I want to learn more about Stroke risk reduction
I have atrial fibrillation (AFib) and want to learn more about stroke risk reduction
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I have had a stroke or TIA ("mini-stroke") and want to reduce the risk of another stroke
Talking to your doctor
Working with your doctor is an important part of managing your risk of stroke. Be prepared and learn how to talk to your doctor.
What can I do to reduce my stroke risk?
About 300,000 Canadians are living with the after-effects of a stroke, such as paralysis, vision problems, and difficulties with memory and thinking. But this doesn't have to be your story. AFib puts you at a higher risk of stroke, but there are ways you can reduce your stroke risk:
Get a treatment plan for your AFib
With AFib, your risk of a stroke caused by a blood clot is 3 to 5 times what it would be otherwise. But you can take action to reduce your risk.
Talk to your doctor
to get a treatment plan that will help you manage your AFib and reduce your risk of a stroke.
Your treatment plan may involve medications
and healthy lifestyle changes. Some people may also need non-drug treatments such as catheter ablation (inserting a long, flexible tube into the heart to deliver controlled electrical pulses, which destroy malfunctioning areas of heart tissue) or electrical cardioversion (using a defibrillator to give controlled electrical pulses to "shock" the heart back into a normal rhythm).
Possible side effects of catheter ablation include pain, bleeding, or infection where the catheter is inserted. It may also cause puncture of the heart or blood clots. Electrical cardioversion side effects may include skin burns, heart rhythm problems, or dislodged blood clots.
It's very important to follow your treatment plan. If you have any questions or concerns,
talk to your doctor.
If you are a caregiver, get
tips on caring for someone with AFib.
My AF Plan
to help you take positive steps in managing your AFib.
Live a healthy lifestyle
A few simple lifestyle changes can help you live well with AFib and cut your stroke risk:
|Healthy lifestyle change
What to aim for
|How to make it happen*
|Eat healthy (good nutrition) as directed by your doctor
Each day, try to eat:
- 7-10 servings of fruits and vegetables
- 6-8 servings of grains (with at least half of these from whole grain products)
- 2-3 servings of low-fat dairy products
- 2-3 servings of lean meat or meat alternatives (such as tofu)
Don't eat too much sodium. Aim for:
- age under 50: 1500 mg/day
- age 50-70: 1300 mg/day
- age over 70: 1200 mg/day
- Buy whole-grain bread instead of white.
- Add berries to your morning cereal, carrot sticks to lunch, or a salad to dinner.
- Whenever you would usually drink pop or juice, drink water instead.
- Use healthy snacks such as precut fruit and veggies and salad in a bag.
- Cook up a large batch of healthy food on the weekend, then freeze it in meal-sized portions for the week.
- Consult your doctor before making any changes to your diet.
|Exercise as directed by your doctor
||Ask your doctor how much activity and what types of exercise are safe for you.
Check with your doctor before starting to exercise.
If your doctor gives you approval to exercise, start slowly - even 10 minutes of activity is enough to get started. Then gradually work your way up to longer exercise times:
- Today, after dinner, put on some comfortable shoes and walk around the neighborhood.
- Park a bit further from work or shopping.
- Do more gardening and physical household chores (such as vacuuming).
|Reach a healthy weight as directed by your doctor
- waist size of less than 80 cm (31.5 inches) for women or less than 94 cm (37 inches) for men
- Try eating healthy and exercising (see above) to lose weight safely.
- Consult your doctor before making any changes to your physical activity or diet.
|Use alcohol in moderation as directed by your doctor
- Limit yourself to no more than 2 drinks a day, to a maximum of 10 drinks per week for women, and no more than 3 drinks a day, to a maximum of 15 drinks per week for men.
(If you have liver disease, check with your doctor to find out your maximum recommended alcohol consumption.)
- Keep track of your drinking for a week to see if you're over the limit. One drink is:
- 341 mL (12 ounces) beer
- 142 mL (5 ounces) wine
- 43 mL (1.5 ounces) spirits
- Cut back if you are over the limit. If you are having trouble, talk to your doctor.
|Quit smoking as directed by your doctor
||Quit smoking and avoid second-hand smoke. If you are a non-smoker, do not start smoking.
