Know The Risk Factors for Stroke
Lifestyle, Genetics, and Certain Exposures Put Some People in the Crosshairs. Take Control, Now.
Introduction
A stroke occurs when the blood supply to part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die, leading to lasting brain damage, disability, or even death. Strokes are a severe medical emergency, and immediate treatment can mean the difference between life and death or long-term impairment.
Understanding and managing the risk factors that can contribute to risk of stroke is essential for prevention. Many risk factors are preventable or manageable through lifestyle changes, medical treatment, or early intervention. By being aware of these risks, you can take proactive steps to reduce your chances of experiencing a stroke.
Stroke is the second leading cause of death globally, accounting for approximately 11% of all deaths. In the United States alone, someone has a stroke every 40 seconds, and every 3.5 minutes, someone dies from one. Stroke is also a leading cause of long-term disability, making it a major public health issue. However, up to 80% of strokes are preventable, primarily by addressing risk factors like high blood pressure, smoking, and poor diet.
In this article, we’ll take a closer look at some of the most common risk factors for stroke, both modifiable and non-modifiable. These include conditions like hypertension, which is especially significant—over 50% of adults in the U.S. have high blood pressure, making it one of the leading contributors to stroke risk. Other factors we’ll review include lifestyle habits like smoking and physical inactivity, as well as medical conditions such as diabetes and atrial fibrillation. By recognizing these risks and taking steps to manage them, you can significantly reduce your chances of suffering from a stroke.
Metabolic and Lifestyle Risk Factors
When it comes to preventing stroke, taking personal responsibility for your health is key. Many of the most significant stroke risk factors are tied to metabolic conditions and lifestyle choices that we have the power to control. In addition to the positive effects of lowering your stroke risk, managing these factors also protects your overall well-being. Let’s explore some of the most critical metabolic and lifestyle risk factors for stroke and how you can take action to keep yourself out of harm's way.
Diabetes
Did you know that people with diabetes are up to twice as likely to have a stroke? This is because diabetes can severely damage your blood vessels, making them more prone to blockages or bleeding. Significantly, high blood sugar levels, when poorly managed, contribute to this damage, putting you at higher risk for both ischemic and hemorrhagic stroke.
The good news is that by managing your diabetes through diet, exercise, and regular monitoring, you can significantly reduce your stroke risk. A diet rich in vegetables, whole grains, and lean proteins can help regulate blood sugar levels, while regular physical activity enhances your body’s ability to use insulin effectively. Monitoring your blood sugar and follow your doctor’s advice on medications or insulin. With the right management plan, you can take control of your diabetes and lower your chances of a stroke.
Reference: https://pubmed.ncbi.nlm.nih.gov/29571978/
Obesity and Sedentary Lifestyle
Carrying excess weight, particularly around the midsection, is a major risk factor for stroke. Obesity is often associated with high blood pressure, diabetes, and high cholesterol—all of which increase the likelihood of stroke. But it’s not just the weight; a sedentary lifestyle also compounds the risk. Spending too much time sitting and not enough time moving weakens the heart and vascular system, further elevating the risk.
Even if you feel pressed for time, remember that small changes can make a big impact. Just 10 minutes of brisk walking daily can improve your heart health, boost your energy, and lower your stroke risk. You don’t need to become a gym fanatic—adding little movements like taking the stairs, parking farther away, or walking during work breaks can make a huge difference over time.
Reference: https://pubmed.ncbi.nlm.nih.gov/36401452/
Smoking
Quitting smoking is one of the best things you can do for your health. Smoking doubles your risk of stroke, largely because it damages blood vessels, making them narrower and more prone to clotting. The chemicals in tobacco also raise blood pressure and decrease the amount of oxygen your blood can carry to the brain.
If you smoke, there’s no better time to quit. Within weeks of quitting, your blood pressure will start to drop, and your risk of stroke will decrease significantly. There are many resources available to help you quit, including nicotine replacement therapies, prescription medications, and counseling services. Support groups, online resources, and quitlines are also available for encouragement and advice. The journey to quitting can be tough, but the benefits are immediate and life-changing—not just for reducing your stroke risk but for improving your overall health and longevity.
