There are several well identified stroke risk factors. Treating these risk factors substantially reduces the risk of having more strokes

Elevated cholesterol

Treating elevated cholesterol, especially elevations in LDL (“bad cholesterol”) with statin type drugs has been shown to reduce to substantially reduce the risk of subsequent stroke. This is most often done with “statin” type drugs (we prefer lovastatin--Mevacor® as it is the most cost effective). In several studies, statins reduced the relative risk of stroke by about 30%. The target LDL cholesterol for patients who have had a previous stroke or TIA (transient ischemic attack – sometimes called “mini stroke”) is less than 100.

High Blood Pressure

High blood pressure is an enormous risk factor for stroke. Reducing elevated blood pressure reduces the relative risk of stroke by about 30%. Even modest elevations of pressure should be treated. Even transient elevation (“white coat hypertension” so-named because some patients only have high blood pressure at the doctor's office) requires treatment.

Smoking

Smoking is another huge risk factor for stroke. Stopping smoking reduces the relative risk of stroke about 30% and within just a few years after quitting the stroke risk returns to the level of nonsmokers.

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Anticlotting agents

A variety of medications are commonly used to reduce the chances of blood clots forming and thus reduce the risk of stroke. These include:

• Aspirin: Aspirin reduces the risk of stroke by about 20-30% relative to not taking aspirin in patients at high risk of stroke
• Aspirin-Persantine combination treatment(Aggrenox®): This medication is also very effective in stroke reduction and may be used in some cases instead of Aspirin
• Clopidogrel(Plavix®): This medication is another alternative to Aspirin in patients who cannot tolearte Aspirin products
• Warfarin (Coumadin®): This medication requires more monitoring and has a higher chance of complications than Aspirin, but is superior to Aspirin in preventing strokes in most patients with strokes due to blood clots coming from the heart, as in heart valve relavcements or atrial fibrillation.

Vascular Surgery for Stroke Surgery can also be used to prevent stroke. Click on the link for information about surgical treatment of stroke.