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Risks factors for stroke

Many things can increase your risk of stroke. Some are manageable and some are not.

Risk factors that can NOT be managed 

  • Age: Although stroke can occur at any age, the risk of having one doubles every decade after the age of 55. 
  • Gender: Strokes are more common in men than women. 
  • Race: African Americans have the highest risk of stroke, followed by Hispanics, Asians and then Caucasians.  
  • Heredity: Your risk of stroke is higher if your parent, grandparent, sister or brother has had a stroke. This is usually linked to other risk factors that run in families, such as high blood pressure, high cholesterol, diabetes or a genetic disorder. 
  • Prior stroke: This makes it likely you will have another stroke.
  • Hole in the heart: Patent foramen ovale (PFO) occurs in about one in five Americans. Many don’t know they have it until a medical condition such as a stroke or TIA occurs.
  • Autoimmune disorders such as Lupus 
  • Clotting disorders such as thrombophilia, Protein C deficiency, Factor V Leiden and Antiphospholipid Syndrome (APS) increase the risk. 

Risk factors that CAN be controlled

  • High blood pressure
    • This is the number one cause of stroke. It puts unnecessary stress on blood vessel walls, causing them to thicken or break open. Combined with plaque build-up, this can cause blockage in an artery.
    • Check your blood pressure once a week. You can do this at your doctor’s office, at health fairs, at home with an automatic blood pressure machine or at your local pharmacy or supermarket.
    • A blood pressure reading more than 140/90 is considered high blood pressure. A blood pressure of <120/80 is considered normal. If your blood pressure is elevated, follow your doctor’s advice to keep it under control.
    • Most people are able to control high blood pressure through a combination of diet, exercise and medication. 
  • Diabetes
    • Diabetes increases the risk of stroke by two to three times. It can cause disease of the blood vessels in the brain. Excess sugar in the blood also leads to plaque buildup. 
    • Many people with diabetes often also have additional risk factors, further increasing their risk for stroke. 
    • Work with your doctor to manage diabetes and reduce other risk factors.
  • Tobacco use
    • Smoking doubles the risk of stroke.
    • If you smoke, STOP! It is never too late to quit smoking. The nicotine and carbon monoxide in cigarette smoke damages your blood vessels, making clots more likely to form.
    • You are more likely to have a stroke, heart attack, lung disease and cancer if you smoke.
    •  Tobacco use in any form, especially cigarette smoking, is hazardous to your health. 
  • High cholesterol
    • High blood cholesterol increases the risk of clogged arteries. If an artery leading to the brain becomes blocked, a stroke can result.
    • Have your cholesterol level checked at regular intervals. If your total cholesterol or LDL (low density ipoprotein) is elevated or your HDL (high density lipoprotein) is low, follow your doctor’s advice to keep it under control. The American Stroke Association (ASA) recommends that you keep your LDL (bad cholesterol) under 100 and your HDL (good cholesterol) above 50 for women and above 40 for men.
    • Regular exercise and a diet low in fat and high in fiber, like the Dash Eating Plan (see resource section), can be helpful in lowering your cholesterol. Your doctor may also prescribe medication.
  • Physical inactivity and obesity
    • Being inactive and/or overweight can contribute to many stroke risk factors — high blood pressure, high blood cholesterol, diabetes and heart disease.  
  • Diet and nutrition
    • Foods with high contents of fat and salt can lead to elevated blood pressure and blood cholesterol. 
    • Eating a diet low in sodium and cholesterol and high in healthy foods, such as fruits, vegetables and other sources of fiber, can help prevent a recurrent stroke. 
  • Oral contraception and/or hormone replacement therapy
    • Women who take even low-estrogen birth control may have double the risk of having a stroke. 
    • The risk of a stroke related to hormone use dramatically increases when combined with age over 30 and smoking.
  • Alcohol or drug use
    • Alcohol can raise blood pressure and can lead to stroke. 
    • Drinking alcohol should be limited to one drink per day for women and two drinks per day for men. 
    • Binge drinking can lead to stroke.
    • Cocaine, methamphetamines (meth) and heroin are street (illegal) drugs that increase your risk of having a stroke and heart attacks, even for first-time users.
  • Stress
    • Ongoing or unresolved stress over the years can contribute to high blood pressure, which can weaken blood vessel walls, leading to a vessel rupture and a brain hemorrhage.
  • Heart conditions
    • People with the following conditions should work closely with their doctor to treat and manage them.
    • Atrial fibrillation: Abnormal heart rhythms and incomplete emptying of the heart can allow blood to pool and clot. Warfarin, a blood-thinning medication, is typically prescribed to prevent blood clots; it does not resolve atrial fibrillation.
    • Peripheral artery disease (PAD): People with PAD — the narrowing of blood vessels carrying blood to the leg and arm muscles — are more likely to have carotid artery disease (blood vessels in the neck that carry blood to the brain), which raises their risk of stroke. 
    • Coronary heart disease, heart failure, heart valve disease and congenital heart disease can also increase your risk of stroke.