Strokes seemingly come out of nowhere and can have devastating effects on life. While many people think strokes are just a brain issue, the truth is that they’re also a heart issue. 

A stroke can result from a clot that develops in an area damaged by atherosclerosis, a buildup of plaque, and fatty deposits in your arteries. It can also result from a clot that forms elsewhere in the body (like your heart) and travels through the blood until it becomes lodged in a smaller artery within your brain.

Additionally, a transient ischemic attack (TIA) or ministroke makes it much more likely that you’ll experience a full-blown stroke within the next 90 days. TIA should be taken as a serious warning sign of an oncoming stroke if you don’t take action against your cardiometabolic risk factors. 

If you’re at risk for having a stroke, have had one (or a TIA), or are caring for someone who has, you’re probably wondering how to help offer protection against a first or subsequent stroke. 

In my experience working with clients as a cardiovascular dietitian, many people are simply told to limit their sodium intake after a stroke. There’s no conversation about what to add nutritionally for optimal vascular health and to support a healthy blood viscosity to avoid blood clots. 

Nutrition is key to stroke prevention and recovery. Starting with diet, you can ensure you’re getting enough of the best nutrients for stroke prevention. Much of the focus on nutrition is on counting macros, but it’s important to prioritize the right minerals and vitamins to prevent stroke and heart attacks. 

Note that all the nutrients I mention below are found in foods. You can work with a registered dietitian specializing in heart disease to ensure adequate amounts (not too much or too little), based on your medical history, labs, medications, and more. 

Below are 13 important nutrients for stroke prevention and how they can improve your vascular health. Plus, we’ll talk about supplements for stroke prevention. 

1. Water

Adequate water intake helps the heart pump blood more easily. Given that the heart pumps about 2,000 gallons of blood a day, water is vital for optimal heart health.

Research shows that most of the elderly who presented with stroke in hospitals were dehydrated (measured by plasma osmolarity), and those who were dehydrated had a worse outcome. This may be because when you are dehydrated, your blood thickens, reducing your blood volume and causing the heart to overwork. 

Thickened blood increases the risk of blood clots, which increases your risk of stroke. High blood pressure is also more prevalent in those who are chronically dehydrated. When your body’s cells are deprived of water, the brain signals the pituitary gland to constrict the blood vessels. 

High blood pressure is a very prominent stroke risk factor. Staying hydrated is crucial for optimal heart health and primary and secondary stroke prevention. Some people may require a fluid restriction, and the specific amount will vary per person. 

2. Omega-3 Fatty Acids

Omega-3 fats, including EPA and DHA, have potent anti-inflammatory effects. They can also reduce platelet aggregation and help reduce plaque buildup in the setting of atherosclerosis. 

One systematic literature review found that higher circulating levels of DHA were inversely associated with incident atherothrombotic stroke risk. Some research even suggests that omega-3s may offer some neuroprotective benefits among people following a stroke. 

3. Fiber

Fiber, a nutrient only found in plant foods, helps lower the risk of hemorrhagic stroke. In one systemic review and meta-analysis of eight cohort studies, consuming 7gm/day of fiber reduced the risk of stroke by 7%. 

Another meta-analysis showed that for those who consumed 3-5 daily portions of dietary fiber, their risk of ischemic and hemorrhagic stroke was reduced by 26%. 

4. Vitamin D

Research shows that Vitamin D levels are low in most people who experience a stroke, and vitamin D insufficiency is extremely common worldwide. Therefore vitamin D deficiency may be one of the risk factors for stroke. 

More research is needed to explain why and confirm the exact link between the two. However, it is still important to ensure adequate consumption or supplementation before and after an acute stroke for prevention and optimal recovery.

5. Magnesium

In a meta-analysis of seven prospective studies including 241,378 participants, an additional 100 mg per day of magnesium from food was associated with an 8% decreased risk of total stroke, especially ischemic stroke. It has also been found to be especially important in secondary stroke prevention.

This may be because of the integral role magnesium plays in positively influencing the electrical signals of the heart. This allows the heart to fill up with blood before it contracts properly — which helps optimize proper blood flow to the rest of the body. Magnesium also influences the movements of potassium, sodium, and calcium across cell membranes.

6. Potassium

In one meta-analysis, a statistical analysis that combines the results of multiple scientific studies assessed potassium levels in 11 different studies. It was found that consuming 1600 mg more potassium per day was associated with a 21% lower risk of stroke.

In another study, research showed that post-menopausal women who ate the most potassium had a 27% lower risk of ischemic stroke (the most common type of stroke). As well as a 21% reduced risk for all stroke types compared with women who ate the least potassium. 

Potassium reduces stroke by lessening the effects of salt, positively influencing blood pressure, and adding heart-healthy nutrients found in potassium-rich foods. For instance, many foods that are high in potassium also contain fiber.

