Stroke prevention: Why medications and lifestyle both matter

Brain Health

by Baylor Scott & White Health

Jan 25, 2022

The most common conditions that contribute to stroke risk are high blood pressure, high cholesterol and Type 2 diabetes—the same culprits that can raise your risk of heart disease. So, it makes sense that managing these chronic conditions is key to stroke prevention.

But because these diseases are often “silent,” not everyone is motivated to take their prescribed medications regularly, said Jared Wolf, MD, emergency medicine physician on the medical staff at Baylor Scott & White Medical Center – Lake Pointe. Dr. Wolf is also the chief medical officer and vice president of medical affairs for Baylor Scott & White Medical Center – Lake Pointe.

“We can have issues with all three of these conditions but really feel like we’re doing pretty well,” he said. “Oftentimes, we start questioning why we’re even taking these medicines.”

It can also be hard to remember to take your medication every morning and you may experience side effects that make you want to stop taking the medicines.

What difference does it make, you ask? For the first few days, it’s not that big a deal, according to Dr. Wolf. Most people can tolerate elevated blood pressure or blood sugar for that long.

But it’s not the day-to-day issue that’s a problem. It’s the chronic everyday kind of damage that happens over the course of months to years of not taking these medications. People living with these conditions left untreated develop chronic inflammation that can lead to plaque buildup in their arteries, which then leads to narrowing of the arteries. Eventually, that plaque can rupture and cause an ischemic stroke.

Please note, blood-thinning medications to treat conditions like atrial fibrillation are a different situation. Stopping blood thinners for even a day can be dangerous because it immediately raises the risk for developing a clot that could lead to a stroke. If you’re taking a blood thinner, do not stop taking it or skip even a single day. Talk to your doctor if you are having trouble remembering or staying motivated to take your medication.

Taking control of chronic conditions

Although high blood pressure, cholesterol and Type 2 diabetes are often thought of as issues that affect older people, according to Dr. Wolf, unfortunately, they’re becoming more prevalent among people in their 20s, 30s and 40s.

“At that point in our lives, we kind of feel bulletproof—like we don’t need to take care of ourselves,” he said. “But that’s the time when we can do the most good for our body long. We also can do the most damage because if we don’t take care of ourselves now, it will lead to complications down the road.”

To prevent those complications, we have to take control of our own health. How? One important way to do that is to make sure you regularly see a primary care physician who can help diagnose conditions early and develop a long-term treatment plan.

Are you at risk for stroke? Take this quiz and find out.

In addition to medication, that includes things like diet and exercise.

“We have a propensity as a society toward obesity and, unfortunately, many of us have picked up a little more weight than we ought to,” Dr. Wolf said.

That extra weight can lead to those conditions of early hypertension, early diabetes and early cholesterol issues.

“If someone in their 20s or 40s isn’t seeing a primary care doctor, those conditions can escalate,” Dr. Wolf said. “It really is important for us to take ownership of our health early in life by trying to keep a healthy lifestyle and a reasonable weight. And if you do have issues, that’s OK, we’re all human. But acknowledge them and take steps to fix them with your doctor’s support.”

Keep in mind, just because you start on a medicine, that doesn’t mean you will have to take it forever, though that might be the case for some.

“If taking medications is a negative for you, then having a goal in mind of working on improving your health by improving your diet and exercise routine could help you no longer need those medications,” Dr. Wolf said.

But again, never stop taking a medication without consulting with your doctor, even if you’re feeling better.

Starting new, sustainable healthy habits

For people who do end up having a stroke, making changes—like taking daily medications and altering your lifestyle—can be hard.

“It’s a shock to your system when you’re suddenly told you have a medical issue,” Dr. Wolf said. “It can be hard for people to comprehend that their world has changed and they now have a ‘new normal’ as a stroke survivor.”

That new normal means taking care of yourself, often by taking medications to manage the conditions like high blood pressure that contributed to the stroke. Dr. Wolf said that it takes about a month to establish a habit, so early on you might struggle with your new routine, and that’s perfectly normal. But remember, what we’re after is consistent healthy habits.

Related: How to reduce your risk of having a second stroke

“You may think, ‘I feel fine. I’m not having a stroke today.’ Well, the stroke wasn’t because you had high blood pressure that day. It was because you had high blood pressure for a long time,” Dr. Wolf said. “By not taking care of yourself now, you’re going to further progress the damage.”

The other reason people often stop taking medications is because of side effects. But Dr. Wolf said there are alternatives for most medications that treat high blood pressure, cholesterol and diabetes. Always talk with your doctor about any side effects you’re experiencing and about whether switching to a different medication could help.

Questions about your medications? Talk to your doctor or find a doctor near you today.

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