INDIANAPOLIS (WISH) — The American Heart Association and American Stroke Association have updated key guidelines to help people prevent a first stroke.

Every 40 seconds, an American suffers a stroke and every three minutes, an American dies from a stroke.. More than 600,000 Americans will have their first stroke this year, a preventable event if underlying risk factors are controlled or eliminated.

What causes a stroke?

Stroke is caused by a lack of blood flow to part of the brain due to a blood clot, rupture of a blood vessel or hemorrhage, vasoconstriction of a blood vessel or dissection of an artery.

Risk factors

• High blood pressure (goal <130/80).
• High cholesterol level.
• Diabetes.
• Obesity.
• Obstructive sleep apnea (consider people with hard-to-control blood pressure, difficulty sleeping, fatigue, snoring, or a combination of these).
• Endometriosis.
• Pre-eclampsia.
• Premature menopause (44 years and under).
• Sickle cell disease.
• Lupus.
• Racism and discrimination.
• Lack of access to stable housing, nutritious food, walkable neighborhoods, education and health care.
• African Americans have a risk factor twice that of Caucasians. The risk of death from stroke is highest among Black and Pacific Islanders.
• Use of additional hormones for gender-affirming care.
• Oral hormone replacement therapy in women over 60 and 10 years after the onset of menopause.
• Smoking and vaping.
• Physical inactivity.

Health care professionals should screen for these risk factors and recommend lifestyle changes and, in some cases, medications.. Healthcare teams can inform people of their risks and next steps.

Preventive measures

• Mediterranean diet or similar culturally relevant intake of whole fruits, vegetables, lean protein, whole grains as tolerated, nuts, seeds, and oil sparingly. Use extra virgin olive oil for low temperature cooking and avocado oil for high temperature cooking.
• Salt reduction.
• 75 minutes of vigorous-intensity activity or 150 minutes of moderate activity per week.
• Reduce sedentary behavior. Get up every hour if you sit for long periods of time.

• Balance: loss of balance, dizziness or difficulty walking.
• Eyes: sudden loss of vision, double vision or blurred vision.
• Face: Facial drooping, numbness, or uneven smile.
• Arm: Numbness in one arm, or one arm drifting downward when both are raised.
• Speech: difficulty speaking or confusion.
• Time: Time is life with a stroke. If any of these symptoms are present, call 911 and mention when the symptoms first began.