Symptoms of a stroke
The main symptoms of stroke can be remembered with the word FAST:
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have dropped.
- Arms – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you see any of these signs or symptoms.
If you suspect you or someone else is having a stroke, phone 999 immediately and ask for an ambulance.
Even if the symptoms disappear while you’re waiting for the ambulance, it’s still important to go to hospital for an assessment.
After an initial assessment, you will be referred to a specialist for further tests to help determine the cause of the stroke.
You should be referred to see a specialist within 24 hours of the start of your symptoms.
Treatment can also begin if necessary.Symptoms of a stroke that disappear quickly and in less than 24 hours may mean you had a transient ischaemic attack (TIA).
These symptoms should also be treated as a medical emergency to reduce the chances of having another stroke.
Causes of a stroke
Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly.
If the supply of blood is restricted or stopped, brain cells begin to die. This can lead to brain injury, disability and possibly death.
There are 2 main causes of strokes:
- ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85% of all cases
- haemorrhagic – where a weakened blood vessel supplying the brain bursts
There’s also a related condition called a transient ischaemic attack (TIA), where the blood supply to the brain is temporarily interrupted.
This causes what’s known as a mini-stroke. It can last a few minutes or persist up to 24 hours.
TIAs should be treated urgently, as they’re often a warning sign you’re at risk of having a full stroke in the near future.
Seek medical advice as soon as possible, even if your symptoms get better.
Certain conditions increase the risk of having a stroke, including:
Treating a stroke
Treatment depends on the type of stroke you have, including which part of the brain was affected and what caused it.
Strokes are usually treated with medication. This includes medicines to prevent and dissolve blood clots, reduce blood pressure and reduce cholesterol levels.
In some cases, procedures may be required to remove blood clots. Surgery may also be required to treat brain swelling and reduce the risk of further bleeding if this was the cause of your stroke.
Recovering from a stroke
People who survive a stroke are often left with long-term problems caused by injury to their brain.
Some people need a long period of rehabilitation before they can recover their former independence, while many never fully recover and need ongoing support after their stroke.
Local authorities should provide free reablement services for anyone assessed as needing them.
These services help the person recovering from a stroke learn or relearn the skills they need to live at home independently.
Some people will continue to need some form of care or help with their daily activities.
For example, a care worker may come to the person’s home to help with washing and dressing, or to provide companionship.
If you’re recovering from a stroke or caring for someone who is, it may be useful to read a guide to care and support.
This is written for people with care and support needs, as well as their carers and relatives.
Preventing a stroke
You can significantly reduce your risk of having a stroke by:
- eating a healthy diet
- taking regular exercise
- following the recommended guidelines on alcohol intake (not drinking more than 14 units a week)
- not smoking
If you have a condition that increases your risk of a stroke, it’s important to manage it effectively. For example, taking medicine you have been prescribed to lower high blood pressure or cholesterol levels.
If you have had a stroke or TIA in the past, these measures are particularly important because your risk of having another stroke is greatly increased.
Recognising the signs of a stroke
The signs and symptoms of a stroke vary from person to person, but usually begin suddenly.
As different parts of your brain control different parts of your body, your symptoms will depend on the part of your brain affected and the extent of the damage.
The main stroke symptoms can be remembered with the word FAST:
- Face – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have drooped.
- Arms – the person may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
- Speech – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
- Time – it’s time to dial 999 immediately if you notice any of these signs or symptoms.
It’s important for everyone to be aware of these signs and symptoms, particularly if you live with or care for a person who is in a high-risk group, such as someone who is elderly or has diabetes or high blood pressure.
Other possible symptoms
Symptoms in the FAST test identify most strokes, but occasionally a stroke can cause different symptoms.
Other signs and symptoms may include:
- complete paralysis of 1 side of the body
- sudden loss or blurring of vision
- difficulty understanding what others are saying
- problems with balance and co-ordination
- difficulty swallowing (dysphagia)
- a sudden and very severe headache resulting in a blinding pain unlike anything experienced before
- loss of consciousness
But there may be other causes of these symptoms.
Transient ischaemic attack (TIA)
The symptoms of a transient ischaemic attack (TIA), also known as a mini-stroke, are the same as a stroke, but tend to only last between a few minutes and a few hours before disappearing completely.
Although the symptoms do improve, a TIA should never be ignored as it’s a serious warning sign of a problem with the blood supply to your brain.
It means you’re at an increased risk of having a stroke in the near future.
