The majority of strokes could be prevented, according to new guidelines aimed at helping patients and their doctors do so.

Stroke was the fourth leading cause of death in the United States in 2023, according to the Centers for Disease Control and Prevention, and more than half a million Americans suffer a stroke each year. But up to 80% of strokes could be prevented through better diet, exercise and identification of risk factors.

The first new stroke prevention guidelines in 10 years from the American Stroke Association, a division of the American Heart Association, include recommendations for people and doctors that reflect a better understanding of who gets stroke. a stroke and why, as well as new medications that can help reduce your risk.

The good news is that the best way to reduce your risk of stroke is also the best way to reduce your risk of a whole host of health problems: eat healthy, move your body, and don’t smoke. The bad news is that it’s not always that easy to maintain.

Dr. Sean Duke, a stroke doctor at the University of Mississippi Medical Center, blames societal forces that keep people sedentary and eating poorly, such as cell phones and unhealthy, cheap foods. “Our world is against us,” he said.

Here’s what you need to know about stroke and the new guidelines:

What is a stroke?

A stroke occurs when blood flow to part of the brain is blocked or if a blood vessel in the brain bursts. This deprives the brain of oxygen, which can cause brain damage that can lead to difficulty thinking, speaking and walking, or even death.

How Eating Healthy Can Reduce Your Risk of Stroke

According to the Heart Association, eating healthily can help control several factors that increase your risk of stroke, including high cholesterol, high blood sugar, and obesity.

The group recommends foods from the so-called Mediterranean diet, such as fruits, vegetables, whole grains and olive oil, which can help keep cholesterol levels low. He suggests limiting red meat and other sources of saturated fat. Instead, get your protein from beans, nuts, poultry, fish and seafood.

Limit highly processed foods and foods and drinks with lots of added sugar. It can also reduce your calorie intake, which helps control your weight.

Moving Your Body May Help Prevent Strokes

Getting up and walking around for at least 10 minutes a day can “dramatically” reduce your risk, said Dr. Cheryl Bushnell, a neurologist at Wake Forest University School of Medicine who was part of the group that developed the new guidelines. Among the many benefits: Regular exercise can help reduce blood pressure, a major risk factor for stroke.

Of course, more is better: The Heart Association recommends at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity — or a combination — per week. How you do it doesn’t matter much, experts say: Go to the gym, take a walk or run around your neighborhood, or use treadmills or stepper machines at home.

New tools to reduce obesity, a risk factor for stroke

Diet and exercise can help control weight, another important risk factor for stroke. But a new class of drugs capable of significantly reducing weight has been approved by regulators, providing new tools to reduce stroke risk since the guidelines were last updated.

The guidelines now recommend doctors consider prescribing these drugs, including those sold under the brand names Ozempic, Wegovy, Mounjaro and Zepbound, to people with obesity or diabetes.

But even if these medications can help, people still need to eat well and exercise, cautions Dr. Fadi Nahab, a stroke expert at Emory University Hospital.

New guidelines help doctors identify people who may be at higher risk of stroke

New guidelines recommend for the first time that doctors screen patients for other factors that may increase stroke risk, including sex and gender, as well as non-medical factors such as economic stability , access to health care, discrimination and racism. For example, the risk of having a first stroke is almost twice as high for black adults in the United States as for white adults, according to the CDC.

“If someone doesn’t have insurance or they can’t get to a doctor because of transportation issues or they can’t leave work to get health care…this are all things that can impact the ability to prevent strokes,” Bushnell said.

Doctors may be able to point out resources for low-cost health care or food, and can provide ideas on how to be active without breaking the bank for a gym membership.

The guidelines also now recommend that doctors screen for conditions that may increase a woman’s risk of stroke, such as high blood pressure during pregnancy or early menopause.

How do I know if I’m having a stroke and what should I do?

Three of the most common stroke symptoms include facial weakness, arm weakness, and difficulty speaking. And time is important, because brain damage can occur quickly and damage can be limited if a stroke is treated quickly. Stroke experts came up with an acronym to help you remember: FAST. F for face, A for arm, S for speech and T for time. If you think you or a loved one may be having a stroke, call 911 immediately.

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AP data journalist Kasturi Pananjady contributed to this story.