Health
90% of strokes are avoidable with a few lifestyle changes!
Cleveland Clinic Expert Shares Six Simple Steps to Prevent Vast Majority of Strokes
December 5, 2023 – According to the World Stroke Organization (WSO), stroke is the leading cause of disability worldwide. The WSO says one in four people will have a stroke in their lifetimes, and each year over 12 million people worldwide have strokes. However, it adds that 90% of strokes are preventable by addressing a small number of risk factors that are responsible for most strokes. In The Bahamas, on average 224 people (or 9.56%) die annually from strokes.
Here, Andrew Russman, DO, Medical Director of Cleveland Clinic’s Comprehensive Stroke Center and a vascular
neurology specialist, offers advice on how to reduce stroke risk by better managing existing health conditions and also through implementing lifestyle changes. “These tips are interrelated as most of the lifestyle changes mentioned also play a role in improving management of hypertension, high cholesterol and diabetes, which all increase stroke risk,” Dr. Russman points out.
- Reduce hypertension
Uncontrolled hypertension – that is, blood pressure that is consistently above 130/80 – is the single most important modifiable risk factor in stroke worldwide, says Dr. Russman.
Aside from medication, an important step in reducing blood pressure is to reduce salt intake, which Dr. Russman says is good advice even if you don’t have high blood pressure. “We recommend consuming no more than 2g of salt per day. I advise my patients to check food labels and nutritional websites for sodium levels as their intake is usually far higher than they realize,” he adds.
- Be wary of diabetes
It is important to be tested for diabetes, and if diagnosed, to manage the condition wells, says Dr. Russman. He explains that diabetes causes narrowing of small, medium and large blood vessels in the body, including vessels of the eyes, kidney, heart and brain. Owing to this, diabetes can contribute to a variety of vascular, cardiovascular and cerebrovascular problems including stroke. In addition, for patients who have survived a stroke, the risk of having a second is three times higher in those patients whose diabetes is not controlled.
Dr. Russman says that as part of their treatment plan, people with diabetes should have their condition monitored through HbA1C tests, which provide a three-month snapshot of their blood sugar control. “We recommend that these individuals aim for an HbA1C result of 7.0 or less. Taking prescribed medication correctly, watching their diet, exercising regularly, and following their healthcare provider’s recommendations will help them achieve this.”
- Address atrial fibrillation
The WSO says atrial fibrillation is associated with one in four strokes, and Dr. Russman says these strokes tend to be more severe and disabling than strokes associated with other risk factors.
“Atrial fibrillation is a heart rhythm condition characterized by very rapid heartbeats that don’t allow the top left chamber of the heart – the left atrium – to contract normally. Instead, it fibrillates and flutters so blood is not ejected normally from the chamber,” he says. “Anytime blood is stagnant for too long, it can form a blood clot that can travel elsewhere in the body. This clot could cause a stroke by blocking a blood vessel in the brain, depriving that part of the brain of the oxygen and nutrients it needs.”
Dr. Russman says atrial fibrillation is the most common acquired heart rhythm disorder in older adults, and its associated risk is strongly related to age. “The older you are, the more at risk you are of acquiring the condition, but also the higher the risk of stroke associated with the condition,” he says. “It is estimated that up to half of all patients with a heart rhythm condition are not aware of it. However, once diagnosed, atrial fibrillation can be treated with a blood-thinning medication. These do carry some risks, but the benefits far outweigh these in the vast majority of patients.”
- Manage cholesterol levels
In addition to reducing high levels of low-density lipoprotein (LDL) or ‘bad’ cholesterol through diet, for example, by avoiding saturated fat, individuals might be prescribed statin medications that reduce future risk of heart attacks and strokes. Dr. Russman says these medications, particularly rosuvastatin and atorvastatin, may benefit patients
beyond simply reducing cholesterol levels in that they also appear to reduce inflammation and stabilize plaque build-up in blood vessels.
- Stop smoking
“Any type of smoking is associated with increased risk of cardiovascular disease and stroke, and is strongly associated with accelerated hardening of the arteries and narrowing of blood vessels in the brain, heart and elsewhere,” says Dr. Russman. “We therefore strongly recommend everyone completely stop any form of nicotine ingestion to significantly reduce their long-term risk for a multitude of diseases.”
- Adopt a healthy lifestyle
Dr. Russman recommends following an eating plan that is low in saturated fats and sodium, and to avoid alcohol and excessive caffeine consumption. Regular physical activity is also important as it can reduce the risk of stroke directly, but also indirectly as it helps to lower high blood pressure and blood sugar levels. Exercise can also help to reduce stress, as can other activities such as meditation or deep breathing, which is important as stress causes the body to release chemicals that can increase blood pressure, affect hormones and raise blood sugar levels, says Dr. Russman.
Deandrea Hamilton | Editor
Turks and Caicos, September 6, 2025 – COVID-19 fears in the Turks and Caicos Islands that once had residents on edge are now giving way to a sense of relief. The Ministry of Health and Human Services reports a dramatic reversal: from dozens of new cases in July to zero cases and zero hospitalizations today.
Between August 17 and 23, 2025, officials confirmed no new cases, no hospitalizations, and no new deaths. Just two recoveries were recorded, bringing the national recovery tally to 6,866. The total confirmed cases since 2020 stand at 6,922, with deaths unchanged at 41. Health officials say August has been relatively quiet overall, with 19 new cases and recoveries recorded for the month — a fraction of what the islands faced just weeks earlier.
The contrast could not be sharper. The most concerning bulletin came in mid-July, when the Ministry reported 54 new cases in a single
week. Ten were fresh positives, while the other 44 came from a backlog of April samples. At that time, two new hospitalizations were recorded, and the islands mourned one additional COVID-related death, bringing the total to 41. It was a sobering reminder that the virus was still circulating, pushing recoveries to 6,845 and raising the cumulative case count to 6,910. The July spike stirred fear among residents and renewed calls for vigilance, as community spread and delayed lab results painted a worrying picture.
