How To Prevent Stroke & Manage Atrial Fibrillation | PrevMed Health (2023)

Every 40 seconds, someone in the US has a stroke. Every 4 minutes, someone dies from this condition.

That’s not all. Here are the other stroke statistics from the Centers for Disease Control and Prevention (CDC, 2020):

  • In 2018, 1 in 6 deaths from cardiovascular disease was because of stroke.
  • Over 795,000 people in the US have a stroke every year. 610,000 of these are first-time strokes. The remaining—185,000—are repeat strokes.
  • 87% of strokes are ischemic strokes. Here, blood flow to the brain is blocked, and blood supply is lost. (The other type of stroke is hemorrhagic stroke.)
  • Stroke is costly. In 2014-2015, stroke-related costs reached $46 billion per year. This amount includes the cost of healthcare services, medicines, and missed days of work because of stroke.
  • Stroke is the leading cause of serious long-term disability. More than half of stroke survivors 65 years old and above have reduced mobility.

While the above facts are worrying, there’s good news—we can prevent stroke!

In this post, we’ll discuss stroke risks and how to manage them, as well as a related condition called atrial fibrillation.

Stroke and stroke risk factors

A stroke is when the brain loses its blood supply.

Aging, family history, and genetics—these are a few factors that make a person susceptible to having a stroke. While these 3 factors can’t be stopped or reversed, there are several other risk factors that are controllable.

For a start, here’s a good list from the INTERSTROKE study (O’Donnell, 2010):

  1. History of hypertension or high blood pressure
  2. Smoking
  3. Waist-to-hip ratio
  4. Diet
  5. Physical inactivity
  6. Diabetes
  7. Alcohol intake
  8. Psychosocial stress
  9. Cardiac causes
  10. The ratio of apolipoprotein B to A1

How to Prevent Stroke

Knowing the controllable risk factors is the first step to stroke prevention. Acting to control them is the next big step.

Harvard Health Publishing provides an easy-to-understand list of things we can do to prevent stroke. I add a 7th—manage atrial fib—which should be useful for people diagnosed with atrial fib and those who may not know they have it.

1. Lower blood pressure.

High blood pressure or hypertension remains the biggest contributor to the risk of stroke in both men and women. It can double or quadruple stroke risk.

(Video) How To Prevent Stroke & Manage Atrial Fibrillation

We were unaware of how many people do have high blood pressure in the old days, as we didn’t check for high blood pressure that much back then.

When lots of people start having heart attacks and strokes, we notice that these people are likely to be hypertensive too. We then realized that high blood pressure is indeed a big risk factor. That’s why we started monitoring it.

Is hypertension a bigger risk than atrial fib?

No. A lot more people have high blood pressure problems than there are people with atrial fib.

Just look at me. I do have high blood pressure problems. I treat and control it. But since I have atrial fib, atrial fib is a much bigger stroke risk factor for me than my hypertension.

2. Lose weight.

Obesity and its linked complications raise the odds of having a stroke.

If you’re overweight, losing as little as 10 pounds can already have an enormous impact on your stroke risk. Not only that. Losing weight also has an enormous impact on prediabetes, diabetes, and heart attack risk.

3. Exercise more.

Exercise can lower blood pressure and help people lose weight.

Amazingly, exercise also stands on its own as an independent stroke reducer. In one study, stroke risk is reduced by 11% in moderately active people, and by up to 19% in very physically active ones (Diep, 2010).

There are debates, though, whether the difficulty and duration of the exercise are important. One study showed that every little activity counts, whether it’s just a leisure activity, walking, or a physically demanding task (SAFE, 2020).

On the other hand, another study stated that 30 minutes of moderate-intensity exercise is more beneficial to stroke survivors than doing an entire hour of lower-intensity exercise (Rimmer, 2009). This is one “soft” indicator that moderate to intense activity is a bigger deal for stroke prevention.

(Video) What lifestyle changes help manage AFib and prevent stroke?

So, is a more strenuous exercise better? The answer is that we don’t know for sure.

For an additional perspective, I made this video where I covered an article from Mayo Clinic.

One thing this article hinges on is on how important mitochondrial mass is in our muscle tissues. I think most of us would agree and say, “That’s probably the case.”

The bottom line here is that you can increase mitochondrial mass mostly with high-intensity interval training, followed by resistance training as a moderate second, and then by aerobic training or mild activity as a distant third.

4. Keep your blood sugar under control.

Having high blood sugar damages blood vessels. This leads to the formation of soft plaque, which could form a blood clot.

5. If you drink, do it in moderation.

Studies show that with 1 drink per day, the risk is lower. But once you get to 2 drinks, the risk goes up sharply.

I would tell you, with any addictive substance (like alcohol), if you take it every day, you would greatly increase your risk of addiction.

I know many people would say, “Well, you should have a glass of red wine each day for your heart.” While wine may help with some of these risk factors (like LDL and HDL), overall, things should be in balance.

6. Quit smoking.

You may already know this, but smoking does bring a lot of bad things to you.

It speeds up clot formation. It thickens the blood. Moreover, it increases plaque buildup.

