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There are many articles out there about stroke. However, most are focused on initial strokes – what causes them, how to identify them and what to do if you or your loved ones have a stroke. Not much is said about the possibility of getting another stroke after you’ve had your first.
Generally, people refer to a stroke as “mild” if it goes away within 24 hours (transient ischaemic attack, TIA) or if there is only a bit of residual weakness that does not affect daily activities much.
Although it appears you have “recovered” from the stroke, it is evidence that your blood vessels have been compromised and you are at risk of other cardiovascular diseases, including a second stroke.
The risk of another stroke accumulates with time. The risk is 3.1% within 30 days of the first stroke, 11.1% at 1 year, 26.4% at 5 years and 39.2% at 10 years after initial stroke. Multiple studies have also shown that a previous stroke – regardless of severity – is an independent risk factor for recurrent stroke.
This means that even if your stroke was “mild”, there is a risk of you getting another one!
However, it is not all doom and gloom. A study comparing risk factors in patients with and without recurrent stroke shows that good control of blood pressure and blood glucose, high level of high density lipoproteins (HDL), and initiation of statins (drugs for blood cholesterol control) are associated with decreased incidence of recurrent stroke.
After your first stroke, your doctor would have given you a combination of medications to take, lifestyle modification advice and a follow up schedule for blood taking and consultations. All these are aimed to reduce your risk of recurrent stroke and also prevent other cardiovascular diseases like a heart attack or kidney failure.
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In summary, you can reduce your risk of another stroke by:
- Taking your medications as prescribed
- Getting regular check ups with your doctor
- Exercising regularly
- Taking a well-balanced diet
Knowing your medications and what they do will help you stick to them better. Details on diet and exercise should be discussed with your doctor and dietician to formulate a plan that is tailored for you.
Take control of your health and you can reduce the risk of recurrent stroke!
Dr Chua Li-Shun is a medical officer undergoing her post-graduate training in Kuala Lumpur.
References:
- Mohan, KM et al. Risk and cumulative risk of stroke recurrence: a systematic review and meta-analysis. Stroke 2011; 42:1489-1494
- Chin YY, et al. Prevalence, risk factors and secondary prevention of stroke recurrence in eight countries from south, east and southeast asia: a scoping review. Med J Malaysia 2018 Apr; 73(2):90-99
- Suanprasert N, Tantirithisak T. Impact of risk factors for recurrent ischaemic stroke in Prasat Neurological Institute. J Med Assoc Thai 2011; 94(9):1035-1043
[This article belongs to The Malaysian Medical Gazette. Any republication (online or offline) without written permission from The Malaysian Medical Gazette is prohibited.]