressure. I’m free of diabetes. I’m thinner. And I’m much, much happier.”

    Edited by Kell Wynn, March 7, 2019


    Centers For Disease Control and Prevention
    Institute of Medicine
    National Stroke Association
    Pritikin Longevity Center Faculty

    1 Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation, 2013; 127 (1): e6.
    2 JAMA, 2014; 312 (3): 259.
    Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation, 2013; 127 (1): e6.
    4 Heart disease and stroke statistics – 2013 update: a report from the American Heart Association. Circulation, 2013; 127 (1): e6.
    6 Neurology, 10.1212/WNL.0000000000000268. Published online before print March 12, 2014, doi: 10.1212/WNL.0000000000000268
    7 National Research Council. Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate. Washington, DC: The National Academies Press, 2005.
    8 Journal of Applied Physiology, 2005; 98: 3.
    9 Archives of Internal Medicine, 1991; 151: 1,389.
    10 Diabetes Care, 1994; 17: 1469.

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