No one likes to think about having a stroke. But maybe you should. The grim reality: Stroke strikes about 800,000 Americans each year and is the leading cause of disability.

Now for the remarkable part: About 80% of strokes can be prevented. You may think that you've heard it all when it comes to preventing strokes-it's about controlling your blood pressure, eating a good diet and getting some exercise, right? Actually, that's only part of what you can be doing to protect yourself. Surprising recent. findings on stroke-and the latest advice on how to avoid it...

Even "low" high blood pressure is a red flag. High blood pressure-a reading of 140/90 mmHg or higher-is widely known to increase one's odds of having a stroke. But even slight elevations in blood pressure may also be a problem.

An important recent study that looked at data from more than half a million patients found that those with blood pressure readings that were just slightly higher than a normal reading of 120/80 mmHg were more likely to have a stroke.

Any increase in blood pressure is worrisome. In fact, the risk for a stroke or heart attack doubles for each 20-point rise in systolic (the top number) pressure above 115/75 mmHg-and for each 10-point rise in diastolic (the bottom number) pressure.

My advice: Don't wait for your doctor to recommend treatment if your blood pressure is even a few points higher than normal. Tell him/her that you are concerned. Lifestyle changes-such as getting adequate exercise, avoiding excess alcohol and maintaining a healthful diet-often reverse slightly elevated blood pressure. Blood pressure consistently above 140/90 mmHg generally requires medication.

Sleep can be dangerous. People who are sleep deprived-generally defined as getting less than six hours of sleep per night-are at increased risk for stroke.

What most people don't realize is that getting too much sleep is also a problem. When researchers at the University of Cambridge tracked the sleep habits of nearly 10,000 people over a 10-year period, they found that those who slept more than eight hours a night were 46% more likely to have a stroke than those who slept six to eight hours.

It is possible that people who spend less/ more time sleeping have other, unrecognized conditions that affect both sleep and stroke risk.

Example: Sleep apnea, a breathing disorder that interferes with sleep, causes an increase in blood pressure that can lead to stroke. Meanwhile, sleeping too much can be a symptom of depression-another stroke risk factor.

My advice: See a doctor if you tend to wake up unrefreshed... are a loud snorer... or often snort or thrash while you sleep. You may have sleep apnea. (For more on this condition, see page 351.) If you sleep too much, also talk to your doctor to see if you are suffering from depression or some other condition that may increase your stroke risk.

What's the sweet spot for nightly shut-eye? When it comes to stroke risk, it's six to eight hours per night.

What you drink matters, too. A Mediterranean-style diet-plenty of whole grains, legumes, nuts, fish, produce and olive oil-is perhaps the best diet going when it comes to minimizing stroke risk. A recent study concluded that about 30% of strokes could be prevented if people simply switched to this diet.

But there's more you can do. Research has found that people who drank six cups of green or black tea a day were 42% less likely to have strokes than people who did not drink tea. With three daily cups, risk dropped by 21% .. The antioxidant epigallocatechin gallate or the amino acid L-theanine may be responsible.

Emotional stress shouldn't be poohpoohed. If you're prone to angry outbursts, don't assume it's no big deal. Emotional stress triggers the release of cortisol, adrenaline and other so-called stress hormones that can increase blood pressure and heart rate, leading to stroke.

In one study, about 30% of stroke patients had heightened negative emotions (such as anger) in the two hours preceding the stroke.

My advice: Don't ignore your mental health-especially anger (it's often a sign of depression, a potent stroke risk factor). If you're suffering from "negative" emotions, exercise regularly, try relaxation strategies (such as meditation) and don't hesitate to get professional help.

Be alert for subtle signs of stroke. The acronym "FAST" helps people identify signs of stroke. "F" stands for facial drooping-does one side of the face droop or is it numb? Is the person's smile uneven? "N' stands for arm weakness-ask the person to raise both arms. Does one arm drift downward? "S" stands for speech difficulty-is speech slurred? Is the person unable 'to speak or hard to understand? Can he/she repeat a simple sentence such as, "The sky is blue" correctly? "T" stands for time-if a person shows any of these symptoms (even if they go away), call 911 immediately. Note the time so that you know when symptoms first appeared.

But stroke can also cause one symptom that isn't widely known-a loss of touch sensation. This can occur if a stroke causes injury to the parts of the brain that detect touch. If you suddenly can't "feel" your fingers or toes-or have trouble with simple tasks such as buttoning a shirt-you could be having a stroke. You might notice that you can't feel temperatures or that you can't feel it when your feet touch the floor.

It's never normal to lose your sense of touch for an unknown reason-or to have unexpected difficulty seeing, hearing and/or speaking. Get to an emergency room!

Also important: If you think you're having a stroke, don't waste time calling your regular doctor. Call an ambulance, and ask to be taken to the nearest hospital with a primary stroke center. You'll get much better care than you would at a regular hospital emergency room.

A meta-analysis found that there were 21% fewer deaths among patients treated at stroke centers, and the surviving patients had faster recoveries and fewer stroke-related complications.

My advice: If you have any stroke risk factors, including high blood pressure, diabetes or elevated cholesterol, find out now which hospitals in your area have stroke centers. To find one near you, go to

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