Reference: https://pubmed.ncbi.nlm.nih.gov/34397463/
By taking responsibility for your health and addressing these metabolic and lifestyle risk factors, you can take real steps to reduce your risk of stroke. Every healthy choice you make—from managing your diabetes to staying active and quitting smoking—brings you one step closer to a stroke-free life. The power is in your hands, and the time to act is now.
Non-Modifiable Risk Factors
In addition to factors individuals can control with their lifestyle choices, there are certain risk factors for stroke that cannot be changed. These non-modifiable risk factors are linked to biological traits and family history. While you can’t alter them, understanding their influence on your health can help you and your healthcare provider develop a plan for reducing your overall risk.
Age
Did you know that your risk of having a stroke doubles every decade after you turn 55? This happens because, as we age, our blood vessels naturally become stiffer and more prone to blockages. Conditions that elevate stroke risk—such as high blood pressure and atrial fibrillation—also become more common with age. While aging is inevitable, being aware of this increased risk can motivate you to focus on managing the factors you can control, like maintaining healthy blood pressure, eating a balanced diet, and staying physically active.
Reference: https://pubmed.ncbi.nlm.nih.gov/25547343/
Genetics and Family History
Your genes play a critical role in determining your stroke risk. If any close family members—such as parents, siblings, or grandparents—have had a stroke, your chances of having one are higher. This may be due to inherited conditions such as high blood pressure, diabetes, or clotting disorders. In some families, genetic conditions like sickle cell disease or familial hypercholesterolemia (which causes dangerously high cholesterol levels) can further increase stroke risk.
Knowing your family’s health history is essential. Share this information with your healthcare provider to help them assess your stroke risk more accurately. They may recommend more frequent screenings for blood pressure, cholesterol, or other conditions and personalized strategies for managing your health. Early awareness of genetic risk factors allows you to take preventive measures and work closely with your healthcare team to mitigate those risks as much as possible.
Reference: https://pubmed.ncbi.nlm.nih.gov/27796860/
By considering these non-modifiable risk factors alongside the lifestyle changes you can control, you’ll have a more comprehensive plan for reducing your stroke risk. Understanding your age-related and genetic risks empowers you to make informed decisions about your health and take preventive action early on.
Modifiable Cardiovascular Risk Factors
While some stroke risk factors can’t be changed, there are many cardiovascular conditions that can be managed or improved through lifestyle choices and medical treatment. Taking charge of these modifiable risk factors is essential to reducing your stroke risk. Let’s look at three key cardiovascular conditions contributing to stroke and explore the steps you can take to manage them.
Hypertension (High Blood Pressure)
High blood pressure, or hypertension, is one of the most significant risk factors for stroke. When your blood pressure is consistently too high, it damages your blood vessels, making them weaker and more prone to rupture or clotting. This increases the likelihood of both ischemic stroke (caused by a clot) and hemorrhagic stroke (caused by a burst blood vessel). Having your blood pressure checked on a regular basis is important to know of you have chronic hypertension. Over 50% of adults in the U.S. have hypertension, making it a widespread and dangerous health concern.
Fortunately, hypertension can often be controlled or even prevented with some simple lifestyle changes:
Diet: Eating a diet rich in fruits, vegetables, whole grains, and lean proteins can help lower blood pressure. Reducing salt (sodium) intake is also crucial, as too much salt causes the body to retain fluid, which raises blood pressure. The DASH (Dietary Approaches to Stop Hypertension) diet is designed to specifically help manage blood pressure.
Exercise: Regular physical activity strengthens the heart and improves blood flow, which helps lower blood pressure. Aim for at least 30 minutes of moderate exercise, such as brisk walking, most days of the week.
Medication: If lifestyle changes aren’t enough, your healthcare provider may prescribe medications such as ACE inhibitors, beta-blockers, or diuretics to help control your blood pressure. Taking medications as prescribed and monitoring your blood pressure regularly is essential.
Reference: https://pubmed.ncbi.nlm.nih.gov/28041900/
Atrial Fibrillation (AFib)
Atrial fibrillation, or AFib, is a common heart condition characterized by an irregular and often rapid heart rate. In AFib, the upper chambers of the heart (the atria) beat chaotically, which can cause blood to pool and form clots. If a clot forms in the heart and travels to the brain, it can block an artery and cause an ischemic stroke. People with AFib are five times more likely to have a stroke than those without this condition.
