Preventing another stroke: Changes in life style
The risk of having a stroke is higher for people who have had one already and for people who have had a TIA (minor stroke). To reduce the risk you are recommended to follow advice on a healthy diet, to exercise, to watch your weight and alcohol intake and, if you smoke, to stop. It is also important to make sure your blood pressure is controlled and is checked regularly and to take any medication you are prescribed to help stop blood clotting and reduce cholesterol.
Whilst many people said they had made changes to a healthier lifestyle after their stroke others said they had not because their lifestyle had been healthy anyway. These people did not see their lifestyle as contributing to the cause of their stroke (see 'Causes and risk factors'). Some said that although they knew the healthy lifestyle advice they did not always follow it.
Most respondents said they did lead a generally healthier lifestyle after their stroke and followed the advice they were given.
- Age at interview:
- Is a married process operator with 2 adult children. Ethnic background/nationality' White/Scottish.
Sort of thinking about, you know, the future and perhaps the possibility of having another stroke, have you thought about that? Is that something that worries you at all?
Mmm. Mmm. Aye. Thought about it. That's why I'm working hard at the fitness level of things. Really, really a lot more conscious about diet. You know, my diet wasn't bad anyway. My diet was not bad. Fairly healthy diet. Moderate drinker but I've cut out a lot of sugar. In fact, I've cut out sugar entirely. I use a sweetener now, as opposed to sugar, put it that way. Very, very conscious about 5 portions of fruit and veg a day things. That kind of thing. Very, very conscious about sugar on the likes of shortbread and things like that. Biscuits, you know. I'm a great lover of chocolate biscuits, which I'm struggling to cut out, you know. But I'm very, very conscious of that and trying to, and this has all come through, through the hospital, through the, again, the talks we get from dieticians, pharmacists, these kind of people, you know. It makes you so much more aware, it's made me so much more aware of how things works, how your body works how your, your, your arteries can clog up, you know. I've always been pretty fit and I'm, that's what I'm working towards again, allied with a healthier, healthier diet, healthier than was the last time but it's, as I say, it wasn't bad before. It wasn't bad at all but it's better now and it's going to be better. Aye.
If they had smoked prior to their stroke most gave up immediately which was sometimes made easier by being in hospital. However, two people said they had taken up smoking again, or started for the first time, after their stroke because they felt defiant and angry that leading healthy lives had not prevented a stroke or its recurrence.
- Age at interview:
- Is a married father of 2 adult children and 2 stepchildren. He works as a senior psychiatric nurse trainer. Ethnic background/nationality' White/Welsh.
Well, I used to enjoy smoking. I knew there was risks involved. So it's not like I was completely in the dark of the risks that I was taking because I knew I was taking risks at the time it seemed like I enjoyed it, so I smoked and that was that. You just take chances, I suppose, in life.
And how did you find having to give it up?
Well, the first 3 weeks I was basically oblivious to what was going anyway around me. Just lying on my back in bed for 3 weeks, so I didn't miss them at all then. I wasn't able to smoke then physically, so it wasn't like that I really missed the thought of it or anything, it just wasn't a possibility. It was quite easy to give up at the time.
Do you have any advice for anybody else that, that is still a smoker?
I'd say it's not worth it, no. It's easier to give up smoking than live in a wheelchair' I know a couple of the people I was playing football with that night gave up smoking afterwards as well, just because of the shock and, and the fear in what they saw. They thought, 'No, it's not worth it' so maybe in some ways, it did some good to some friends and maybe it's been something that's made it less likely that their health will be damaged.
- Age at interview:
- Is a divorced career counsellor but is not working due to strokes. Ethnic background/nationality' White/English.
Well, I was a smoker actually, I thought, I know this, sounds like you're justifying yourself really, but I don't drink alcohol obviously and I used to say, 'You've got to do something naughty' which is a pathetic excuse really but when I had the stroke and became paralysed, I stopped smoking, because you can't ask, actually ask for a cigarette, 'Can I have a cigarette?' when you're in intensive care, paralysed. And it was such a traumatic experience, I didn't even think about a cigarette and actually I didn't want one and I stopped and I was delighted. I thought, 'Wonderful, I've stopped smoking, great, why did I ever bother doing that?'
But then, as it happens, in August of that year, I was put back in the hospital again very, being very ill with, they thought it was epilepsy but I think it was a migraine. And I thought I was going to die actually. The, what was happening to me was making me so ill at the time I literally thought I was dying, and, this is a piece of kind of self destructive negative behaviour really, which is when I'd, recovered enough in the hospital ward and that was in the days when you could, they had smoking rooms in hospitals, [takes deep breath], I remember thinking, 'Right, that's it, I've had enough, I'm sick to death of hospitals and all this stuff, I'm going to do something defiant.' Which is a defiant negative thing to do, which I admit is highly unintelligent and I went into the smoking room and actually sitting in the smoking room was an alcoholic who had, I'd listened to them stand around his bed and tell him if he didn't stop drinking, he was going to die, and he was going to die. And I looked at this alcoholic and I said, 'Have you got a fag, have you got a cigarette?' [laughter], and he gave me one and I sat smoking with this, he was a street drunk and I said, 'I'm a recovering alcoholic actually' and I don't think he believed me but I started to smoke again and I wish I never had, you know, and I really want to stop and it really annoys me. It really, really annoys me. Yeah.