(Video) Preventing Stroke from Atrial Fibrillation

7. Manage atrial fib.

Have you ever had this little flutter in your chest quite often? That may be nothing, but sometimes, that’s an atrial fib.

Atrial fib (also known as AF, AFib, or atrial fibrillation) is the most common abnormal heart rhythm. It can increase stroke risk by 5 to 8 times. That’s why I added atrial fib management as it’s a big part of stroke prevention.

Unfortunately, 10-20% of people with atrial fib are uncertain if they did have a stroke. One reason they are uncertain is that they don’t have those usual stroke symptoms.

I suspected that I had atrial fib because I had that little fluttering thing. I woke up one morning, and I felt this sensation of a trout flipping around in my chest. I expected it to go away, but it didn’t. I’m also aware that I have 4q25, the atrial fib gene.

Thanks to a wearable technology called iKardia, I was able to diagnose my atrial fib. This device has a little electrode that everyone can use to find out if they do have atrial fib. I plugged it in, I used it, and sure enough, I found out I have atrial fib.

Atrial fib treatment

If you know you have it, how do we treat atrial fib then?

There are several ways to do this. There are medicines for atrial fib, with different effects like restoring the heart’s normal rhythm beat rate, or preventing blood clotting (e.g., warfarin and aspirin). There’s also a procedure called catheter ablation where diseased areas of the heart are destroyed (NHS, 2018).

A cardiologist friend of mine strongly suggested that I get an ablation. He was very proud of his results. He said almost a third of his patients never need a new ablation.

But can atrial fibrillation ablation really reduce the risk of stroke?

While ablation is considered to be “a cure” for atrial fib, you should know that atrial fib has this nasty habit of coming back. That’s the reason I decided not to get an ablation.

(Video) Afib: Prevention of Stroke in AFib and Atrial Flutter

I did several other things, though. I improved my sleep. I further lost weight. I increased my exercise. In the end, there are lots of things in terms of lifestyle that are more effective than ablation, medications, or even surgery.

My name is Ford Brewer. My team and I work to prevent heart attack, stroke, cancer, and dementia. Our goal is to help you understand how to prevent major killers and disablers. Most of them are driven by the process of cardiovascular inflammation.

If you want to know more about the science of preventive medicine or you have questions about certain aspects of your health, check out our webinars, membership programs, and online courses.

If you’d like to learn about the basics of heart attack & stroke prevention for free, complete this form, and get access to our CV inflammation course.If you’re interested in how we can help you, check out our services page.


Centers for Disease Control and Prevention (CDC). Stroke Facts. CDC website. Page last reviewed September 8, 2020. Accessed October 14, 2020.

Diep L, Kwagyan J, Kurantsin-Mills J, Weir R, Jayam-Trouth A. Association of physical activity level and stroke outcomes in men and women: a meta-analysis. J Womens Health (Larchmt). 2010 Oct;19(10):1815-22. doi: 10.1089/jwh.2009.1708.

Harvard Health Publishing. 7 things you can do to prevent a stroke. Harvard Health Publishing website. Updated June 26, 2020. Accessed August 25, 2020.

National Health Service (NHS). Atrial fibrillation: Treatment. NHS website. Page last reviewed April 24, 2018. Accessed October 14, 2020.

O’Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010 Jul 10;376(9735):112-23. doi: 10.1016/S0140-6736(10)60834-3.

PrevMed. PrevMed website. Accessed October 14, 2020.

Rimmer JH, Rauworth AE, Wang EC, Nicola TL, Hill B. A preliminary study to examine the effects of aerobic and therapeutic (nonaerobic) exercise on cardiorespiratory fitness and coronary risk reduction in stroke survivors. Arch Phys Med Rehabil. 2009 Mar;90(3):407-12. doi: 10.1016/j.apmr.2008.07.032.

(Video) How to Avoid a Wheelchair - Stroke & Atrial Fib

Stroke Alliance for Europe (SAFE). 8 Facts on Exercise and Stroke Risk. SAFE website. Accessed August 25, 2020.


How can you reduce the risk of a stroke with atrial fibrillation? ›

Shang-Chiun Lee with Mercy Clinic Cardiology has seven things you can do to help lower your risk of stroke while living with AFib:
  1. Get your AFib under control. ...
  2. Exercise. ...
  3. Maintain a healthy weight. ...
  4. Avoid alcohol. ...
  5. Don't smoke. ...
  6. Keep diabetes in check. ...
  7. Get quality sleep.

What is the best way to manage atrial fibrillation? ›

Lifestyle changes often include:
  1. Eating heart-healthy foods. ...
  2. Exercising regularly. ...
  3. Quitting smoking. ...
  4. Maintaining a healthy weight. ...
  5. Keeping blood pressure and cholesterol levels under control. ...
  6. Limiting alcohol. ...
  7. Getting follow-up care.
Oct 19, 2021

Which is most recommended by guidelines for the prevention of stroke in patients with atrial fibrillation? ›

The 2 drugs which are indicated for stroke prophylaxis in patients with AF are warfarin and aspirin. For primary prevention, warfarin reduces the risk of stroke approximately 68%. Aspirin therapy is less effective, resulting in a 20 to 30% risk reduction.