If you have AFib, it’s critical to monitor and treat the condition to reduce your stroke risk. Treatment options include:
Medications: Blood thinners (anticoagulants) such as warfarin or newer medications like apixaban can help prevent clots from forming. Beta-blockers or calcium channel blockers may be prescribed to control heart rate and rhythm.
Lifestyle changes: Reducing alcohol and caffeine intake, managing stress, and quitting smoking can improve heart health and reduce AFib episodes.
Monitoring: Regular check-ups with your doctor and self-monitoring for irregular heartbeats are key to managing AFib. In some cases, medical procedures such as electrical cardioversion or catheter ablation may be recommended to restore a normal heart rhythm.
Reference: https://pubmed.ncbi.nlm.nih.gov/37760839/
Coronary Artery Disease
Coronary artery disease (CAD) occurs when the coronary arteries, which supply blood to the heart, become narrowed or blocked due to atherosclerosis—a buildup of fatty deposits (plaque) on the artery walls. Atherosclerosis not only affects the heart but also increases the risk of stroke by restricting blood flow to the brain or by causing clots to form and travel to the brain. CAD is one of the leading causes of stroke, particularly ischemic stroke.
Fortunately, CAD can often be prevented or managed through heart-healthy living:
Diet: Like managing hypertension, eating a diet low in saturated fats, trans fats, and cholesterol can help prevent plaque buildup. Incorporating heart-healthy fats, like those found in olive oil and avocados, is a smart way to support artery health.
Exercise: Regular aerobic exercise improves circulation and strengthens the heart, reducing the risk of CAD and stroke.
Quit Smoking: Smoking damages blood vessels and accelerates the buildup of plaque in the arteries. Quitting smoking is one of the best things you can do for your heart and brain.
Medications: For those already diagnosed with CAD, medications such as statins (to lower cholesterol) or antiplatelet drugs (to prevent clots) are commonly prescribed. Managing high blood pressure and diabetes is also crucial for those with CAD.
Reference: https://pubmed.ncbi.nlm.nih.gov/34911345/
By taking charge of these modifiable cardiovascular risk factors, you can significantly reduce your chances of having a stroke. Managing blood pressure, heart rhythm, and artery health through lifestyle choices and medical treatment is crucial for protecting your brain and ensuring a long, healthy life.
Environmental Risk Factors
While many stroke risk factors stem from personal lifestyle choices or genetics, some risks are tied to environmental and occupational influences that may seem less within your control. However, by understanding these emerging and environmental risk factors, you can still take meaningful steps to minimize exposure and protect your health.
Air Pollution
Emerging research has shown that long-term exposure to air pollution, especially fine particulate matter (PM2.5), can significantly increase your risk of stroke. These tiny particles enter the bloodstream through the lungs, causing inflammation and damage to blood vessels over time. This damage can lead to atherosclerosis, which increases the risk of blood clots that can block blood flow to the brain, triggering an ischemic stroke. Urban areas, where pollution levels tend to be higher, pose an even greater risk for those with pre-existing conditions like asthma or heart disease.
While you can’t fully control the air you breathe, there are steps you can take to reduce your exposure to harmful pollutants:
Monitor air quality: Use apps or websites like AirNow to monitor daily air quality reports. Limit outdoor activities, especially strenuous exercise, on days when pollution levels are high.
Stay indoors during peak pollution times: Avoid outdoor activities during rush hour or when pollution levels are highest, typically in the late afternoon.
Improve indoor air quality: Using air purifiers with HEPA filters can significantly reduce indoor particulate matter. Keep windows closed on days with poor air quality, and avoid using tobacco or harsh chemical cleaners indoors.
Taking these precautions limits your exposure to harmful pollutants and better protects your cardiovascular health.
