I’m a stroke doctor. Here’s how I reduce my own risk

For the first time, new guidelines by the American Stroke Association have highlighted the risks of stroke faced by women. They reference hormone-related conditions like endometriosis, as well as early menopause, pre-term births and estrogen prescribed for transgender women.

They also call attention to longer-established risks that are associated with poverty, stress, diet and exercise.

Lauren Patrick, MD, assistant clinical professor in Neurology at UCSF’s Weill Institute for Neurosciences, has studied brain vessel blockage that can lead to strokes and how to triage strokes for best results. And as a woman of color, she’s acutely aware of the risks, as well as the health disparities affecting Black Americans – who are 50% more likely than white Americans to suffer from stroke and 45% more likely to die.

First, what causes a stroke and how many people are affected each year?

A stroke is triggered by a disruption of blood flow to the brain, or brain bleeding, causing devastating disability and death at its most extreme.

There are approximately 800,000 cases each year, of which 57% occur in women. Most patients are over 65, but incidents are rising in those under 50, according to the updated guidelines released in October 2024.

Are patients doing better with stroke these days?

Generally, yes. More patients are surviving, but it depends on the type of stroke. Large vessel occlusion (LVO) is a less common but more serious stroke caused by the blockage of a major artery in the brain. Patients with LVO require prompt treatment at a specialized stroke center offering endovascular thrombectomy. This clears the blocked artery.

Our research shows that stroke severity tools, LVO diagnostic devices and mobile stroke clinics, used in prehospital settings, such as ambulances, improve outcomes for patients with LVO.

Risks for stroke start as early as childhood. What risks were you exposed to?

I grew up in a food desert, where most of our meals were processed, and there were few fresh fruits and vegetables available. It wasn’t until I attended Columbia University that I realized people ate differently. That was a big shock to me. That experience transformed my understanding of food and nutrition. After graduating, I taught myself to cook.

Many older adults in my family have stroke risk factors, like high blood pressure, high cholesterol, kidney disease and diabetes. I have endometriosis, a condition in which tissue grows outside the uterus, causing pelvic pain and irregular periods. This can disrupt hormones, raising blood pressure and cholesterol. That made me more mindful of managing what I can to lower my risk.

Now, I meal prep every Sunday. For breakfast, I might have eggs with mushrooms, broccoli and sausage. For lunch, I might prepare a black tofu pepper dish with rice. And dinner, I’ll make chicken with cauliflower. I often follow recipes from The New York Times.

What do you do to maintain good heart health?

I get up at 5 a.m. every day to exercise. It’s not that I don’t love sleeping, but I know that I’ll feel better afterwards. I never regret a good workout. My first love is weightlifting; I’m pretty strong. I enjoy the challenge of reaching new lifting goals. I’ve learnt that it’s not the physical limits that hold you back, it’s the mental block. I remind myself to silence those thoughts, and it feels amazing when I break through and hit a new milestone.

I enjoy indoor cycling and Pilates. While I don’t consider myself a runner because I’m not particularly fast, I like the way it makes me feel.

You mention stress. How do you care for your mental health?

My job can be very stressful. I meet patients on the worst day of their lives – after they’ve had a stroke. To manage, I meditate and practice gratitude. My interactions with patients enable me to I find reasons to be grateful each day. I also engage in talk therapy, which has been invaluable for processing challenging cases. I encourage my patients to consider therapy or support groups. Stroke is traumatic and recovery can be a long, difficult process.

How does your life experience help you interact with patients?

My background gives me a unique skill set. It helps me connect with my patients on a deeper level. I’m able to be vulnerable with them because I truly understand their circumstances.

Instead of telling patients that they need to eat better, I ask them what changes they can realistically make to their diet. This extends to smoking and alcohol. With physical activity, I encourage them to find a way to move their bodies that brings them joy. For some, it might be walking around the neighborhood with a friend and grabbing a coffee, then making that a more regular habit.

Does just asking them work? What if they don’t follow through?

I’m a strong believer in habit formation, the process through which healthy actions become automatic, and encourage that. Once something becomes a habit, you don’t have to think about it, it just happens.

I’ve seen patients significantly reduce their cholesterol without medication by switching to a minimally processed diet, and others go from being sedentary to regularly exercising. Changing behavior is one of the toughest challenges. But I’m inspired to see patients who’ve had a stroke – some of them are young – who are determined to do everything they can to prevent it from happening again. Their dedication is humbling.