Fast forward to late August, and the numbers tell a very different story. Not only are new cases negligible, but the hospitals are reporting no COVID-19 patients at all. Officials say testing continues across a wide range of categories, and the Ministry urges the public to stay cautious: wash hands, wear masks in crowded spaces, protect the vulnerable, and get vaccinated. But the tone now is one of optimism.
Since the pandemic began in 2020, Turks and Caicos has recorded nearly 7,000 cases in total, with 6,866 recoveries and 41 deaths. The islands’ small population means every case has felt significant, and surges like July’s were especially unsettling. But today’s figures suggest the country has reached a new stage: COVID-19 is no longer the disruptive force it was. The Ministry credits continued public vigilance and the accessibility of free testing and vaccines at government clinics. While the numbers are cause for celebration, health leaders are careful not to declare the fight over. The Ministry’s latest bulletin reminds residents to maintain hygienic practices, follow self-isolation guidelines if infected, and ensure vaccinations are up to date.
The pandemic may not be entirely behind the Turks and Caicos, but compared to the frightening figures of July, the near-zero landscape of August offers a powerful sign of hope.
The Ministry released the bulletin on September 2, confirming that for the week of August 17–23, no new cases, hospitalizations, or deaths were recorded — a sharp contrast to the surge just weeks earlier.
Health
Turks and Caicos Islands Health Delegation Completes Strategic Visits to Florida and Cayman Islands to Advance Health Sector Reform and Strengthen Treatment Abroad Programme
Providenciales, Turks and Caicos Islands, 22 August 2025 — A high-level delegation from the Ministry of Health and Human Services (MOHHS) has successfully concluded strategic working visits to Florida and the Cayman Islands from August 5–13, 2025. The mission aimed to strengthen the Treatment Abroad Programme, explore innovative health system models, and advance the Turks and Caicos Islands’ health sector reform agenda through strategic regional partnerships.
Delegation Members:
- Hon. Kyle Knowles – Minister of Health and Human Services
MoHHS Team with Health City Executive Management Team
- Mrs. Desiree Lewis – Permanent Secretary, Health and Human Services
- Mr. Lynrod Brooks – Director, Health Policy and Planning
- Ms. Florinda Talbot – Contract Performance Manager
- Mrs. Romaine Missick-Smith – CEO, Health Regulations Authority
- Ms. Jasmine Malcolm – Executive Administrator, MOHHS
Minister of Health and Human Services, Hon. Kyle Knowles, highlighted the significance of these engagements:
“These visits were not ceremonial; they were strategic, focused, and impactful. In Florida, we reinforced partnerships with leading healthcare providers to ensure TCI patients referred overseas receive the highest standards of clinical care and patient support. In the Cayman Islands, our mission was two-fold: to study the operations of the Cayman Islands Health Services Authority as a model to guide the establishment of our own Health Services Authority, and to strengthen ties with Cayman-based treatment partners, where many of our patients are referred under the Treatment Abroad Programme. Both visits underscored that small island states share many health challenges, and that collaboration, innovation, and adapting best practices to our local context are essential to achieving better health outcomes for our people.”
Florida – Strengthening the Treatment Abroad Programme
MoHHS Team with Cayman Minsterial officials
During the period August 5–9, the delegation visited Broward Medical Center, University of Miami Health System, Cleveland Clinic, Nicklaus Children’s Hospital, and the International Reinsurance Managers Network. They also toured REVA Air Ambulance Services to review medical evacuation operations and patient transfer management. Discussions centered on patient care pathways, specialized services in ophthalmology, cardiology, oncology, and pediatrics, family-centered care models, advanced telemedicine for pre- and post-treatment consultations, and reinsurance strategies for high-cost overseas cases. Key outcomes include agreements to expand telehealth consultations, develop a standardized referral package to reduce delays, explore reinsurance arrangements to safeguard public health budgets, and establish specialized pediatric transfer protocols.
Cayman Islands – Health Sector Reform and Treatment Abroad Partnerships
From August 10–13, the delegation engaged with senior executives at Health City Cayman Islands, including Dr. Binoy Chattuparambil (Clinical Director), Shomari Scott (Chief Business Development Officer), Rebecca Brooks (Head of Marketing and Sales), and Ingrid Harris (Sales and Marketing). The team toured two hospital facilities and held in-depth discussions with Lizzette Yearwood, Chief Executive Officer along with leadership staff of the Cayman Islands Health Services Authority
The focus was two-fold:
- Health Sector Reform – Examining governance, financial management, and operational structures of the Cayman Islands HSA model
MoHHS Team with CEO and senior official Cayman HSA
to inform TCI’s development of its own Health Services Authority.
- Treatment Abroad Strengthening – Reviewing current referral arrangements with Cayman healthcare partners to enhance patient care coordination and improve treatment pathways for TCI patients referred to Cayman.
The delegation also met with Honourable Katherine Ebanks-Wilks, Minister for Health, Environment, Sustainability, and Honourable G. Wayne Panton, Parliamentary Secretary for Health. The team concluded with a meeting with Acting Premier Hon. Gary B. Rutty and Cabinet members, reaffirming the shared commitment to improving healthcare access and outcomes through regional collaboration.
Next Steps
The Ministry will incorporate lessons learned from these visits into ongoing health reform planning, ensuring that the proposed Health Services Authority is tailored to TCI’s needs while reflecting regional best practices. Efforts will continue to ensure that the Treatment Abroad Programme delivers efficient, sustainable, and patient-centered care.