Reference: https://pubmed.ncbi.nlm.nih.gov/30878142/
Occupational Stress and Long Working Hours
Job stress and working long hours have emerged as significant risk factors for stroke. Research shows that individuals who work long hours (55 hours or more per week) are up to 33% more likely to suffer from a stroke compared to those with a standard workweek. Chronic stress raises cortisol levels in the body, which increases blood pressure, triggers inflammation, and can damage blood vessels over time. Furthermore, long working hours often lead to poor coping mechanisms like unhealthy eating, lack of exercise, or smoking, which compound the risk.
To manage occupational stress and reduce your stroke risk, try these strategies:
Set boundaries: Establish clear working hours and stick to them. Learn to say “no” to additional responsibilities that could overextend you, and prioritize your work-life balance.
Take regular breaks: Short breaks throughout the day can help you reset and manage stress. Simple activities like deep breathing or stretching during breaks can reduce tension and improve mental clarity.
Exercise regularly: Physical activity is a powerful tool for managing stress and improving cardiovascular health. Incorporating even short bursts of activity—like a brisk walk or a quick stretching session—can help counteract the negative effects of long working hours.
Prioritize sleep: Quality sleep is essential for both mental and physical health. Ensure you get 7-9 hours of sleep per night and create a consistent sleep routine that promotes relaxation before bed.
On a broader scale, consider advocating for workplace policies that promote healthier work environments, such as flexible working hours, mental health support, and stress management programs. By addressing job stress at both the individual and organizational levels, you can significantly reduce your risk of stroke.
Reference: https://pubmed.ncbi.nlm.nih.gov/37813670/
Female-Specific Risk Factors
Certain risk factors for stroke are unique to women, particularly those related to pregnancy and hormonal changes. Recognizing these female-specific risk factors and taking proactive steps can help reduce the long-term risks for women. This section will focus on pregnancy-related conditions, such as preeclampsia, and the importance of maintaining a healthy waist-to-hip ratio, which can also elevate stroke risk.
Preeclampsia and Hypertensive Disorders of Pregnancy
Preeclampsia and other hypertensive disorders during pregnancy are serious medical conditions that increase the risk of stroke both during pregnancy and later in life. Preeclampsia, characterized by high blood pressure and signs of damage to another organ system (usually the liver or kidneys), typically occurs after 20 weeks of pregnancy. Women who have had preeclampsia are at a significantly higher risk of developing chronic hypertension, cardiovascular disease, and stroke in the years following pregnancy.
The increased stroke risk is largely due to the long-term effects of high blood pressure, which can damage blood vessels and increase the likelihood of clots or hemorrhages in the brain. For women with a history of preeclampsia, taking steps to reduce their stroke risk post-pregnancy is crucial:
Monitor blood pressure: Regular blood pressure checks are essential after pregnancy, especially for women with a history of preeclampsia. If high blood pressure persists, medications may be necessary to control it.
Adopt a heart-healthy lifestyle: Eating a balanced diet, exercising regularly, and maintaining a healthy weight can all help manage blood pressure and reduce stroke risk.
Manage other risk factors: Women with preeclampsia are also at higher risk for diabetes and high cholesterol, both of which contribute to stroke. Regular health screenings and early intervention can make a significant difference.
Women should continue working closely with their healthcare providers to monitor cardiovascular health beyond pregnancy.
Reference: https://pubmed.ncbi.nlm.nih.gov/27842176/
Waist-to-Hip Ratio Risk
A woman’s body shape, particularly the distribution of body fat, can also influence stroke risk. Studies have shown that an elevated waist-to-hip ratio—a measure of abdominal fat distribution—is a significant predictor of stroke risk, particularly in women. Women who carry more fat around their abdomen, compared to their hips, are more likely to experience stroke due to the metabolic effects of abdominal fat, including increased blood pressure, insulin resistance, and inflammation.
To assess this risk, measure your waist and hips and divide the waist measurement by the hip measurement. A ratio of more than 0.85 for women is considered high and indicates an elevated risk for cardiovascular issues, including stroke. To reduce this risk:
Focus on reducing abdominal fat: Diet and exercise that target overall body fat, particularly around the midsection, can significantly lower stroke risk.
Increase physical activity: Engaging in regular aerobic exercise helps burn fat, reduce blood pressure, and improve heart health.
