Good afternoon. I have some exciting news. My colleague Dr Ali Sheikh is hosting a stroke prevention seminar on Friday the 30th January at Aintree hospital, Liverpool 9am to 5pm. There will be some high profile speakers talking about stroke prevention. We'd love it if you can attend. I think there will be face to face and online options. We're also looking for 2 stroke survivors to talk briefly and share their story with the audience of anyone is willing to volunteer. Have a great evening. Nik

Chronic stress is a major cause of stroke and is one of the 10 factors identified by the INTERSTROKE study that cause 90% of strokes. However, most people have no way to catch rising stress. We usually spot it when it's too late. So today's tip: Once a day ask yourself: “Am I reacting more than I’m responding?” If yes → use 30 seconds of slow breathing or a short walk. It’s a simple cue that interrupts stress-driven cortisol surges. Then use the headspace you've bought to do something constructive that will meaningfully reduce your stress going forward. Tackle the underlying cause of your stress.

This tip is a little different. I wanted to share something I've been using recently during the resident doctor strikes that has really helped me to make sure I'm not missing anything for our stroke patients. It's a mnemonic that covers most of the things we need to check in stroke patients to help prevent future strokes. You might use it to make sure you had all the right tests, or medical professionals in the group might want to use this on the ward. BALD DADDIES B - Blood pressure optimised A - Antiplatetlets (Aspirin or Clopidigrel) or Anticoagulation L - Lipids (cholesterol) treatment D - check for or optimise diabetes D - Doppler scan of neck arteries A - AF screen - ECG and heart monitor D - Diet and Drink advice D- Driving advice I - Info leaflet on Stroke E - Exercise advice S - Smoking cessation advice Let me know what you think!!

I've already mentioned the importance of avoiding inactivity several times, but it's not all about formal exercise. In fact, most of your daily calorie burn doesn’t come from workouts — it comes from NEAT: 🧍‍♂️ Non-Exercise Activity Thermogenesis. That means all the movement you do outside of formal exercise — walking to meetings, standing while on the phone, tidying up, pacing when you think, gardening, carrying shopping... ♥️ I've even read one study that suggests fidgeting might be a major reason why some people keep weight off easier than others! 👉 Research shows that people with higher NEAT have lower blood pressure, lower insulin resistance/diabetes risk, and a reduced risk of stroke and heart disease — even when their gym time is the same. 👉 Sitting for long stretches, on the other hand, is linked to higher all-cause mortality, regardless of exercise levels. 🧠 How to integrate this: Find 3 extra ways to move more in your normal day. Here are some ideas: 🚶 Park further away (I always park at the top of the multistorey at work and make myself take the stairs) or get off the bus one stop early ☎️ Take phone calls standing or walking 🪑 Set a timer to stand every 30–45 minutes 📺 March on the spot during TV ads 🧹 Do one 5-minute tidy-up sprint before bed Each small movement nudges your metabolism, circulation, and blood pressure in the right direction. Over time, these micro-movements compound. Let me know what you're going to try!

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