Stroke is the third leading cause of death and leading cause of adult disability in the US. It is caused by a blockage or bleeding in the brain. High blood pressure is the most important modifiable risk factor. Signs of stroke include sudden weakness, abnormal speech, and vision changes. Management involves lifestyle changes like diet and exercise as well as medication to prevent further strokes. Preventing and controlling risk factors such as high blood pressure, atrial fibrillation, diabetes, and high cholesterol can significantly reduce stroke risk.

1. Stroke 3rd leading cause of death in the U.S. and the leading cause of adult disability

2. The rapidly developing loss of brain function(s) due to disturbance in the blood supply to the brain Also know as a cerebrovascular accident (CVA) Definition

3. Ischemia - lack of blood flow caused by blockage (thrombosis, arterial embolism) Hemorrhage - leakage of blood Causes

4. Advanced age Hypertension (high blood pressure) Previous stroke or transient ischemic attack (TIA) Diabetes High cholesterol Cigarette smoking Atrial fibrillation High blood pressure is the most important modifiable risk factor of stroke Risk Factors

5. Heavy alcohol consumption Drug use Lack of physical activity Obesity Unhealthy diet Other Risk Factors

6. Sudden-onset face weakness Arm drift (if a person, when asked to raise both arms, involuntarily lets one arm drift downward) Abnormal speech Proposed systems include FAST (stroke) (face, arm, speech, and time) Signs and Symptoms

7. Advice on diet, exercise, smoking and alcohol use Medication or drug therapy is the most common method of stroke prevention (i.e. aspirin) Management

8. Hypertension: Studies suggest that even a small blood pressure reduction (5 to 6 mmHg systolic, 2 to 3 mmHg diastolic) would result in 40% fewer strokes Lowering blood pressure has been conclusively shown to prevent both ischemic and hemorrhagic strokes Prevention

9. Atrial Fibrillation: Patients with atrial fibrillation have a risk of 5% each year to develop stroke Depending on the stroke risk, anticoagulation with medications such as aspirin is warranted for stroke prevention Prevention

10. High Cholesterol: High cholesterol levels have been inconsistently associated with ischemic stroke Statins have been shown to reduce the risk of stroke by about 15% Prevention

11. Diabetes: Intensive disease control has been shown to reduce microvascular complications such as nephropathy and retinopathy Prevention

12. Anticoagulation Drugs: Oral anticoagulants such as warfarin have been the mainstay of stroke prevention for over 50 years However, several studies have shown that aspirin and anti-platelet drugs are highly effective in secondary prevention after a stroke or transient ischemic attack Except for in atrial fibrillation, oral anticoagulants are not advised for stroke prevention —any benefit is offset by bleeding risk Prevention

13. Nutritional Intervention: Nutrition, specifically the Mediterranean-style diet, has the potential of more than halving stroke risk Prevention