- Age at interview:
- Age at diagnosis:
- Mr. Singh is a 65 year old retired postmaster. He experienced several strokes (the first one in 2003 and the last one 2010). His ethnic background is Indian Muslim.
Although most people felt that they had only ever drunk alcohol in moderation a few had to cut back. This could sometimes have an impact on people's social life, although most felt they could still enjoy the company of friends without drinking or drinking less than before. Others only drank moderately on special occasions.
- Age at interview:
- Is a single man with no children and is a retired postman. Ethnic background/nationality' White/English.
I mean, I don't drink, I have, don't drink hardly any now, I have a, you know, couple of pints but not a lot. They said don't drink too much, [my friend] says don't have too much, I have, I have 2, if I go out, I have a couple of pints. They said you can have 2 and a half, you know and people say, 'Come on, have another' 'No, I don't want one' I'll just keep to two.
Diet and healthy eating
As well as taking cholesterol reducing medication many people had been advised to reduce the amount of fat in their diet. Some had also been advised to reduce salt, particularly those with high blood pressure. A few people had also found out that they were diabetic and needed to reduce sugar in their diet.
It was sometimes hard to know what to cut back on. Some people had got advice from a dietitian or from the nurses in the hospital or local surgery. Generally people said they had cut out fried food and now grilled things instead and that they had cut back on cheese, cakes and biscuits. Some found it best to keep things like sweets and chocolate for special occasions.
A few people said they now used a low fat spread or one that was meant to help reduce cholesterol. For more on and stroke see the Stroke Association's website.
Monitoring blood pressure
People were generally more aware of getting their blood pressure checked and attended a clinic or their doctors regularly. Sometimes people were asked to take a blood pressure monitor home with them, usually because they had an unusually high reading which could possibly have been brought on by worrying about the test. A few people had purchased or had access to machines to monitor their own blood pressure. One man found this very reassuring, but another woman said she had become obsessed with checking her blood pressure which only made her worried.
- Age at interview:
- Is divorced with 4 adult children and she is a retired carer. Ethnic background/nationality' White/Scottish.
And how do you find your GP?
Oh, she's lovely, yeah. Very good.
And has she given you any information about stroke?
Not really, no. You just get weighed and they take your blood test and' what was the other thing? There was another thing oh, I had to take a urine test only the once and it was alright and blood tests and my blood pressure. When I started to go there, oh, it was sky high' and but then again, I told, I said to them the first time I went, they said, 'Oh, it's very, very high'. I said, 'I never slept last night'. So uptight at going, you know. So they gave me a machine home with me and I had to do it myself night and morning and write what the things were. She said, 'Oh you're perfect at home. It's just when you come here' [laughs]. But the last time I went, they said, 'yeah, I wish my blood pressure and that was like yours [own name]' she said, she said, 'I'm so, so pleased' so, yeah, it's good.
Although there is no proven link between stress and stroke a few people felt that stress may have contributed to their high blood pressure and had given up stressful jobs or voluntary work. One man who had seen a psychologist used breathing to help reduce stress and others had paid for complementary therapies such as massage and reiki.
The effects of the stroke itself made taking more exercise difficult for some and older people in particular mentioned that they had cut back on activities generally and went out less than they used to. Some explained that although they knew they should exercise they did not because it was too difficult to fit in, or seemed like too much hassle. One person described how he did not exercise much, even though he knew he should, but balanced that with a healthy diet and taking prescribed medications.
- Age at interview:
- Is a married father of 2 adult children and a retired industrial training manager. Ethnic background/nationality' White/English.
I think in terms of health, I did swim and I used to jog, I told you that before but no, not more, no. I don't think so. Partly because I've had a problem with my knee as well. Which has caused some sort of a problem with that and it's not been able to as much now but we, no, and of course my wife can't too much walking. She can walk a bit, so we don't sort of go out, you know, long hikes if you like, we don't do that because that's too much, you know, and even to go to [the local town] sometimes I'll walk down with her or sometimes I'll take the car down there and she'll walk down and I will wait for her down there, you know and perhaps if she feels good, she'll walk back. If not we have the car, I know its only a mile and a half, a mile and a bit from here but with walking round there and duh duh duh sometimes it's too much so we don't. No, I don't do enough in terms of exercise, I know that and I keep saying, I'm going to go back swimming, because swimming even though my knee's got a slight problem here I could still swim, so I'm going to try and do that. So I'm trying to look after it in terms of food. She my wife always gives us good food, decent food, and we don't have any rubbish, you know, sort of junk food, junk food, we, I think we, pretty well in terms of that. But health wise, I think I'm alright at the moment.
Those who had tried to increase their exercise did so by walking more, using exercise bikes at home, attending a gym or attending special exercise classes for people who have had a stroke.
See the Stroke Association resource sheet ‘Gentle exercise’ for more information.
Last reviewed August 2013
Last updated August 2013