After a stroke, you may suddenly find yourself taking several tablets every day. But often we aren't clear about what each tablet does and why. Many of the medicines prescribed after a stroke have one very important job — reducing your risk of another stroke. Here are some of the common ones: 🩸 CLOPIDOGREL / ASPIRIN — stopping platelets sticking together If you’ve had an ischaemic stroke — a stroke caused by a blood clot blocking an artery — you will often be prescribed an antiplatelet medicine. The most common long-term medication is clopidogrel. Aspirin is another antiplatelet and is commonly used immediately after an ischaemic stroke or TIA. Some people take aspirin instead of clopidogrel, and in certain situations aspirin and clopidogrel may be used together for a short period. These medicines make platelets less likely to stick together and form another clot. ❤️ APIXABAN, RIVAROXABAN, DABIGATRAN or EDOXABAN — preventing clots from the heart These belong to a group called DOACs — Direct Oral Anticoagulants. They are particularly important if your stroke was associated with atrial fibrillation (AF). AF causes the heart to beat irregularly. Blood can pool inside the heart, allowing a clot to form. That clot can then travel to the brain and cause a stroke. DOACs reduce the ability of the blood to form these dangerous clots. They include: • Apixaban • Rivaroxaban • Dabigatran • Edoxaban Some people need warfarin instead — for example, in certain types of heart-valve disease or with a mechanical heart valve. Importantly, anticoagulants and antiplatelets are not the same thing, and most people do not need both long-term unless there is another reason. 🫀 ATORVASTATIN and other statins — reducing cholesterol and stabilising arteries Statins are not simply “cholesterol tablets”. After an ischaemic stroke or TIA, a high-intensity statin such as atorvastatin is commonly prescribed to reduce the risk of another event. Lowering LDL cholesterol reduces the chance of cholesterol-rich plaques (artery deposits) growing or causing further problems in your arteries.

Hi everyone. I'm currently reviewing the support that we provide to our stroke survivors in the NHS, through this community and beyond. I have lots of ideas for things that might help, but rather than starting with my ideas I'd like to start by understanding what the biggest issues that need improving are. Please could I ask all of the stroke survivors in this community to think about the following and post your thoughts below, if you are happy to? 1. What did you need after your stroke that wasn't provided for you? 2. How long after your stroke was it when you were ready to really engage with information about your stroke? 3. Did you feel that you understood what to do to prevent a future stroke? 4. What do you wish you were offered/given/told about your stroke but wasn't? 5. If you could go back in time to when you were leaving hospital what would you tell yourself then? 6. If you were designing a service to help stroke survivors what would it look like? 7. What would have made you engage with stroke prevention before your stroke? Thank you for your consideration.

This isn’t strictly a stroke-prevention post. It’s a dementia-prevention post. But Stroke‑Proof is ultimately about protecting the brain—and looking after your hearing and eyesight may be a more important part of that than most people realise. The 2024 Lancet Commission estimated that addressing 14 modifiable risk factors could potentially prevent or delay around 45% of dementia cases. Two of those factors involve our senses: 👂 Hearing loss in midlife was estimated to account for around 7% of dementia cases at population level. 👁️ Untreated vision loss in later life was estimated to account for around 2%. Why might our senses affect the health of our brain? Think about how much stimulation reaches your brain through your eyes and ears. Every conversation you follow, face you recognise, book you read and environment you navigate activates complex networks of brain cells. When hearing or vision deteriorates, several things may happen: • The brain receives less sensory stimulation. • It has to work harder to interpret incomplete information. • People may withdraw from conversations and social activities. • Reading, exercise, travel and other cognitively stimulating activities can become more difficult. • Reduced input may contribute to changes in the brain regions that process sensory information. It may therefore be partly a case of maintaining the connections that keep our brain circuits active—continuing to stimulate the wiring rather than gradually allowing those pathways to become less active. In the ACHIEVE randomised trial, treating hearing loss did not significantly slow cognitive decline across the entire study population. However, among participants already at higher risk of cognitive decline, a hearing intervention slowed cognitive decline by 48% over three years. For vision, one study of more than 3,000 older adults with cataracts found that cataract surgery was associated with a 29% lower risk of subsequently developing dementia. That cannot prove that the surgery caused the reduction, but it strengthens the case for taking treatable vision loss seriously.

Welcome to Week 2 of our series courtesy of Prof Chatterjee on diabetes and insulin resistance. You will find the post attached below. Please comment and let us know your thoughts below. Have a great week and keep doing all the great stuff that you are doing!

Hello everyone, Nik and I, together with the Stroke Prevention Team in our local stroke service have been developing a three-session Secondary Stroke Prevention Programme for stroke survivors and their families. Before we launch the pilot, we'd like to make sure we're focusing on what matters most to stroke survivors and their families. Please have a look at the programme outline. We'd love to hear any suggestions or advice that could help make the programme as useful and practical as possible for stroke survivors and their families. Secondary Stroke Prevention Programme (Pilot) Aim: To improve stroke survivors' knowledge, confidence and self-management skills to reduce the risk of recurrent stroke through education, behaviour change and ongoing peer support. Target audience - stroke survivors - Family members encouraged to attend - Format - Three weekly group sessions - 90 minutes each - Interactive, discussion-based sessions combining education with practical self-management strategies Session 1 Understanding My Stroke Objectives Participants will: - Understand what happened during their stroke - Understand why their stroke occurred - Recognise their own stroke risk factors - Begin reflecting on their personal recovery journey Topics · Welcome and programme overview · Brief introduction to what is stroke, types, How stroke affects the brain and causes symptoms, Recovery after stroke, Why another stroke can happen · Understanding personal risk factors- introduction to stroke risk factors · Personal stroke story and group discussion Session 2 Protecting My Brain Objectives Participants will: - Understand the main medical treatments that prevent another stroke - Gain confidence in monitoring important risk factors - Feel confident taking prescribed medications Topics - Antiplatelets and anticoagulants - Medication adherence, managing side effects and knowing when to seek advice - Blood pressure: understanding targets and home monitoring - Cholesterol and statin therapy - Atrial fibrillation and stroke prevention