Certain precautionary steps for how to prevent a stroke can lower your risk and prolong your life.

Stroke is the fifth leading cause of death in the United States, so it’s in your best interests to prevent a stroke whenever possible. The encouraging news is that there are precautionary tips for how to prevent a stroke and a large percentage of ischemic strokes could be prevented by controlling risk factors.

If you have not had a stroke, but have risk factors, you can take steps to prevent a stroke. If you have already had a stroke, and your doctor has advised you on how to prevent a stroke, following your doctor’s advice could lower your risk as much as 65 percent and prolong your life. Moreover, it may improve your quality of life, since many of the same risk factors associated with stroke—particularly high systolic blood pressure, diabetes, and left ventricular hypertrophy—also are associated with cognitive decline.

Here are 11 tips on how to prevent a stroke.

Lower Your Blood Pressure

Hypertension—a reading higher than 140/90 mmHg—is the single most important modifiable stroke risk factor. Because hypertension rarely produces worrisome symptoms, it has long been called “the silent killer.” Have your blood pressure checked. If it’s high, you may need one or more drugs to bring it down. If it’s only a little higher than it should be, your doctor may recommend making dietary changes, such as lowering salt intake, and increasing aerobic exercise.

If you have an LDL cholesterol level of 100 mg/dL or more, lowering your LDL with statins can lower your stroke risk, regardless of whether your blood pressure is normal or high. If you have hypertension, lowering your LDL is even more important. Taking medications to bring down both your LDL and blood pressure as far as possible will give you the greatest protection.

Lower Your Risk for Atherosclerosis

Atherosclerosis is a major risk factor for stroke as well as heart attack. The causes of atherosclerosis are well known and include hypertension, smoking, abnormal cholesterol and triglyceride levels, diabetes, obesity, and lack of physical activity. Fortunately, there are many ways to reduce your risk of developing atherosclerosis.

Stop Using Tobacco

Smoking increases the risk of clotting by raising fibrinogen levels and making platelets stickier. Smoke irritates the lining of the blood vessels and decreases the body’s ability to dissolve clots. Quitting smoking causes stroke risk to drop fairly quickly.

Adjust Your Blood Lipid Levels

Cholesterol and triglycerides are fats (lipids) used to make cell membranes and certain hormones. Triglycerides are the body’s main energy-storage molecules and are stored in fat tissue. Although cholesterol and triglycerides are essential for life, having too much increases the risk of developing atherosclerosis. High triglycerides more than double the risk of stroke. For these reasons, cholesterol and triglycerides levels should be kept within normal limits.

Eat a Heart-Healthy Diet

A heart-healthy diet can prevent or slow the development of atherosclerosis. Most foods recommended in heart-healthy diets are low in fat and cholesterol and high in nutrients thought to provide additional protection.

Take Lipid-Lowering Drugs

Several types of drugs are available to lower total cholesterol, LDL-cholesterol and triglyceride levels. The choice of lipid-lowering drug depends on your individual situation. Your doctor will set goals for you and recommend the drug or drugs with the greatest probability of helping you meet your lipid goals.

Statins

Statins are the first-line cholesterol-lowering drugs, because they are known to reduce fatal and non-fatal ischemic strokes. Every drop of 39 mg/dL in LDL cholesterol achieved with statins lowers the risk of stroke about 21 percent. In addition to protecting against a first stroke, statins may help prevent a recurrent stroke.

Lose Weight

Obesity is a risk factor for every cardiovascular disease, including stroke. It is also a risk factor for death from stroke. In fact, the more overweight you are, the greater your risk of stroke.

The key to losing weight is to improve your food choices and eating habits. The American Heart Association and National Cholesterol Education Program recommend a diet in which only eight to 10 percent of calories come from saturated fats, 10 percent or less from polyunsaturated fats, and 15 percent or less from monounsaturated fats. Experts agree that the most successful weight-loss programs involve making changes that you can stick with over time. Losing a pound or two each week is a reasonable goal.

Be Physically Active

Regular physical activity significantly reduces your risk of any cardiovascular disease, including stroke. This effect may be largely due to the effect of exercise on reducing other risk factors, such as obesity and diabetes.

Research also suggests moderate-to-intense physical activity may protect the brain from so-called “silent strokes.” These strokes do not produce the normal stroke symptoms, but rather contribute to mental decline and dementia, and increase the risk of a subsequent stroke.

Treat Metabolic Syndrome

The term “metabolic syndrome” is used to define a cluster of risk factors for cardiovascular disease. The presence of metabolic syndrome in people with atherosclerosis increases the risk for ischemic stroke or TIA.

Metabolic syndrome is treated by addressing the individual components—losing weight, lowering cholesterol levels and blood pressure, and correcting blood sugar levels.

Watch Your Blood Sugar

Diabetes increases the risk of stroke two to eight times, and also increases the risk of heart disease and peripheral arterial disease. The longer a person has diabetes, the higher the risk for stroke.

Diabetes is primarily a disorder of sugar metabolism. People with diabetes need to take steps to control their blood sugar levels with diet, exercise, and medications.