Adopt a healthy diet: A diet rich in whole foods, particularly fruits, vegetables, and lean proteins, helps maintain a healthy weight will reduce your waist-to-hip ratio.
Monitoring the waist-to-hip ratio, in conjunction with other health screenings, can be an effective way for women to assess and manage their stroke risk.
Reference: https://pubmed.ncbi.nlm.nih.gov/36068544/
Hypertension-Inducing Medicines
Many commonly prescribed medications can raise blood pressure as a side effect, increasing the risk of stroke, particularly in individuals already prone to hypertension or cardiovascular disease. It’s important for anyone on these medications to monitor their blood pressure regularly and consult with healthcare providers about managing these risks.
Key Medications to Watch:
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs, e.g., Ibuprofen, Naproxen): NSAIDs are widely used for pain and inflammation, but they can raise blood pressure by affecting kidney function and fluid balance, leading to a higher risk of stroke and other cardiovascular events.
Reference: https://pubmed.ncbi.nlm.nih.gov/34767568/Decongestants (e.g., Pseudoephedrine): Found in many over-the-counter cold and allergy medications, decongestants can narrow blood vessels and elevate blood pressure, posing significant risks for people with hypertension.
Reference: Ephedrine-and-Pseudoephedrine-A-Comprehensive-Review-of-Their-Pharmacology-and-Clinical-Applications.pdf (researchgate.net)Certain Antidepressants (e.g., SNRIs like Venlafaxine): Antidepressants, particularly in higher doses, can increase blood pressure, contributing to an elevated stroke risk, especially in association with high-fructose diets.
Reference: PMID: 32461723Hormonal Contraceptives: Birth control pills containing estrogen can raise blood pressure, especially in women over 35 or those who smoke, increasing stroke risk.
Reference: PMID: 22129517Immunosuppressants (e.g., Cyclosporine): These drugs, used to prevent organ rejection in transplant patients or to treat autoimmune conditions, can significantly raise blood pressure, increasing the risk of stroke.
Reference: PMID:20091657Corticosteroids (e.g., Dexamethasone): Corticosteroids are commonly used for treating inflammation and autoimmune diseases, but they can lead to increased blood pressure by causing the body to retain salt and water. Risk is pronounced with long-term exposure due to glutathione depletion and impairment of a critical detoxification pathway for iron. Long-term use can raise the risk of stroke, particularly in people with preexisting cardiovascular conditions.
Reference: PMID: 35108055Stimulants (e.g., medications for ADHD like Methylphenidate): Stimulants can increase both heart rate and blood pressure, posing risks for individuals with existing cardiovascular concerns.
Reference: PMID: 32792083
Managing Medication-Related Stroke Risk
If you're taking any of these medications, it's important to be vigilant against polypharmacy: using more than one may enhance risk. It’s also important to be proactive in monitoring your blood pressure. Regular health checks and discussions with your doctor can help you find safer alternatives if necessary. Home blood pressure monitors are a practical way to track changes over time, especially when starting or adjusting medications.
Take Control of Your Health
If you're concerned about how your medications might affect your blood pressure or increase your stroke risk, consult your doctor or pharmacist immediately. Together, you can explore safer alternatives, adjust doses, or develop a plan to manage your blood pressure while still treating your condition effectively.
Preventive Measures
Taking control of your health is the most powerful way to reduce your risk of stroke. By being proactive, you can manage key risk factors and make choices that protect your long-term cardiovascular health. The following preventive measures are essential steps that everyone should incorporate into their routine, but they also emphasize the importance of owning your health journey and not allowing external pressures to put you at risk.
Know Your Numbers
Regular health checks are crucial for monitoring key risk factors contributing to stroke. Conditions like high blood pressure, high cholesterol, and high blood sugar often develop silently, with no noticeable symptoms, until they lead to more serious health issues like stroke. This makes it critical to "know your numbers" and stay on top of these vital signs:
Blood Pressure: High blood pressure is the single most important modifiable risk factor for stroke. Regularly checking your blood pressure ensures that you catch any increases early so that you can take action to control it. Aim for a blood pressure reading of 120/80 mmHg or lower.
