How to avoid having a stroke

A guide for the over 50s

Stroke is the second biggest cause of death, globally, after coronary heart disease. In 2023, the World Stroke Organization reported that by 2050 the number of people dying from the disease was expected to increase by 50%.

Rates of stroke continue to rise, as does the number of statins prescribed to prevent stroke. Statins (Atorvastatin) are the most prescribed drugs in the world. The incongruity speaks for itself.

Stroke is so common that it has been normalised as a side effect of ‘living longer than ever.’ But it isn’t normal, and life expectancy rates are falling.

Like so many chronic conditions, stroke is largely avoidable. Not smoking, not drinking too much, and exercising regularly all constitute sound, preventative advice. Smoking narrows arteries and makes blood more likely to clot. Excessive alcohol can cause high blood pressure and atrial fibrillation, or irregular heartbeat, both risk factors.

The usual, vague dietary advice given by health authorities such as the NHS is to ‘eat a healthy diet’, advice that is about as helpful as telling people to ‘stay safe’.

Advice needs to be specific, and it needs to be evidence-based. But first, you need to know your nemesis.

TIA and stroke

Stroke, sometimes called a cerebrovascular accident, is like a heart attack to the brain. It occurs when the blood supply to part of the brain is blocked, either by a clot (ischaemic stroke) or by a burst artery (haemorrhagic stroke). Brain cells that are deprived of blood become damaged, or die. Ischemic stroke accounts for 85% of all cases.

A stroke may be preceded by a transient ischemic attack (TIA), previously known as a ministroke. With TIA, there is a brief blockage of blood flow to the brain that lasts just a few minutes and causes no permanent damage.

That sounds benign enough, but a TIA should be seen as a warning of what may come: 1 in 3 cases soon progress to stroke.

The symptoms are the same, and include:

• Slurred speech

• Numbness in the face, arm or leg, usually on one side of the body

• Visual disturbances

• Dizziness or loss of balance

Well-known risk factors include hypertension and diabetes. When it comes to diet, one of the most significant, modifiable risk factors is one that gets the least attention, arguably because there are no drugs to treat it.