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Stroke risk factors

Preventing stroke; Stroke - prevention; CVA - prevention; TIA - prevention

A stroke occurs when blood flow to a part of the brain suddenly stops. A stroke is sometimes called a "brain attack or cerebrovascular accident." If blood flow is cut off for longer than a few seconds, the brain cannot get nutrients and oxygen. Brain cells can die, causing lasting damage.

Risk factors are things that increase your chance of getting a disease or condition. This article discusses the risk factors for stroke and things you can do to lessen your risk.

What is a Risk Factor?

A risk factor is something that increases your chance of getting a disease or health problem. Some risk factors for stroke you cannot change. Some you can. Changing the risk factors that you have control over will help you live a longer, healthier life.

Risk Factors you Cannot Change

You cannot change these stroke risk factors:

  • Your age. The risk of stroke goes up with age.
  • Your sex. Men have a higher risk of getting heart disease and stroke than women, except in older adults.
  • Your genes and race. If your parents had a stroke, you are at higher risk. African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk. Also, some families pass on traits that make them more likely to have blood clots.
  • Diseases such as cancer, chronic kidney disease, autoimmune diseases, and some types of arthritis.
  • Prior stroke. If you have already had one or more strokes or transient ischemic attacks (TIAs) you are at greater risk of having another stroke.
  • Weak areas in an artery wall or abnormal arteries and veins.
  • Pregnancy. Both during and in the weeks right after the pregnancy.

Blood clots from the heart may travel to and block the blood vessels in the brain and cause a stroke. This may happen in people with manmade or infected heart valves. It may also happen because of a heart defect you were born with.

A very weak heart and abnormal heart rhythm, such as atrial fibrillation, can also cause blood clots.

Risk Factors you can Change

Some risk factors for stroke that you can change are:

  • Not smoking. If you do smoke, quit. Ask your health care provider for help quitting.
  • Controlling your blood cholesterol and lipids (fats) through diet, exercise, and medicines, if needed.
  • Controlling high blood pressure through diet, exercise, and medicines, if needed. Ask your provider what your blood pressure should be.
  • Controlling diabetes through diet, exercise, and medicines, if needed.
  • Exercising at least 30 minutes every day.
  • Maintaining a healthy weight. Eat healthy foods, eat less, and join a weight loss program, if you need to lose weight.
  • Limiting how much alcohol you drink. Women should have no more than 1 drink a day, and men no more than 2 a day.
  • Not using cocaine and other recreational drugs.
  • Seeking medical care for problems that increase risk of stroke, such as atrial fibrillation and sleep apnea.

Birth control pills (particularly those with higher estrogen content) can raise your risk of blood clots. Clots are more likely in women who also smoke and who are older than 35. Talk with your provider about other birth control options that do not increase the risk of blood clots.

Good nutrition is important to your heart health. It will help control some of your risk factors.

  • Choose a diet rich in fruits, vegetables, and whole grains.
  • Choose lean proteins, such as chicken, fish, beans, and legumes.
  • Choose low-fat dairy products, such as 1% milk and other low-fat items.
  • Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods.
  • Eat fewer animal products and fewer foods with cheese, cream, or eggs.
  • Read food labels. Stay away from saturated fat and anything with partially-hydrogenated or hydrogenated fats. These are unhealthy fats.

Your provider may suggest taking aspirin or another blood thinner to help prevent blood clots from forming. Do not take aspirin without talking to your doctor first. If you are taking these medicines, take steps to prevent yourself from falling or tripping, which can lead to bleeding.

Follow these guidelines and the advice of your provider to lower your chances of stroke.

References

American Diabetes Association website. Standards of medical care in diabetes - 2023. Diabetes Care. 2023;46(Suppl 1):S1-S284. diabetesjournals.org/care/issue/46/Supplement_1.

Biller J, Schneck MJ, Ruland S. Ischemic cerebrovascular disease. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 65.

Centers for Disease Control and Prevention website. Risk factors for stroke. www.cdc.gov/stroke/risk-factors/?CDC_AAref_Val=https://www.cdc.gov/stroke/risk_factors.htm. Updated May 15, 2024. Accessed June 18, 2024.

