What lifestyle modifications should I advise to patients with carotid artery stenosis to reduce their stroke risk?

Lifestyle modifications for patients with carotid artery stenosis to reduce stroke risk should focus on comprehensive cardiovascular risk factor management. Advise patients to adopt a heart-healthy diet low in saturated fats, trans fats, and cholesterol, emphasising increased intake of fruits, vegetables, whole grains, and oily fish to improve lipid profiles and reduce atherosclerotic progression NICE NG238 Cheng & Brown 2017. Encourage regular physical activity tailored to the patient’s ability, aiming for at least 150 minutes of moderate-intensity exercise per week to improve vascular health and control blood pressure NICE NG238 Musialek et al. 2025. Smoking cessation is critical, as tobacco use accelerates carotid atherosclerosis and increases stroke risk; provide support and pharmacotherapy as needed NICE NG238 Musialek et al. 2025. Weight management to achieve and maintain a healthy body mass index reduces metabolic risk factors associated with carotid disease NICE NG238. Blood pressure control through lifestyle, including salt reduction and stress management, is essential to lower stroke risk NICE NG238 Cheng & Brown 2017. Additionally, moderation of alcohol intake according to national guidelines is advised to avoid exacerbating hypertension and vascular damage NICE NG238. These lifestyle changes should be integrated with medical therapies such as antiplatelet agents and statins for optimal stroke prevention Musialek et al. 2025. Regular follow-up and patient education on adherence to these modifications are vital for long-term risk reduction.