It’s important to phone 999 immediately and ask for an ambulance if you or someone else have TIA or stroke symptoms.
If a TIA is suspected, you will be offered aspirin to take straightaway. This helps to prevent a stroke.
Even if the symptoms disappear while you’re waiting for the ambulance to arrive, an assessment in a hospital should still be done. You should be referred to see a specialist within 24 hours of the start of your symptoms.
If you think you have had a TIA before, but the symptoms have since passed and you did not seek medical advice at the time, make an urgent appointment with a GP.
They can refer you for a hospital assessment, if appropriate.
Ischaemic strokes are the most common type of stroke. They happen when a blood clot blocks the flow of blood and oxygen to the brain.
These blood clots typically form in areas where the arteries have been narrowed or blocked over time by fatty deposits known as plaques. This process is known as atherosclerosis.
Your artieries may naturally become narrower as you age, but there are some things that dangerously speed up this process.
- high blood pressure (hypertension)
- high cholesterol levels
- excessive alcohol intake
Another possible cause of ischaemic stroke is a type of irregular heartbeat called atrial fibrillation.
This can cause blood clots in the heart that break apart and end up in the blood vessels that supply the brain.
Haemorrhagic strokes (also known as cerebral haemorrhages or intracranial haemorrhages) are less common than ischaemic strokes.
They happen when a blood vessel inside the skull bursts and bleeds into and around the brain.
The main cause of haemorrhagic stroke is high blood pressure, which can weaken the arteries in the brain and make them more likely to split or rupture.
Things that increase the risk of high blood pressure include:
- being overweight
- drinking excessive amounts of alcohol
- a lack of exercise
Haemorrhagic strokes can also be caused by the rupture of a balloon-like expansion of a blood vessel (brain aneurysm) or abnormally formed blood vessels in the brain.
Reducing the risk of a stroke
It’s not possible to completely prevent strokes because some things that increase your risk of the condition cannot be changed.
- age – you’re more likely to have a stroke if you’re over 55, although about 1 in 4 strokes happen to younger people
- family history – if a close relative (parent, grandparent, brother or sister) has had a stroke, your risk is likely to be higher
- ethnicity – if you’re south Asian, African or Caribbean, your risk of stroke is higher, partly because rates of diabetes and high blood pressure are higher in these groups
- your medical history – if you have previously had a stroke, transient ischaemic attack (TIA) or heart attack, your risk of stroke is higher
But it’s possible to significantly reduce your risk of having a stroke by making lifestyle changes to avoid problems such as atherosclerosis and high blood pressure.
You should also seek medical advice if you think you may have an irregular heartbeat.
This can be a sign of atrial fibrillation, which increases the risk of a stroke.
Find out more about how to prevent strokes.
- A blood test to find out your cholesterol and blood sugar level
- checking your pulse for an irregular heartbeat
- taking a blood pressure measurement
Even if the physical symptoms of a stroke are obvious, brain scans should also be done to determine:
- if the stroke has been caused by a blocked artery (ischaemic stroke) or burst blood vessel (haemorrhagic stroke)
- which part of the brain has been affected
- how severe the stroke is
Everyone with suspected stroke should have a brain scan within 1 hour of arriving at hospital.
An early brain scan is especially important for people who:
- might benefit from medicine to clear blood clots (thrombolysis), such as alteplase or early anticoagulant treatment
- are already taking anticoagulant treatments
- have a lower level of consciousness
This is why a stroke is a medical emergency and you should call 999 when a stroke is suspected – there’s no time to wait for a GP appointment.
The 2 main types of scan used to assess the brain in people who have had a suspected stroke are:
A CT scan is like an X-ray, but uses multiple images to build up a more detailed 3-dimensional picture of your brain to help your doctor identify any problem areas.
During the scan, you may be given an injection of a special dye into one of the veins in your arm to help improve the clarity of the CT image and look at the blood vessels that supply the brain.
If it’s suspected you’re experiencing a stroke, a CT scan is usually able to show whether you have had an ischaemic stroke or a haemorrhagic stroke.
It’s generally quicker than an MRI scan and can mean you’re able to receive appropriate treatment sooner.
An MRI scan uses a strong magnetic field and radio waves to produce a detailed picture of the inside of your body.
It’s usually used in people with complex symptoms, where the extent or location of the damage is unknown.
It’s also used in people who have recovered from a transient ischaemic attack (TIA).
This type of scan shows brain tissue in greater detail, allowing smaller, or more unusually located, areas affected by a stroke to be identified.
As with a CT scan, special dye can be used to improve MRI scan images.
