Stroke — NZ Condition Guide | KiwiMeds

What is Stroke?

A stroke is a medical emergency where blood supply to part of the brain is cut off, causing brain cells to die. There are two main types: ischaemic stroke (caused by a blood clot blocking an artery — around 85% of strokes) and haemorrhagic stroke (caused by bleeding in the brain). Time is brain — every minute without treatment, approximately 1.9 million brain cells die. Stroke is a leading cause of death and disability in New Zealand.

Overview

Remember FAST for stroke recognition: Face drooping (one side of the face droops or is numb — ask the person to smile), Arm weakness (one arm is weak or numb — can they raise both arms?), Speech difficulty (slurred or strange speech), Time to call 111. Other symptoms include sudden severe headache, sudden vision changes, and sudden loss of balance or coordination. Call 111 immediately if you suspect a stroke — do not wait to see if symptoms improve.

Treatment in New Zealand

Acute ischaemic stroke is treated with thrombolysis (clot-dissolving medication — alteplase) within 4.5 hours of onset, or mechanical thrombectomy (physically removing the clot) within 24 hours for eligible patients. Stroke units at NZ hospitals provide specialised care. After a stroke, rehabilitation (physiotherapy, occupational therapy, speech therapy) is crucial. Stroke prevention medications include antiplatelets (aspirin, clopidogrel), anticoagulants (for AF-related stroke — apixaban, warfarin), antihypertensives, and statins.

NZ-Specific Information

The Stroke Foundation of New Zealand (stroke.org.nz) provides support and rehabilitation resources. Stroke Units are available at all major NZ hospitals. After a TIA (transient ischaemic attack — “mini-stroke”), urgent assessment is needed — up to 10% of people have a stroke within 48 hours. The ABCD2 score helps risk-stratify TIA.

Frequently Asked Questions

What is a TIA? A transient ischaemic attack (TIA or mini-stroke) causes the same symptoms as a stroke but resolves within 24 hours (usually within minutes). It is a medical emergency and a warning sign of stroke. Seek urgent care. Can young people have strokes? Yes — stroke can occur at any age, though risk increases with age. How much does stroke affect quality of life? This varies enormously — some people make a full recovery, while others have lasting disability.

Supplements That May Support Management

⚠️ Important: The supplements listed below have varying levels of clinical evidence. They are not a substitute for prescribed medications and should only be considered as adjunctive support under the guidance of a qualified healthcare professional. Always inform your GP or pharmacist before commencing any supplement, as interactions with prescribed medicines are possible.

• Omega-3 Fatty Acids — Dietary omega-3 intake is associated with reduced stroke recurrence risk. Post-stroke supplementation may support neuroprotection and vascular recovery.
• Vitamin D — Vitamin D deficiency at stroke onset is associated with worse neurological outcomes. Supplementation in deficient post-stroke patients is recommended as part of standard supportive care.
• Folate, B6, B12 (homocysteine reduction) — Elevated homocysteine is an independent stroke recurrence risk factor. B vitamin supplementation (folate 0.5–5 mg/day with B6 and B12) reduces homocysteine levels, with benefit strongest in those with dietary insufficiency or MTHFR gene variants.
• Coenzyme Q10 — CoQ10 supports mitochondrial function and reduces oxidative stress, potentially providing neuroprotective benefit post-stroke and addressing mitochondrial dysfunction in ischaemic brain tissue.

Relevant Vaccinations

Individuals living with stroke may benefit from the following vaccinations. Please discuss your vaccination status with your GP or practice nurse, as eligibility and funding through the New Zealand National Immunisation Schedule may apply.

• Influenza (annual) — Influenza markedly increases short-term stroke risk through coagulation activation and vascular inflammation. Annual vaccination is strongly recommended for post-stroke patients and is funded.
• Pneumococcal — Post-stroke patients are at increased aspiration and pneumonia risk. Pneumococcal vaccination is recommended.
• COVID-19 — COVID-19 significantly increases stroke risk via coagulopathy and vascular inflammation. Maintaining vaccination is strongly recommended post-stroke.

Dietary Guidance

Evidence-based dietary modifications play a meaningful role in the management of stroke. The following foods are generally recommended as part of a balanced, condition-appropriate diet. A referral to a registered dietitian may be beneficial for personalised nutritional planning.

• DASH or Mediterranean dietary pattern — Both dietary patterns are evidence-based for secondary stroke prevention, reducing blood pressure, inflammation, and recurrent vascular events.
• Potassium-rich foods — Adequate dietary potassium reduces blood pressure — the primary modifiable stroke risk factor.
• Low sodium diet (≤2000 mg/day) — Sodium restriction lowers blood pressure and is central to secondary stroke prevention dietary management.
• Oily fish (omega-3 source) — Regular dietary omega-3 intake is associated with reduced stroke recurrence and supports vascular health.
• Limit: saturated fats, processed meats, refined carbohydrates — Pro-atherogenic dietary components increase risk of recurrent vascular events post-stroke.

Related Conditions & Medications

Related conditions: Atrial Fibrillation, Hypertension, High Cholesterol.