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  • Stroke

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    Stroke - Animation

    When blood flow to an area of your brain stops, it's serious. It's called a stroke, and will often cause permanent, debilitating damage to your brain and change your life. Let's talk about strokes. If blood flow to your brain is stopped for longer than a few seconds, your brain can't get blood and oxygen. Brain cells die, causing permanent damage. There are two types, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when a blood clot forms in a very small artery, or when a blood clot breaks off from another artery and lodges in your brain. Hemorrhagic strokes can happen when a blood vessel in your brain becomes weak and bursts open. High blood pressure is the number one risk factor for strokes. People with atrial fibrillation, when your heart rhythm is fast and irregular, diabetes, a family history of stroke, and high cholesterol are most at risk. You are also at risk for stroke if you are older than age 55. Other risk factors include being overweight, drinking too much alcohol, eating too much salt, and smoking. Symptoms of a stroke usually develop suddenly, without warning. You may have a severe headache that starts suddenly, especially when you are lying flat, often when you awake from sleep. Your alertness may suddenly change. You may notice changes in your hearing, your sense of taste, and your sense of touch. You may feel clumsy or confused or have trouble swallowing or writing. So, how are strokes treated? A stroke is a medical emergency. Immediate treatment might save your life and reduce disability. Call your local emergency number -- or have someone call for you -- at the first sign of a stroke. Most of the time, someone having a stroke should be in the hospital within three hours after symptoms first begin. If a doctor suspects you've had a stroke, the doctor will check for problems with your vision, movement, feeling, reflexes, and your ability to understand and speak. You may have several tests to check for blocked or narrowed arteries. If the stroke is caused by a blood clot, you'll be given a clot-busting drug to dissolve the clot. Treatment depends on how bad your stroke is and what caused it. But you will probably need to stay in the hospital for a few days. Besides clot-busting drugs, called thrombolytics, you may need blood thinners, medicine to control high blood pressure, and surgery to unclog one of your carotid arteries-which carry blood to the brain. After your stroke, treatment will focus on helping you recover as much function as possible, and preventing future strokes. Most people need stroke rehabilitation therapy. If you can return home, you may need help making safety changes in your home and to help you with using the bathroom, cooking, dressing, and moving around your home. After a stroke, some people have trouble speaking or communicating with others, and a speech therapist might help. Depending on the severity of the stroke, you may have trouble with thinking and memory, problems with your muscles, joints, and nerves, trouble going to the bathroom, and difficulty swallowing and eating. Therapies and support for you and your family are available to help with each of these problems. Your treatment will also focus on preventing another stroke. You may need to be on several medications to help prevent this. And, eating healthy and controlling problems like diabetes and high blood pressure can be very important.

  • Stroke

    Animation

  •  

    Stroke - Animation

    When blood flow to an area of your brain stops, it's serious. It's called a stroke, and will often cause permanent, debilitating damage to your brain and change your life. Let's talk about strokes. If blood flow to your brain is stopped for longer than a few seconds, your brain can't get blood and oxygen. Brain cells die, causing permanent damage. There are two types, ischemic stroke and hemorrhagic stroke. Ischemic stroke happens when a blood clot forms in a very small artery, or when a blood clot breaks off from another artery and lodges in your brain. Hemorrhagic strokes can happen when a blood vessel in your brain becomes weak and bursts open. High blood pressure is the number one risk factor for strokes. People with atrial fibrillation, when your heart rhythm is fast and irregular, diabetes, a family history of stroke, and high cholesterol are most at risk. You are also at risk for stroke if you are older than age 55. Other risk factors include being overweight, drinking too much alcohol, eating too much salt, and smoking. Symptoms of a stroke usually develop suddenly, without warning. You may have a severe headache that starts suddenly, especially when you are lying flat, often when you awake from sleep. Your alertness may suddenly change. You may notice changes in your hearing, your sense of taste, and your sense of touch. You may feel clumsy or confused or have trouble swallowing or writing. So, how are strokes treated? A stroke is a medical emergency. Immediate treatment might save your life and reduce disability. Call your local emergency number -- or have someone call for you -- at the first sign of a stroke. Most of the time, someone having a stroke should be in the hospital within three hours after symptoms first begin. If a doctor suspects you've had a stroke, the doctor will check for problems with your vision, movement, feeling, reflexes, and your ability to understand and speak. You may have several tests to check for blocked or narrowed arteries. If the stroke is caused by a blood clot, you'll be given a clot-busting drug to dissolve the clot. Treatment depends on how bad your stroke is and what caused it. But you will probably need to stay in the hospital for a few days. Besides clot-busting drugs, called thrombolytics, you may need blood thinners, medicine to control high blood pressure, and surgery to unclog one of your carotid arteries-which carry blood to the brain. After your stroke, treatment will focus on helping you recover as much function as possible, and preventing future strokes. Most people need stroke rehabilitation therapy. If you can return home, you may need help making safety changes in your home and to help you with using the bathroom, cooking, dressing, and moving around your home. After a stroke, some people have trouble speaking or communicating with others, and a speech therapist might help. Depending on the severity of the stroke, you may have trouble with thinking and memory, problems with your muscles, joints, and nerves, trouble going to the bathroom, and difficulty swallowing and eating. Therapies and support for you and your family are available to help with each of these problems. Your treatment will also focus on preventing another stroke. You may need to be on several medications to help prevent this. And, eating healthy and controlling problems like diabetes and high blood pressure can be very important.

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Review Date: 1/23/2023

Reviewed By: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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