Learn About Stroke Risk Factors and Prevention

Understanding What a Stroke Is and Why Prevention Matters

A stroke happens when blood flow to the brain stops or becomes severely limited. When brain cells don't receive oxygen-rich blood, they begin to die within minutes. This is why strokes are medical emergencies that require immediate hospital care.

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There are two main types of strokes. An ischemic stroke occurs when a blood clot blocks a blood vessel in the brain. These account for about 87% of all strokes. A hemorrhagic stroke happens when a blood vessel in the brain ruptures and bleeds into the surrounding tissue. Though less common, hemorrhagic strokes are often more severe.

The statistics on stroke are significant. According to the Centers for Disease Control and Prevention (CDC), one person has a stroke every 40 seconds in the United States. Stroke is the fifth leading cause of death and a leading cause of long-term disability. However, the encouraging news is that about 80% of strokes may be prevented through lifestyle changes and medical management.

Understanding your personal stroke risk is the first step toward prevention. Risk factors fall into two categories: those you cannot change and those you can control through lifestyle or medical treatment. Some people are born with conditions that increase stroke risk, while others develop risk factors over time through daily choices and health decisions.

Learning about stroke risk factors helps you recognize which dangers apply to your situation. This knowledge allows you to work with your healthcare provider to create a plan that reduces your risk. Many people don't realize they have stroke risk factors until a healthcare provider screens them during a regular checkup.

Practical takeaway: Schedule a conversation with your doctor about your stroke risk. Bring a list of any family members who have had strokes or heart disease, as this information helps your doctor assess your personal risk.

Non-Modifiable Risk Factors: What You Cannot Change

Some stroke risk factors are determined by your genetics, age, or circumstances you cannot alter. While you cannot change these factors, knowing about them helps you understand why paying attention to the factors you can control becomes even more important.

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Age significantly influences stroke risk. People aged 55 and older have a higher risk of stroke than younger adults. The risk increases with each passing year. However, strokes do occur in younger people. About 10-15% of strokes happen to people under age 45. Young adults may face stroke risk from conditions like heart problems present from birth, blood clotting disorders, or pregnancy-related complications.

Sex and gender also play a role in stroke risk. Men have a higher stroke risk in younger and middle-aged years. However, women face particular risks during certain life stages. Pregnancy increases stroke risk, particularly during the final trimester and immediately after delivery. Women who take birth control pills or hormone replacement therapy have a modestly increased stroke risk. Women are also more likely to have a stroke at older ages because they tend to live longer than men.

Race and ethnicity influence stroke risk as well. African Americans have a higher stroke risk and tend to have strokes at younger ages than other groups. They are also more likely to die from strokes. Hispanic and American Indian populations also experience higher stroke rates than non-Hispanic white populations. These differences partly reflect genetic factors but also relate to differences in access to healthcare, income levels, and the prevalence of conditions like diabetes and high blood pressure.

Family history matters significantly. If a parent, sibling, or grandparent had a stroke, your stroke risk is higher. Some families carry genetic conditions that increase stroke risk, such as familial hypercholesterolemia, which causes very high cholesterol levels. Other families may share lifestyle patterns that increase risk, which technically can be changed but often runs strong in families.

A personal history of stroke substantially increases the chance of having another stroke. People who have had one stroke face about a 25% chance of having another stroke within five years if they don't receive treatment to prevent it.

Practical takeaway: Write down your family's stroke and heart disease history. Note the ages when relatives experienced these events. Share this information with your doctor to clarify your personal risk level.

Controlling High Blood Pressure: The Most Important Prevention Step

High blood pressure, also called hypertension, is the single most important controllable risk factor for stroke. About half of American adults have high blood pressure, but many don't know it because there are usually no symptoms. High blood pressure damages the inner walls of blood vessels over time, making them more likely to develop clots or rupture.

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Blood pressure is measured in two numbers: systolic pressure (the higher number) and diastolic pressure (the lower number). Normal blood pressure is less than 120/80 mmHg. The American Heart Association considers blood pressure of 130/80 mmHg or higher as high blood pressure. For people with a history of stroke or heart disease, doctors often recommend keeping blood pressure even lower.

Treating high blood pressure dramatically reduces stroke risk. Studies show that lowering systolic blood pressure by just 10 mmHg can reduce the risk of stroke by about 20%. Several types of medications work to lower blood pressure through different mechanisms. ACE inhibitors and ARBs relax blood vessels. Beta-blockers slow the heart rate. Diuretics help the body remove excess fluid. Calcium channel blockers prevent calcium from entering cells in the heart and blood vessels.

Many people can lower blood pressure through lifestyle changes alone or use medication more effectively when combined with these changes. Reducing sodium intake to less than 2,300 mg per day (about one teaspoon of salt) can lower blood pressure. The DASH diet, which emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy while limiting salt, sugar, and saturated fat, has been shown to reduce blood pressure by up to 11 mmHg in some studies.

Physical activity strengthens the heart and helps maintain a healthy weight, both of which lower blood pressure. The recommendation is at least 150 minutes of moderate-intensity aerobic activity per week, such as brisk walking. Limiting alcohol consumption also helps—women should limit intake to one drink per day and men to two drinks per day. Stress management techniques, adequate sleep, and maintaining a healthy weight all contribute to blood pressure control.

Regular blood pressure monitoring at home helps you and your doctor track how well treatment is working. Home monitors are inexpensive and easy to use. Taking your own readings provides more information than occasional doctor's office checks and helps identify patterns.

Practical takeaway: Have your blood pressure checked at your next doctor visit. If it's elevated, ask your doctor whether lifestyle changes, medication, or both are recommended. Consider purchasing a home blood pressure monitor to track your numbers regularly.

Managing Diabetes and Maintaining a Healthy Weight

Diabetes substantially increases stroke risk. People with diabetes are 1.5 times more likely to have a stroke than people without diabetes. The risk is even higher for people with poorly controlled diabetes. High blood sugar levels damage blood vessels and increase clotting risk. Diabetes often occurs alongside other stroke risk factors like high blood pressure, high cholesterol, and obesity, which multiplies the danger.

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Type 2 diabetes, which accounts for about 90% of diabetes cases, often develops gradually without obvious symptoms. Many people discover they have diabetes during a routine blood test. Risk factors for developing type 2 diabetes include being overweight or obese, having a family history of diabetes, being physically inactive, and being over age 45. Gestational diabetes during pregnancy also increases future stroke risk—women who had gestational diabetes face double the stroke risk compared to women without it.

Controlling blood sugar through medication, diet, and exercise significantly reduces stroke risk. The goal is to keep fasting blood sugar between 80 and 130 mg/dL for most people with diabetes, though targets vary by individual. Hemoglobin A1C, a measure of average blood sugar over three months, should typically be below 7% for most people with diabetes. Working with a diabetes educator helps people learn how to monitor their blood sugar and adjust their diet and medication.

Weight management is critical for both preventing and controlling diabetes. Obesity—defined as a body mass index (BMI) of 30 or higher—is an independent stroke risk factor. Extra weight increases blood pressure, cholesterol levels, and diabetes risk. Losing even 5-10% of body weight can improve blood pressure and blood sugar control. A person who weighs 200 pounds and loses 10-20 pounds may see meaningful improvements in stroke risk factors.