7. Folate, Vitamin B6, and Vitamin B12

Consider adding more of these B vitamins to prevent stroke and heart attack. Why? 

Vitamin B6, folate, and vitamin B12 are needed to avoid high homocysteine levels. Research has shown that high levels of homocysteine, a common amino acid in the blood, can be a risk factor for the early development of heart disease and stroke. 

High homocysteine levels accelerate atherosclerosis formation. It also negatively impacts the endothelium (the tissue that lines blood vessels, heart, and lymphatic vessels) and smooth muscle cells. This means that elevated homocysteine can negatively change the arteries’ structure and function.

8. Vitamin C

Vitamin C isn’t just a vitamin—it’s also a powerful antioxidant. Getting enough vitamin C in your diet helps protect your cells against oxidative stress, which is important for stroke prevention. 

Furthermore, vitamin C may help inhibit LDL cholesterol oxidation, boost the bioavailability of nitric oxide, and lower blood pressure. This helps keep your blood vessels open and prevent blood clots that could lead to strokes or heart attacks. 

9. Vitamin K

Sometimes called “the coagulation vitamin,” vitamin K (K1 and K2) plays a central role in the process of blood clotting and vascular health. 

In one study, the authors found that 82% of chronic stroke survivors consumed less than the recommended intake of vitamin K, despite no significant differences in overall calorie or macronutrient intake between groups. Those who met vitamin K recommendations ate more vegetables and had greater intakes of other important micronutrients like calcium, vitamin A, and vitamin E. 

Vitamin K2, in particular, helps direct calcium away from your arteries and to your bones instead. This helps reduce your risk of atherosclerosis and stroke. 

10. Calcium

Calcium is involved in the proper functioning of your nerves and muscles, which includes the contraction and relaxation of your blood vessels (and your blood pressure regulation). 

Getting enough of this mineral is essential for your heart to pump blood efficiently throughout your body. Note that (like most nutrients) it’s best to get your calcium from whole foods versus supplements, as recent research has identified an association between supplemental calcium intake and a higher risk of heart attacks and heart disease.

Read more in my blog about the role of calcium in heart health. 

11. Coenzyme Q10

Coenzyme Q10 (CoQ10) is an antioxidant that supports healthy mitochondrial function and protects your blood vessels from oxidative damage. It helps improve endothelial function, lower inflammation, and support blood pressure regulation, which is important for lowering stroke risk. 

Research shows that CoQ10 supplementation reduces oxidative stress and mortality from cardiovascular causes. 

A meta-analysis of 50 randomized controlled trials with 2794 participants found that CoQ10 supplementation (400-500 mg per day) decreased total cholesterol, LDL, and triglyceride levels while increasing HDL levels in adults. 

12. Quercetin

Quercetin is a flavonoid (a type of plant chemical responsible for color) that has anti-inflammatory and antioxidant properties to help protect vascular health. 

Some studies suggest that quercetin can help lower blood pressure by improving endothelial function and reducing arterial stiffness. It may also help prevent blood clots by inhibiting platelet aggregation, reducing stroke risk.

13. L-arginine

L-arginine is an amino acid that acts as a precursor to nitric oxide (NO). This is important because NO helps dilate and relax your blood vessels, allowing for healthier circulation, lower blood pressure, and reduced stroke risk. 

Should I Take Supplements for Stroke Prevention? 

Good nutrition is foundational to your heart health and stroke prevention. I always recommend taking a foods-first approach to get your nutrients as much as possible, through a variety of whole and minimally processed foods. 

Eating plenty of nutrient-dense foods is the best way to ensure you’re getting the vitamins, minerals, fiber, and antioxidants your body needs to thrive. This also naturally supports vascular function, reduces inflammation, and helps manage your stroke risk factors like high blood pressure and cholesterol.

However, there are some instances in which supplements to prevent stroke may make sense, such as if your nutrient intake is insufficient or you have symptoms or lab tests that indicate deficiencies. 

A personalized evidence-based nutrition plan guided by a heart health dietitian can help determine which nutrients may need supplementation—and help you avoid potential medication-supplement interactions. 

For example, some people at risk for stroke are put on blood-thinning medications, which can interact with certain supplements, causing the blood to be too thin. High dose potassium supplements can lead to cardiac death. 

Nutrients and Supplements for Stroke Prevention: Next Steps

Nutrition is key to improving your heart health and preventing (or recovering from) a stroke. The amount of nutrients you need will differ based on your current intake and blood levels, as well as other factors like medical history, sex, age, and weight. These factors also play into whether certain supplements that prevent stroke make sense.

If you’re seeking personalized nutrition guidance, learn more about my 1:1 individualized services, or consider joining my next group heart health optimization cohort. You can also click here to schedule a complimentary 15-minute discovery call. 

Sources:

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