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How To Prevent A Stroke

ion. Included in that category is the metabolic syndrome -- a clustering of metabolic disorders that may increase the risk of artery plaque buildup (abdominal obesity, high triglycerides, low HDL-cholesterol or "good" cholesterol, high blood pressure, insulin resistance, high blood levels of fibrinogen or C-reactive protein). Other interventions that may lower stroke risk are limiting alcohol use, not using illicit drugs and avoiding the use of oral contraceptives in women who smoke.

A new recommendation among the potentially modifiable risk factors is evaluating people for sleep apnea. This disorder is marked by extremely loud snoring, daytime sleepiness and is associated with an increased risk of stroke. Sleep apnea sufferers stop breathing several times a night, rousing to gulp in air in a pattern that disrupts normal sleep.

"We know that treating sleep apnea is associated with a reduction of blood pressure," Goldstein said. "And although we don't have direct evidence that treating sleep apnea will reduce stroke risk, the feeling is that it will. But that is not yet supported by randomized trials."

The guidelines suggest that physicians question bed partners and patients -- particularly those with abdominal obesity and hypertension -- about sleep disorder symptoms.

Other risk factors such as inflammation, infection and migraine are all mentioned in the guidelines as areas in which research is evolving.

The guidelines also recommend low-dose aspirin to prevent a first stroke in women whose risk is sufficiently high for the benefits to outweigh the risks associated with long-term aspirin use. The evidence is not strong enough to recommend aspirin in men at high risk of stroke. Men at high cardiovascular risk can also benefit from treatment with aspirin for primary prevention, Goldstein said.

"Stroke is a life-changing event that not only affects the person who may be disabled, but the entire family a
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