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Stroke Stroke Prevention

Secondary Prevention: Stopping the Next Stroke

Summary & Participants

If you've suffered a stroke, one of your greatest concerns should be preventing a second stroke. Currently, 40 percent of stroke survivors have a second stroke within five years. And a repeat stroke is frequently more devastating than the first. But there are things you can do to keep a second attack at bay. Join our panel of experts for a discussion of prevention issues specific to stroke survivors.

Medically Reviewed On: May 07, 2008

Webcast Transcript

DARA JAMIESON, MD: Often a stroke is a wake-up call. I remember a woman I saw in the office today who at 65 really didn't think she needed to go see doctors. But when she had her stroke, it was discovered that her blood pressure was too high, her glucose was too high, her cholesterol was too high and all of a sudden she needed specialists to help her with these risk factors and intervention to help prevent another stroke from occurring.

PAUL J. MONIZ: Dr. Sacco, are second strokes always more serious?

RALPH L. SACCO, MD: Sometimes. The key is that when you have one stroke, and you survived it, if you have another one, the next one may leave you with a lot more disability. For example, if you have right-sided weakness and then go on to have a stroke on the other side of the brain, you may have your right and left side impaired. Clearly if you're going to have another brain injury, another stroke, it's going to disable you further. There are ways that we can think of to try to reduce that risk.

PAUL J. MONIZ: What are some of the ways to reduce the risk?

DARA JAMIESON, MD: The first way which we may think of as being the simplest, but for some patients is truly the hardest, is lifestyle adjustment. Basically decreasing those risk factors, making sure that your physician is keeping your blood pressure under control, making sure your sugar — your glucoses are under control if you have diabetes, making sure your cholesterol is normal. Eating a good diet. If you smoke, stop. Exercise. Get your weight down.

Once you've dealt with risk factors, then there are antiplatelet medications. In some cases, there are anticoagulant medications and, in some cases, surgery that can help decrease your risk as well.

PAUL J. MONIZ: This wave of new medications is certainly increasing the likelihood that people can survive and maintain somewhat of their lifestyle. How effective are they generally?

RALPH L. SACCO, MD: What's great now is we have a lot of medicines to choose from. We think of stroke as many different types of stroke. The first thing we do is try to figure out what caused it. Then try to intervene to reduce the chance of another one occurring. If the stroke was caused by large artery blockage, then surgery is the most effective thing we can do. If the stroke was caused by the heart, then blood thinners are needed to prevent clots from forming to prevent another clot from breaking off and blocking an artery.

If it's one of the other types of stroke, some small arteries or other types, then we have a choice of antiplatelet agents. These are certain kinds of drugs that help prevent certain particles of the blood from sticking together. Something as simple as aspirin, Plavix, clopidogrel, ticlopidine or Aggrenox, the latest one to be approved to really help reduce the risk of a recurrent stroke.

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