Medically Approved

What every stroke survivor should know about preventing a second one

Man and woman jogging on street to prevent a second stroke

About 25% of people who have a stroke will go on to have another. But you can take steps to lower your risk.

Hallie Levine

By Hallie Levine

If you’ve had a stroke, your main concern is to make sure you don’t have a second. Unfortunately, 1 in 4 stroke survivors will. Yet there is good news: About 80% of all strokes can be prevented through a combination of medication and lifestyle habits such as a healthy diet and regular exercise, according to the American Stroke Association.

“Lifestyle is one of the most important things out there in terms of preventing a stroke,” says Nieca Goldberg, MD. She’s the medical director of Atria NYC and a clinical associate professor of cardiology at New York University.

If you’re using medication to manage your stroke risk (or any other condition), Optum Perks may be able to help you save money. Download our prescription discount app to see if you can find a lower price.

And keep reading for 6 things you can do to reduce your odds of a second stroke.

Start monitoring your blood pressure

Hypertension is a huge risk factor for a second stroke. But if you lower your systolic pressure (the top number) by 10 points, you can reduce your risk of stroke by 27%. This is according to a meta-analysis published in The Lancet.

To help keep you on track, Dr. Goldberg recommends using an at-home blood pressure monitor. The monitor itself won’t reduce your blood pressure, of course. But daily testing can help you begin to see how your habits affect your heart so that you can do more of what’s working.

A study presented in February at the American Stroke Association’s annual meeting shows monitors in action. Stroke survivors who used an at-home monitor for 12 weeks (in addition to attending video visits with their care team) were about 3 times as likely as non-testers to get their blood pressure under control.

Feed your heart the right foods

To keep your blood flow strong and reduce your risk of a second stroke, the American Heart Association (AHA) recommends that you follow a Mediterranean-type diet. And the National Institutes of Health has a DASH diet, which is similar. It stands for Dietary Approaches to Stop Hypertension.

Both diets focus on plant foods: fruits, vegetables, whole grains and beans. The NIH also recommends healthy sources of fat such as nuts, fatty fish and olive oil.

If you eat these foods in place of red meat, pastries and fried foods, you can expect your stroke risk to drop. And while you’re at it, cut back on sodium. Dr. Goldberg recommends limiting your intake to less than 1,500 mg a day.

Recommended reading: Learn to recognize the signs of a stroke.

Do a cardio workout every other day

If you’ve had a stroke, it’s more important than ever to stay active, says Alon Gitig, MD. He’s the director of cardiology at Mount Sinai Westchester in Scarsdale, New York.

The AHA recommends that all stroke survivors aim for 40 minutes of aerobic exercise 3 to 4 times per week, when able. This could be moderate intensity, such as brisk walking. Or vigorous, such as running or cycling. The most important part: Do what’s right for you. You may need to get the all-clear from your doctor, or do a cardiac rehab program, before you try this on your own.

If you sit a lot for work, the AHA also presents evidence that you can improve your blood pressure by standing and walking around for about 3 minutes after every half hour of sitting. (Check out these 16 little ways to lower your blood pressure.)

Take all your medications

If you have a stroke, your doctor will put you on certain medications to help prevent another. These medications work to prevent future blood clots from forming. There are 2 main options:

Recommended reading: Easy ways to never forget a dose of medication.

Avoid air pollution

Almost 30% of strokes can be tied to air pollution, according to a study published in The Lancet Neurology.

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If you live in a polluted city, there’s not much you can do about the air. An indoor air purifier may help, but there’s not enough research to know for sure, according to the Cleveland Clinic.

In the meantime, check the daily air pollution forecasts in your area at, and try to avoid prolonged time outside when the pollution spikes.

Quit smoking and drinking

If you haven’t already kicked your vices, now’s the time to start. Smoking just a handful of cigarettes a day raises your risk of developing a stroke by 68%, according to a study published in the Journal of the American Heart Association.

And if you’ve already had a stroke, you need to lay off the booze, too — even moderate alcohol intake (think a drink or 2 a day) can raise blood pressure, says Dr. Goldberg.

Getting your health under control isn’t always easy, but we want to help. So download our Optum Perks discount card. It’s free, it’s accepted at more than 36,000 U.S. pharmacies, and it could help you save money on medication.


Additional sources
Second stroke stats: American Stroke Association
Blood pressure and stroke risk: The Lancet (2016). “Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis"
How at-home monitoring helps blood pressure: American Heart Association
American Heart Association stroke prevention recommendations: Stroke (2021). “2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association"
Stroke and air pollution: Lancet Neurology (2016). “Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013
Air filters and health: The Cleveland Clinic
Smoking and stroke risk: Journal of the American Heart Association (2019). “Impact of Smoking Status on Stroke Recurrence