A swallow test is essential for anybody who has had a stroke, as the ability to swallow is often affected soon after having a stroke.
The test is simple. The person is given a few teaspoons of water to drink. If they can swallow this without choking and coughing, they’ll be asked to swallow half a glass of water.
If they have any difficulty swallowing, they’ll be referred to a speech and language therapist for a more detailed assessment.
They usually will not be allowed to eat or drink normally until they have seen the therapist.
Fluids or nutrients may need to be given directly into a vein in the arm (intravenously) or through a tube inserted into their stomach via their nose.
Heart and blood vessel tests
Further tests on the heart and blood vessels might be done later to confirm what caused your stroke.
Some of the tests that may be performed are described below.
Carotid ultrasoundA carotid ultrasound scan can help to show if there’s narrowing or blockages in the neck arteries leading to your brain.
An ultrasound scan involves using a small probe (transducer) to send high-frequency sound waves into your body.
When these sound waves bounce back, they can be used to create an image of the inside of your body.
When carotid ultrasonography is needed, it should happen within 48 hours.
EchocardiographyAn echocardiogram makes images of your heart to check for any problems that could be related to your stroke.
This usually involves moving an ultrasound probe across your chest (transthoracic echocardiogram).
An alternative type of echocardiogram called transoesophageal echocardiography (TOE) may sometimes be used.
An ultrasound probe is passed down your gullet (oesophagus), usually under sedation.
As this allows the probe to be placed directly behind the heart, it produces a clear image of blood clots and other abnormalities that may not be seen with a transthoracic echocardiogram.
Effective treatment of stroke can prevent long-term disability and save lives.
The specific treatments recommended depend on whether a stroke is caused by:
- a blood clot blocking the flow of blood to the brain (ischaemic stroke)
- bleeding in or around the brain (haemorrhagic stroke)
Treatment usually involves taking 1 or more different medicines, although some people may also need surgery.
Treating ischaemic strokes
If you have had an ischaemic stroke, a combination of medicines to treat the condition and prevent it happening again is usually recommended.
Some of these medicines need to be taken immediately and only for a short time, while others may only be started once the stroke has been treated and may need to be taken long term.
Thrombolysis – “clot buster” medicine
Ischaemic strokes can often be treated using injections of a medicine called alteplase, which dissolves blood clots and restores blood flow to the brain.
This use of “clot-busting” medicine is known as thrombolysis.
Alteplase is most effective if started as soon as possible after the stroke occurs – and certainly within 4.5 hours.
It’s not generally recommended if more than 4.5 hours have passed, as it’s not clear how beneficial it is when used after this time.
Before alteplase can be used, it’s very important that a brain scan is done to confirm a diagnosis of an ischaemic stroke.
This is because the medicine can make the bleeding that occurs in haemorrhagic strokes worse.
A small number of severe ischaemic strokes can be treated by an emergency procedure called a thrombectomy.
This removes blood clots and helps restore blood flow to the brain.
Thrombectomy is only effective at treating ischaemic strokes caused by a blood clot in a large artery in the brain.
It’s most effective when started as soon as possible after a stroke.
The procedure involves inserting a catheter into an artery, often in the groin. A small device is passed through the catheter into the artery in the brain.
Aspirin and other antiplatelets
Most people will be offered a regular dose of aspirin. As well as being a painkiller, aspirin is an antiplatelet, which reduces the chances of another clot forming.
Some people may be offered an anticoagulant to help reduce their risk of developing new blood clots in the future.
Anticoagulants prevent blood clots by changing the chemical composition of the blood in a way that prevents clots from forming.
There are also a number of anticoagulants called heparins, which can only be given by injection and are used short term.
Anticoagulants may be offered if you:
- have a type of irregular heartbeat called atrial fibrillation, which can cause blood clots
- have a history of blood clots
- develop a blood clot in your leg veins (deep vein thrombosis (DVT)) because a stroke has left you unable to move one of your legs
Blood pressure medicines
If your blood pressure is too high, you may be offered medicines to lower it.
Medicines that are commonly used include:
- thiazide diuretics
- angiotensin-converting enzyme (ACE) inhibitors
- calcium channel blockers
If the level of cholesterol in your blood is too high, you’ll be advised to take a medicine known as a statin.
Statins reduce the level of cholesterol in your blood by blocking a chemical (enzyme) in the liver that produces cholesterol.
You may be offered a statin even if your cholesterol level is not particularly high, as it may help reduce your risk of stroke whatever your cholesterol level is.
