Risk Factors and Prevention of Stroke

Heart disease

Blood clots may develop in the heart from a variety of conditions. The most common is atrial fibrillation, an abnormal heart rhythm. Blood clots can leave the heart and travel into the brain, causing a stroke. See Fig. 1.

To lower your risk:  Take heart medications prescribed by your doctor. Anti-clotting medication is commonly used to reduce the risk of stroke by reducing the formation of blood clots in the heart. 

Prior stroke or TIAs

A person who has had a transient ischemic attack (TIA)—stroke-like symptoms that resolve within minutes or hours—is significantly more likely to have a stroke within the first year after experiencing symptoms.

To lower your risk:  For symptoms of a stroke, medical attention is needed IMMEDIATELY, even if the symptoms go away. 

Hypertension (high blood pressure)

High blood pressure (140/90 mm Hg or higher) is the most common risk factor for stroke. Because it may produce no symptoms before causing a stroke or heart attack, high blood pressure is often called the silent killer. It contributes to stroke by causing atherosclerosis (a condition in which plaque forms on the lining of blood vessels) and by causing brain arteries to rupture. See Fig. 2.

To lower your risk:  Take blood pressure medications as prescribed by your doctor. Limit your daily intake of salt. Have regular blood pressure check-ups. Ask your doctor about exercise and maintaining proper weight.

Cigarette smoking

Nicotine increases the risk of stroke. Smoking is an especially strong risk factor for disease of the carotid and coronary arteries.

To lower your risk:  If you smoke, reduce or stop smoking. If you don't smoke, don't start. Even long-time smokers can reduce their risk of stroke by quitting.

 
 
Diabetes

The high blood sugar caused by diabetes contributes to atherosclerosis and increases the risk of stroke.

To lower your risk:  Follow your doctor's advice if you have diabetes.  Close control of blood sugar is an important and effective way to reduce the risk of stroke.

 
 
Alcohol consumption

Excessive alcohol intake or binge drinking triples the risk of stroke.

To lower your risk:  Limit alcohol consumption. Some studies have shown that moderate alcohol consumption (2 drinks per day or less) may actually be beneficial in reducing the risk of stroke in some individuals.

High blood-cholesterol levels

Cholesterol is a fatty substance, manufactured by the liver and obtained from food. It is deposited in the walls of arteries where it reduces blood flow by narrowing the vessel and causing the wall to become less flexible, a condition called atherosclerosis. Laboratory blood tests determine levels of total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL). LDL is the "bad" cholesterol, and the lower it is the better. HDL is the "good" cholesterol, and the higher it is the better. An imbalance between HDL and LDL doubles your risk of stroke. See Fig. 3.

To lower your risk:  Eat plenty of fruits and vegetables. Reduce intake of red meat, dairy products, and eggs. Consult your physician about medication that may substantially help lower cholesterol levels.

  
 
Obesity

Individuals who are more than 20 pounds overweight or more than 10% over their ideal weight are as much as 10 times as likely to develop diabetes, 2-3 times as likely to have severe atherosclerosis, and several times more likely to suffer a stroke than those who are not.

To lower your risk:  Control your weight by keeping it within 20 pounds of your ideal weight for your body type and height. Weight is better controlled by losing a pound or two per week. "Crash" diets are not recommended. An exercise program combined with a sensible diet is the most effective way to lose weight. Consult your physician for the best advice based on your individual circumstances.

Age

The risk of stroke increases steadily with age and increases significantly after age 50. 

 
Family history of stroke

Individuals with a family history of stroke have 5 times the risk of developing a stroke.

 
Race

The risk of strokes among individuals of African descent is somewhat higher than among other groups. Some studies have shown that individuals of Hispanic descent have an increased risk of hemorrhagic strokes.

 
Gender

In younger age groups strokes occur more frequently in men, but in older age groups stroke occurs more frequently in women.