How to prevent a second stroke

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how do you prevent a second stroke one

of the first things that you should ask

your physician if you've had a stroke

and one of the things the rehabilitation

physician or your primary care physician

ought to be thinking about after you've

had a stroke is how do I prevent a

second stroke or the next stroke if

you've had more than one stroke first

question that needs to be answered is

why did you have the stroke in the first

place so we can't ignore that because

that may lead us to exactly what we can

do to try and prevent another one if you

were an atrial fibrillation had an

abnormal heart rhythm well then it's

pretty clear that we're going to put you

on anticoagulation but other types of

strokes need other types of treatment so

that's your first question the answer

the other one to ask is are you on the

best medication to prevent another

stroke or if you're a healthcare

provider or physician watching this

video is my patient on the best

medication to prevent another stroke

were you on aspirin already was your

patient on aspirin already and do I need

to consider something else

so aspirin is first-line therapy and I

won't get into dose it can be somewhat

of a matter of opinion most people are

happy with low-dose aspirin clopidogrel

which is an antiplatelet agent and then

warfarin which is a much stronger

misnomer is it's a blood thinner but

it's an anticoagulant and then for

prevention unless we're dealing with HF

fibrillation we won't talk about the

novel anticoagulants than new drugs them

interestingly enough one of the most

important things is taking a medication

you'd be surprised how many times you

really find out that the patient isn't

accurately taking their medication for

diabetes isn't tightly controlling their

blood pressure isn't tightly controlling

their diabetes or their cholesterol and

we have fabulous medications now for

controlling diabetes hypertension and

high cholesterol

so we may need tighter control you

thought you were getting away with it

and it was okay but now we really want

to prevent that second stroke how's your

diet do you need to lose weight you're

following a good healthy diet can't

stress enough that if you smoke you need

to stop and odds are with you really

that if you change these habits these

life habits that we can work hard

together to prevent that second stroke