Some ischaemic strokes are caused by narrowing of an artery in the neck called the carotid artery, which carries blood to the brain.
The narrowing, known as carotid stenosis, is caused by a build-up of fatty plaques.
If the carotid stenosis is very severe, surgery may be used to unblock the artery. This is called a carotid endarterectomy.
It involves the surgeon making a cut (incision) in your neck to open up the carotid artery and remove the fatty deposits.
Treating haemorrhagic strokes
As with ischaemic strokes, some people who have had a haemorrhagic stroke will also be offered medicine to lower their blood pressure and prevent further strokes.
If you were taking anticoagulants before you had your stroke, you may also need treatment to reverse the effects of the medicine and reduce your risk of further bleeding.
Occasionally, emergency surgery may be needed to remove any blood from the brain and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.
During a craniotomy, a section of the skull is removed to allow the surgeon access to the source of the bleeding.
The surgeon will repair any damaged blood vessels and ensure there are no blood clots present that may restrict the blood flow to the brain.
After the bleeding has been stopped, the piece of bone removed from the skull is replaced, often by an artificial metal plate.
Surgery for hydrocephalus
Surgery can also be done to treat a complication of haemorrhagic strokes called hydrocephalus.
This is where damage resulting from a stroke causes cerebrospinal fluid to build up in the cavities (ventricles) of the brain, causing symptoms such as headaches, sickness, drowsiness, vomiting and loss of balance.
Hydrocephalus can be treated by putting a tube, called a shunt, into the brain to allow the fluid to drain.
You may need further short-term treatment to help manage some of the problems that can affect people who have had a stroke.
For example, you may require:
- a feeding tube inserted into your stomach through your nose (nasogastric tube) to provide nutrition if you have difficulty swallowing (dysphagia)
- nutritional supplements if you’re malnourished
- fluids given directly into a vein (intravenously) if you’re at risk of dehydration
- oxygen through a nasal tube or face mask if you have low levels of oxygen in your blood
- compression stockings to prevent blood clots in the legs (DVT)
- your care after discharge from hospital
- assessing your care and support needs
- care services in your home
A team of different specialists may help with your rehabilitation, including physiotherapists, psychologists, occupational therapists, speech and language therapists, dietitians, and specialist nurses and doctors.
You’ll be encouraged to actively participate in the rehabilitation process and work with your care team to set goals you want to achieve during your recovery.
The different treatment and rehabilitation methods for some of the common problems caused by strokes are outlined below.
Two of the most common psychological problems that can affect people after a stroke are:
- depression – many people experience intense bouts of crying, feel hopeless and withdraw from social activities
- anxiety – where people experience general feelings of fear and anxiety, sometimes with moments of intense, uncontrolled feelings of anxiety (anxiety attacks)
Feelings of anger, frustration and bewilderment are also common.
You’ll receive a psychological assessment from a member of your healthcare team soon after your stroke to check if you’re experiencing any emotional problems.
Advice should be given to help you deal with the psychological impact of stroke. This includes the impact on relationships with other family members and any sexual relationship.
There should also be a regular review of any problems of depression and anxiety, and psychological and emotional symptoms generally.
These problems may settle down over time, but if they’re severe or last a long time, GPs can refer people for expert healthcare from a psychiatrist or clinical psychologist.
For some people, medicines and psychological therapies, such as counselling or cognitive behavioural therapy (CBT) may help.
CBT is a therapy that aims to change the way you think about things to produce a more positive state of mind.
Cognitive is a term that refers to the many processes and functions our brain uses to process information.
One or more cognitive functions can be disrupted by a stroke, including:
- spatial awareness – having a natural awareness of where your body is in relation to your immediate environment
- executive function – the ability to plan, solve problems and reason about situations
- praxis – the ability to carry out skilled physical activities, such as getting dressed or making a cup of tea
As part of your treatment, each one of your cognitive functions will be assessed, and a treatment and rehabilitation plan will be created.
You can be taught a wide range of techniques that can help you relearn disrupted cognitive functions, such as recovering your communication skills through speech and language therapy.
There are many ways to compensate for any loss of cognitive function, such as using memory aids, diaries and routines to help plan daily tasks.
Most cognitive functions will return with time and rehabilitation, but you may find they do not return to the way they were before.
The damage a stroke causes to your brain also increases the risk of developing vascular dementia.
This may happen immediately after a stroke or may develop some time after the stroke happened.
Strokes can cause weakness or paralysis on one side of the body, and can result in problems with co-ordination and balance.
