History of stroke. Not surprisingly, once you've suffered one, you're primed for another—unless you work with your doctors to reduce your risk factors. But efforts to prevent having a second stroke are lacking, suggests a March study published in Stroke. Lifestyle changes known to reduce the risk of a second attack, such as getting regular exercise, were reported by only 57 percent of the people who'd had a stroke.
Other preventive measures include quitting smoking (66 percent of study subjects reported getting counseling to help them do so), taking aspirin regularly (77 percent), taking medication to control high blood pressure (91 percent), making diet changes if high blood pressure is an issue (62 percent got such dietary counseling), at least annual average blood sugar testing if diabetic (89 percent), getting the flu vaccine (52 percent), and getting the pneumococcal vaccine (53 percent). Some experts have suggested that vaccination against common infections may reduce the risk of stroke; flu epidemics have been associated with higher rates of stroke-related hospitalizations.
Too much homocysteine. High blood levels of this amino acid are associated with cardiovascular troubles, including stroke. Genetics and diet each play a role in generating homocysteine. For example, having high levels of dietary nutrients folic acid and vitamins B6 and B12 is associated with lower levels of homocysteine in the blood. While it's not yet clear if acting to lower homocysteine will reduce the risk of stroke or heart attacks, the American Heart Association recommends that high-risk patients get hearty amounts of folic acid, B6, and B12 through green leafy vegetables and fortified grains and cereals.