- When you're ready to quit, ask your friends and family to help, and speak to your doctor or pharmacist about options to help you quit.
|Tame your stress as directed by your doctor
||Understand and control the sources of stress in your life.
- Make a list of things that make you feel stressed.
- Focus on the things that cause you the most stress, and think of ways to avoid or manage them. Try exercising if advised by a doctor (helps relieve stress), talking to a friend, taking breaks, using humour, delegating to someone else, or just saying "no."
- Consult your doctor for assistance with stress management.
|Have regular medical check-ups as directed by your doctor
||Have regular medical check-ups to make sure your AFib is being properly managed and to screen for other conditions that can increase your risk of stroke, such as high blood pressure, high cholesterol, or diabetes.†
- Ask your doctor for an appointment card. Or, better yet, carry an organizer with you to your doctor's appointment and put the appointment in your calendar as soon as it is made.
- Ask your doctor how often you need to have medical check-ups.
*These lifestyle suggestions may not be appropriate for everyone. Check with your doctor to find out which lifestyle changes you should make to reduce your risk of stroke.
†This is not a complete list of all medical conditions that can increase your risk of stroke; speak with your doctor for more information.
Use AFib medications as directed
What medications are available, and how are they used?
There are different types of medication for AFib, and each type has a different purpose:
- medications to control heart rhythm: These medications, also called antiarrhythmics, are used to help the heart beat with a more normal rhythm.
- medications to control heart rate: These medications are used to slow down the rapid heart rate seen in people with AFib. This is also called rate control.
- medications to reduce the risk of blood clots (antiplatelet and anticoagulant medications): These medications, also called blood thinners, are used to reduce the risk that a blood clot will form in the heart and travel to the brain, causing a stroke.
Talk to your doctor
to learn more about the risks and benefits of these medications.
What are the risks of these medications?
These medications may cause side effects, such as:
- medications to control heart rhythm: heart rhythm changes (sometimes the medications used to control heart rhythm can actually worsen existing arrhythmia or cause a new heart rhythm problem), headache, dizziness, visual disturbances, nausea, diarrhea, or constipation
- medications to control heart rate:
- cardiac glycosides (digoxin): depression, decreased sex drive, enlarged breasts in males, allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives), severe headache, fainting, extreme drowsiness or dizziness, irregular heartbeat, slow heartbeat, vision changes (e.g., yellow-green or blurred vision), hallucinations, abnormal behaviour, deceased appetite, diarrhea, unusual tiredness or weakness, nausea or vomiting
- calcium channel blockers: ankle swelling, flushing, headache, palpitations (typically experienced as a rapid thumping in the chest), dizziness, slow heartbeat, constipation, or heart failure (where the heart has difficulty pumping enough blood to meet the needs of the body)
- beta-blockers: fatigue, dizziness, slow heartbeat, low blood pressure, shortness of breath, decreased capacity for exercise, headache, reduction/loss of libido, depression, or heart failure
- medications to reduce the risk of blood clots: bleeding (e.g., nosebleed, bleeding from the stomach or bowel) or bruising, skin rash, upset stomach, liver disorder, or diarrhea
This is not a complete list of all possible side effects. Talk to your doctor or pharmacist for full information on side effects of a particular medication.
How can I get the most from my AFib medication?
Talk to your doctor
to make sure you know how to use your medication. Ask your doctor if there are any special instructions for your medication, such as avoiding certain medications or foods, and whether you need any routine monitoring or testing while you are on the medication.
- Take your medication as recommended by your doctor. If you find that you miss doses of medication or scheduled medical tests, talk to your doctor or pharmacist for help.
- Call your pharmacy for a refill before you run out of medication.
- If you have any
questions or concerns about your medication, ask your doctor or pharmacist for help.
- Use the
Medication Check-Up tool
to make sure you're getting the most out of your medication and see whether it's time to
talk to your doctor
about your medication.