Many people also experience extreme tiredness (fatigue) in the first few weeks after a stroke, and may also have difficulty sleeping, making them even more tired.
As part of your rehabilitation, you should be seen by a physiotherapist, who’ll assess the extent of any physical disability before creating a treatment plan.
Physiotherapy will often involve several sessions a week, focusing on areas such as exercises to improve your muscle strength and overcome any walking difficulties.
The physiotherapist will work with you by setting goals. At first, these may be simple goals, such as picking up an object.
As your condition improves, more demanding long-term goals, such as standing or walking, will be set.
A careworker or carer, such as a member of your family, will be encouraged to become involved in your physiotherapy.
The physiotherapist can teach you both simple exercises you can do at home.
If you have problems with movement and certain activities, such as getting washed and dressed, you may also receive help from an occupational therapist. They can find ways to manage any difficulties.
Occupational therapy may involve adapting your home or using equipment to make everyday activities easier, and finding alternative ways of achieving tasks you have problems with.
After having a stroke, many people experience problems with speaking and understanding, as well as reading and writing.
If the parts of the brain responsible for language are damaged, this is called aphasia, or dysphasia.
If there’s weakness in the muscles involved in speech as a result of brain damage, this is known as dysarthria.
You should see a speech and language therapist as soon as possible for an assessment and to start therapy to help you with your communication.
This may involve:
- exercises to improve your control over your speech muscles
- using communication aids – such as letter charts and electronic aids
- using alternative methods of communication – such as gestures or writing
You can also read our guide on caring for someone with communication difficulties.
The damage caused by a stroke can interrupt your normal swallowing reflex, making it possible for small particles of food to enter your windpipe.
You may need to be fed using a feeding tube during the initial phases of your recovery to prevent any complications from dysphagia.
The tube is usually put into your nose and passed into your stomach (nasogastric tube), or it may be directly connected to your stomach in a small operation done using local anaesthetic (percutaneous endoscopic gastrostomy, or PEG).
In the long term, you’ll usually see a speech and language therapist several times a week to manage your swallowing problems.
Treatment may involve tips to make swallowing easier, such as taking smaller bites of food and advice on posture, and exercises to improve control of the muscles involved in swallowing.
Stroke can sometimes damage the parts of the brain that receive, process and interpret information sent by the eyes.
This can result in losing half the field of vision – for example, only being able to see the left or right side of what’s in front of you.
Stroke can also affect the control of the eye muscles. This can cause double vision.
If you have problems with your vision after a stroke, you’ll be referred to an eye specialist called an orthoptist, who can assess your vision and suggest possible treatments.
For example, if you have lost part of your field of vision, you may be offered eye movement therapy. This involves exercises to help you look to the side with the reduced vision.
You may also be given advice about how to perform tasks that can be difficult if your vision is reduced on one side, such as getting dressed.
Bladder and bowel control
Some strokes damage the part of the brain that controls the bladder and bowel.
This can result in urinary incontinence and difficulty with bowel control.
Some people may regain bladder and bowel control quite quickly, but if you still have problems after leaving hospital, help is available from the hospital, your GP and specialist continence advisers.
Ask for advice if you have a problem, as there are lots of treatments that can help.
Sex after a stroke
Having sex will not put you at higher risk of having another stroke. There’s no guarantee you will not have another stroke, but there’s no reason why it should happen while you’re having sex.
Even if you have been left with a severe disability, you can experiment with different positions and find new ways of being intimate with your partner.
Be aware that some medicines can reduce your sex drive (libido), so make sure your doctor knows if you have a problem as there may be other medicines that can help.
Some men may experience erectile dysfunction after a stroke.
Speak to your GP or your rehabilitation team if this is the case, as there are several treatments that may help.
Driving after a stroke
If you have had a stroke or TIA, you can not drive for 1 month. Whether you can return to driving depends on what long-term disabilities you may have and the type of vehicle you drive.
It’s often not physical problems that can make driving dangerous, but problems with concentration, vision, reaction time and awareness that can develop after a stroke.
Your GP can advise you on whether you can start driving again 1 month after your stroke, or whether you need further assessment at a mobility centre.
Preventing further strokes
If you have had a stroke, your chances of having another one are significantly increased.
You’ll usually require long-term treatment with medicines that improve the risk factors for your stroke.
