The risk of atrial fibrillation increases with age; it becomes more common after age 60. It is often caused by other forms of heart disease and high blood pressure, but it can occur in people who do not have either condition. Atrial fibrillation raises the risk of stroke because irregular heartbeats allow blood to pool in the heart, and pooled blood is more likely to develop clots. Those clots can then travel to the brain and block blood flow. People with atrial fibrillation are usually prescribed warfarin (brand name Coumadin) to prevent blood clots from forming. A pacemaker can also be implanted to control the rhythm of the heart.
Atherosclerosis. A major risk factor for heart disease and stroke is atherosclerosis, in which fatty material, cholesterol, calcium, and other substances accumulate within the inner lining of the artery walls, reducing the flow of blood. Atherosclerosis is diagnosed with stress testing, blood tests, angiogram, and electrocardiogram.
One approach to treating atherosclerosis is described in the book Prevent and Reverse Heart Disease by Caldwell B. Esselstyn, Jr., MD, a former surgeon at the Cleveland Clinic. Dr. Esselstyn recommends consuming a strictly plant-based diet of fruits, vegetables, whole grains and products made from whole grains, and dried beans and other legumes — but no added fats, not even olive oil. Dr. Esselstyn has prescribed this diet to patients with heart disease for more than 20 years and has documented its ability to lower cholesterol, improve blood flow, and prevent cardiac “events” such as heart attacks in this population.
Not all doctors will recommend exactly this dietary approach, but most agree that diet and lifestyle choices play an important role in treating atherosclerosis and will recommend some form of dietary changes. (For more resources on lowering your risk for stroke through diet, see “Eating Your Way to Lower Stroke Risk.”)
Other treatments for atherosclerosis include cholesterol-lowering medicines, procedures such as balloon angioplasty, in which the plaque buildup in the arteries is flattened against the artery walls, or inserting a stent to ease the flow of blood in the arteries. For people with severely clogged arteries, coronary bypass surgery can be performed to restore blood flow to the heart.
High blood pressure. Having high blood pressure greatly increases the risk of stroke. Called “the silent killer,” high blood pressure usually has no symptoms, although extremely high blood pressure can cause severe headache, irregular heartbeat, blurred vision, and chest pain. Such symptoms should be checked immediately by a doctor.
People who have diabetes and hypertension should follow their doctors’ advice for controlling their blood pressure. The American Diabetes Association recommends a target blood pressure of less than 130/80 millimeters of mercury (or mm Hg) for people with diabetes. As a first line of treatment to lower blood pressure, doctors often prescribe regular exercise, dietary measures including lowering sodium intake, and reduced alcohol consumption. If these measures do not lower blood pressure to the desired level, doctors may recommend anti-hypertension medicine.
Some of the dietary measures that can help to lower blood pressure besides lowering sodium intake are the following:
- Consuming at least 3,500 mg of potassium daily in such foods as bananas, oranges, dried fruits, sweet potatoes, white potatoes, greens, and skim milk
- Consuming at least 1,200 mg of calcium a day from foods such as yogurt and skim milk