How can I prevent atrial fibrillation naturally? ›

Examples of healthful habits to follow include:
  1. eating a healthy diet filled with fruits, vegetables, and whole grains.
  2. exercising regularly.
  3. managing high blood pressure through both medications and natural treatments, if desired.
  4. avoiding excess intakes of alcohol and caffeine.

How do you stop atrial fibrillation from happening? ›

You may be able to keep your heart pumping smoothly for a long time if you:
  1. manage your blood pressure.
  2. manage your cholesterol levels.
  3. eat a heart-healthy diet.
  4. exercise for 20 minutes most days of the week.
  5. quit smoking if you smoke.
  6. maintain a healthy weight.
  7. get enough sleep.
  8. drink alcohol in moderation.

What are the odds of having a stroke with AFib? ›

About one in three people with afib will have a stroke at some time. Those at greatest risk have other risk factors for a stroke, such as other forms of heart disease, high blood pressure, obesity, smoking, or high cholesterol.

What aggravates atrial fibrillation? ›

Certain situations can trigger an episode of atrial fibrillation, including: drinking excessive amounts of alcohol, particularly binge drinking. being overweight (read about how to lose weight) drinking lots of caffeine, such as tea, coffee or energy drinks.

How can I strengthen my heart with AFib? ›

Once you've warmed up, try exercises such as power walking, jogging, or hiking to get a good workout without overloading your heart. Riding an exercise bike or using an elliptical machine or treadmill are also safe workouts for people with AFib. Lifting light weights can also be a good workout.

What is the most common cause of atrial fibrillation? ›

Problems with the heart's structure are the most common cause of atrial fibrillation. Possible causes of atrial fibrillation include: Coronary artery disease. Heart attack.

What are 3 ways to prevent a stroke? ›

Prevent Stroke: What You Can Do
  • Choose healthy foods and drinks. Choosing healthy meal and snack options can help you prevent stroke. ...
  • Keep a healthy weight. ...
  • Get regular physical activity. ...
  • Don't smoke. ...
  • Limit alcohol. ...
  • Check cholesterol. ...
  • Control blood pressure. ...
  • Control diabetes.
Apr 5, 2022

Does everyone with AFib need blood thinners? ›

Research suggests that about 10 percent of AFib patients don't need blood thinners because their risk of having a stroke is so low. National data also suggests that an additional 20 percent of AFib patients are not taking a blood thinner when they should be.

Which factor places a patient with atrial fibrillation at highest risk for stroke? ›

Previous stroke or transient ischemic attack (TIA) is perhaps the strongest independent risk factor for stroke in patients with AF. Studies have shown that this risk is increased by 2.5-fold following a previous stroke of TIA [55].

Is walking good for atrial fibrillation? ›

In fact, walking can prove quite beneficial to the health and longevity of a person living with AFib. Why? Aside from its long-term health benefits, such as lower blood pressure and resting heart rate and improved mental well-being, walking can help reduce the onset of AFib symptoms.

Can atrial fibrillation just go away? ›

Atrial fibrillation might come and go (paroxysmal atrial fibrillation), but sometimes it doesn't go away at all. It's not life-threatening, but it's considered serious because it could create blood clots in the heart that may lead to a stroke.

Can you heal atrial fibrillation? ›

There is no definite cure for AFib. The rhythm can be controlled with medicine, ablation and blood thinners and by lowering risk factors.

What is the main reason that AF can cause strokes? ›

In atrial fibrillation, the chaotic heart rhythm can cause blood to collect in the heart's upper chambers (atria) and form clots. If a blood clot in the left upper chamber (left atrium) breaks free from the heart area, it can travel to the brain and cause a stroke.

How long can you have atrial fibrillation before a stroke? ›

The ASSERT study basically said that it takes around 24 hours of silent A-Fib to develop a serious clot/risk of stroke (on average 3.1%).

Does aspirin reduce stroke risk in atrial fibrillation? ›

Patients frequently ask if aspirin is an effective blood thinner for reducing the stroke risk associated with atrial fibrillation. Currently in the American Academy of Cardiology guidelines, aspirin is listed as an option for patients with a CHADS VASC score of 1.

How much does eliquis reduce stroke risk in AFib? ›

Eliquis did just that in the landmark ARISTOTLE clinical trial published in 2011, lowering annual stroke risk in that AFib population to 1.27% compared to 1.6% with warfarin. Eliquis also had a lower risk of bleeding than warfarin in the study.


1. Stroke Prevention in Patients with Atrial Fibrillation (Afib)
(University Hospitals)
2. Treatments for stroke prevention in atrial fibrillation
(Arrhythmia Alliance)
3. Preventing Strokes in Patients with Atrial Fibrillation
(Stanford Health Care)
4. Natural Blood Thinners for Atrial Fibrillation/Stroke Prevention
(Ford Brewer MD MPH)
5. Preventing Atrial Fibrillation (AFib) Related Strokes
(Alliance for Aging Research)
6. An Option for Preventing Stroke from Atrial Fibrillation (AFib)
(Sharp HealthCare)
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