- medicine – to help lower your high blood pressure
- anticoagulants or antiplatelets – to reduce your risk of blood clots
- statins – to lower your cholesterol levels
You’ll also be encouraged to make lifestyle changes to improve your general health and lower your stroke risk, such as:
- eating a healthy diet
- exercising regularly
- stopping smoking if you smoke
- drinking alcohol within the recommended limits
Providing Support for someone who has had Stroke
- helping them do their physiotherapy exercises in between their sessions with the physiotherapist
- providing emotional support and reassurance that their condition will improve with time
- helping to motivate them to reach their long-term goals
- adapting to any needs they may have, such as speaking slowly if they have communication problems
Caring for someone after they’ve had a stroke can be a frustrating and lonely experience. The advice outlined below may help.
Be prepared for changed behaviour
Someone who’s had a stroke can often seem as though they have had a change in personality and appear to act irrationally at times.
This is the result of the psychological and cognitive impact of a stroke.
They may become angry or resentful towards you. Upsetting as it may be, try not to take it personally.
It’s important to remember they’ll often start to return to their old self as their rehabilitation and recovery progresses.
Try to remain patient and positive
Rehabilitation can be a slow and frustrating process, and there will be times when it seems as though little progress has been made.
Encouraging and praising any progress, no matter how small it may appear, can help motivate someone who’s had a stroke to achieve their long-term goals.
Make time for yourself
If you’re caring for someone who’s had a stroke, it’s important not to neglect your own physical and psychological wellbeing.
Socialising with friends or pursuing leisure interests will help you cope better with the situation.
Ask for help
There are a wide range of support services and resources available for people recovering from stroke, and their families and carers.
This ranges from equipment that can help with mobility, to psychological support for carers and families.
The hospital staff involved with the rehabilitation process can provide advice and contact information.
- arteries becoming clogged with fatty substances (atherosclerosis)
- high blood pressure
- high cholesterol levels
If you have already had a stroke, making these changes can help reduce your risk of having another stroke in the future.
An unhealthy diet can increase your chances of having a stroke because it may lead to an increase in your blood pressure and cholesterol levels.
A low-fat, high-fibre diet is usually recommended, including plenty of fresh fruit and vegetables (5 A Day) and wholegrains.
Ensuring a balance in your diet is important. Do not eat too much of any single food, particularly foods high in salt and processed foods.
You should limit the amount of salt you eat to no more than 6g (0.2oz) a day as too much salt will increase your blood pressure: 6g of salt is about 1 teaspoonful.
Combining a healthy diet with regular exercise is the best way to maintain a healthy weight.
Regular exercise can also help lower your cholesterol and keep your blood pressure healthy.
For most people, at least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week is recommended.
If you’re recovering from a stroke, you should discuss possible exercise plans with the members of your rehabilitation team.
Regular exercise may not be possible in the first weeks or months after a stroke, but you should be able to begin exercising once your rehabilitation has progressed.
Smoking significantly increases your risk of having a stroke. This is because it narrows your arteries and makes your blood more likely to clot.
You can reduce your risk of having a stroke by stopping smoking.
The NHS Smoking Helpline can offer advice and encouragement to help you quit smoking. Call 0300 123 1044, or visit NHS Smokefree.
Cut down on alcohol
Excessive alcohol consumption can lead to high blood pressure and trigger an irregular heartbeat (atrial fibrillation), both of which can increase your risk of having a stroke.
Because alcoholic drinks are high in calories, they also cause weight gain. Heavy drinking multiplies the risk of stroke by more than 3 times.
If you choose to drink alcohol and have fully recovered, you should aim not to exceed the recommended limits:
- men and women are advised not to regularly drink more than 14 units a week
- spread your drinking over 3 days or more if you drink as much as 14 units a week
If you have not fully recovered from your stroke, you may find you have become particularly sensitive to alcohol and even the recommended safe limits may be too much for you.
Managing underlying conditions
If you have been diagnosed with a condition known to increase your risk of stroke, ensuring the condition is well controlled is also important for helping prevent strokes.
The lifestyle changes mentioned above can help control these conditions to a large degree, but you may also need to take regular medication.
Want to know more?
- healthtalk.org real stories about living with stroke
- National Institute for Health and Care Excellence (NICE): stroke rehabilitation
- Stroke Association: effects of stroke
- Stroke Association: stroke helpline
- Stroke Association: emotional changes after a stroke
- Stroke Association: vascular dementia
- Stroke Association: memory and thinking after stroke
- Stroke Association: visual problems after stroke
- Stroke Association: swallowing problems after stroke
- Stroke Association: a complete guide to communication problems after stroke