Cerebral infarction (stroke) is the “No. 1 Preventable Disease”—with appropriate measures, you can reduce your risk of onset by half or more. Focusing on the three major risk factors for stroke in Japan—High Blood Pressure, Smoking, and Atrial Fibrillation (AFib)—will significantly influence your future health.
Cerebral Infarction Prevention Methods
| Priority | Prevention Method | Specific Actions to Take | Stroke Risk Reduction Effect (Evidence) |
| ★★★★★ | Lowering Blood Pressure | * Home BP: Aim for <135/85 mmHg (Clinic: <140/90 mmHg) * Limit salt intake to ≤6g per day * Continue taking antihypertensive drugs as directed by your doctor | Treating hypertension reduces stroke risk by 40−50% (The largest effect). |
| ★★★★★ | Smoking Cessation | Quit tobacco completely. | Risk becomes nearly the same as non-smokers after 5 years of cessation. |
| ★★★★★ | Detecting and Treating AFib | * Make a habit of checking your pulse if ≥50 years old. * Suspected arrhythmia → Get a 24-hour Holter ECG. * If detected → Start DOAC immediately. | Anticoagulants reduce cardioembolic stroke risk by 70%. |
| ★★★★☆ | Strict Diabetes Management | * HbA1c<7.0% * SGLT2 inhibitors and GLP-1 analogues are also highly effective in stroke prevention. | Good glycemic control reduces risk by 20−30%. |
| ★★★★☆ | Treating Dyslipidemia | * LDL Cholesterol<100 mg/dL * Statin OR Ezetimibe / PCSK9 Inhibitor. | Statins reduce risk by 25−35%. |
| ★★★☆☆ | Regular Exercise | ≥30 minutes of brisk walking or moderate exercise per day. | Regular exercise reduces risk by 30%. |
| ★★★☆☆ | Addressing Obesity | * Aim for BMI<25 * Waist circumference: Male <85 cm, Female <90 cm (Japan standard). | Resolving metabolic syndrome reduces risk by 20−40%. |
| ★★★☆☆ | Moderate Alcohol Intake | ≤20g pure alcohol per day. Take ≥2 alcohol-free days per week. | Excessive drinking increases BP ↑ and AFib ↑, raising risk. |
| ★★☆☆☆ | Treating Sleep Apnea (SAS) | Get tested if you snore and have daytime sleepiness. Start CPAP treatment. | SAS treatment reduces stroke risk by ≈50%. |
Age-Specific Priority Prevention Checklist
| Age | Highest Priority Action |
| 40s | Quit smoking + Start monitoring BP + Establish exercise habits. |
| 50s | AFib screening (Pulse check) + Check cholesterol and blood sugar in health checkups. |
| 60s and Over | BP control, AFib control, and Fall Prevention (Strength training + balance exercises). |
Prevention Methods Receiving Special Attention
- Early Detection of AFib with Wearable Devices
- Arrhythmia notification functions on Apple Watch, Fitbit, Galaxy Watch, etc., are covered by some insurance.
- → Detection → Immediate DOAC initiation can prevent stroke.
- Polypill (Multiple Medications in One Tablet)
- A single pill combining BP medication, cholesterol medication, and aspirin is being introduced in some areas.
- → Greatly reduces missed doses and enhances prevention efficacy.
- Evolution of Low-Sodium Foods
- The use of potassium salts and umami seasonings makes “low-sodium yet delicious” the norm.
“Immediate Prevention Checklist” You Can Do Today at Home
- Buy a blood pressure monitor and measure morning/evening (See a doctor immediately if ≥135/85).
- Throw away your cigarettes NOW.
- Walk for 30 minutes a day (Take the stairs instead of the elevator).
- Use a salt calculation app to aim for ≤6g per day.
- Check your pulse for 10 seconds to ensure it’s regular (not too fast, slow, or skipping beats).
- Review your health checkup results for Cholesterol, Blood Sugar, and HbA1c.
Cerebral infarction is the “No. 1 Preventable Disease.” Many people can halve their risk of onset in the next 10 yearsjust by making small changes to their lifestyle!
