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Stroke prevention through medicines and surgery

3-minute read

Research has shown that several medicines can be very effective in preventing stroke. The most effective fall into 3 categories:

Antihypertensives

Lowering blood pressure to normal ranges can dramatically reduce the risk of having both types of stroke: either ischaemic (blocked artery) or haemorrhagic (bleeding in the brain).

When blood pressure cannot be controlled by lifestyle modification alone, your doctor may prescribe antihypertensive medication.

Antiplatelet agents

Platelets are a component of the blood which stick together to form a plug. This platelet plug then grows to form a blood clot that is important in stopping bleeding. Antiplatelet medicines keeping the platelets from sticking together and forming abnormal clots/p>

Aspirin is the antiplatelet drug most commonly prescribed to help prevent stroke. It is not recommended for use in haemorrhagic stroke. Some people cannot take aspirin, either because of a bleeding tendency or for some other reason.

Other antiplatelet medicines include dipyridamole, ticlopidine and clopidogrel. These medications need to be prescribed by a doctor and are for people who have had a previous stroke or transient ischaemic attack (TIA) (sometimes known as a 'mini-stroke'). They can be particularly useful for people who cannot take aspirin.

Anticoagulants

Anticoagulant medicines interfere with the production of certain blood components that are necessary for the formation of blood clots. The most effective anticoagulant for ischaemic stroke prevention is warfarin.

Warfarin helps prevent stroke by stopping existing blood clots from growing larger and by helping to prevent new clots from forming. This medication is typically prescribed for older patients with atrial fibrillation (an irregular pulse).

Stroke prevention through surgery

The two main arteries that carry blood to the brain (known as the carotid arteries) can become narrowed at a point in the neck if there is a build-up of cholesterol and other fatty material. This build-up is known as ‘plaque’.

If your carotid arteries become partially blocked, reducing blood flow to the brain, you may be advised to have surgery to prevent a stroke. The procedure, known as carotid endarterectomy, involves removing the plaque from the area of narrowing and opening the artery.

This improves blood flow to the brain and lowers the risk of blood clots or pieces of plaque breaking off and blocking the flow.

The operation is useful for people who have severe, but not total blockage of their carotid arteries. Sometimes both carotid arteries need surgery, but they are usually done one at a time in separate operations.

Results are generally very good, but the carotid endarterectomy operation itself carries a small risk of causing a stroke. With an expert surgeon, however, the benefits of the surgery can outweigh the risks. As with any major surgical procedure, discuss the situation carefully with your doctors before making a decision.

To help keep the artery open, the surgeon will sometimes put in a small, expandable tube known as stent. Again, there are risks associated with this procedure so speak to your doctors before making any decisions.

Not sure what to do next?

If you are still concerned about medical treatments to prevent stroke, why not use healthdirect's online Symptom Checker to get advice on when to seek medical attention.

The Symptom Checker guides you to the next appropriate healthcare steps, whether it’s self-care, talking to a health professional, going to a hospital or calling triple zero (000).

Last reviewed: July 2017

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