Cholesterol: High LDL (“bad”) cholesterol levels can lead to the buildup of plaques in your arteries, increasing your risk of stroke. Aim to keep your LDL levels below 100 mg/dL and discuss any concerning results with your doctor.
Blood Sugar: Elevated blood sugar levels can indicate diabetes or prediabetes, both of which significantly increase your stroke risk. Aim for an A1C level below 5.7%, and if you have diabetes, work with your healthcare provider to maintain control over your condition.
Make it a habit to check these numbers regularly and be your own advocate—ensure that your healthcare providers are helping you stay on top of potential risk factors.
Reference: https://pubmed.ncbi.nlm.nih.gov/28041900/
Healthy Eating
It’s worth repeating that a balanced diet is essential for preventing stroke. Eating the right foods not only keeps your blood pressure, cholesterol, and weight in check, but also supplies your body with the nutrients it needs to protect your heart and brain. Here are some key foods that promote cardiovascular health:
Fruits and Vegetables: Rich in vitamins, minerals, and antioxidants, fruits and vegetables help lower blood pressure and reduce inflammation. Aim for a variety of colors on your plate, and include leafy greens, berries, and cruciferous vegetables like broccoli and cauliflower.
Whole Grains: Whole grains like oats, brown rice, and quinoa are packed with fiber, which helps lower cholesterol and stabilize blood sugar levels.
Healthy Fats: Incorporating healthy fats, such as those found in avocados, olive oil, and nuts, can improve cholesterol levels and reduce your risk of stroke.
Lean Proteins: Include lean proteins like chicken, fish, and plant-based proteins such as beans and legumes, which support cardiovascular health.
It’s important to focus on long-term eating habits, not crash diets. Small, consistent changes to your diet can have a big impact over time. Remember that you control your diet—don’t let others pressure you into unhealthy eating patterns.
Reference: https://pubmed.ncbi.nlm.nih.gov/29571978/
Staying Active
Physical activity is one of the most effective ways to reduce stroke risk. Exercise strengthens your heart, improves circulation, lowers blood pressure, and helps maintain a healthy weight. Incorporating movement into your daily routine doesn’t have to be overwhelming, and small steps can lead to significant health benefits:
Daily Movement: Aim for at least 30 minutes of moderate exercise, such as brisk walking, cycling, or swimming, most days of the week. If 30 minutes at once feels daunting, break it into smaller chunks throughout the day.
Incorporate Movement into Work: If possible, improve your work patterns by incorporating standing or walking breaks, taking the stairs instead of the elevator, or having walking meetings. If you have a desk job, try to stand and stretch every hour.
Fun Activities: Find an activity you enjoy—dancing, hiking, playing a sport—and make it part of your routine. The key is to make exercise something you look forward to, rather than a chore.
Regular physical activity not only lowers stroke risk but also helps reduce stress, which can be a major contributor to cardiovascular issues. Don’t let the demands of others or work pressure sideline your commitment to staying active. Your health should be a top priority.
Reference: https://pubmed.ncbi.nlm.nih.gov/36401452/
Quit Smoking
Smoking significantly raises your risk of stroke by damaging your blood vessels, raising blood pressure, and reducing oxygen in your blood. If you smoke, quitting is the most powerful step you can take to reduce your stroke risk. The good news is that within a few years of quitting, your stroke risk drops to nearly the same level as a non-smoker. Here are some resources and strategies to help you quit:
Nicotine Replacement Therapy: Products like nicotine patches, gum, or lozenges can help manage cravings and make it easier to quit.
Prescription Medications: Talk to your doctor about medications that can help you stop smoking, such as varenicline (Chantix) or bupropion (Zyban).
Counseling and Support: Many people find success through counseling or support groups. Online resources and quitlines, such as 1-800-QUIT-NOW, offer support from trained professionals.
Quitting smoking isn’t easy, but there’s plenty of help available. Most importantly, remember that your health comes first—don’t let others, or even stressors in your life, push you to continue habits that put you at risk.
Reference: https://pubmed.ncbi.nlm.nih.gov/34397463/
Manage Stress
Chronic stress can contribute to high blood pressure, unhealthy coping behaviors, and increased stroke risk. Managing stress is crucial for maintaining your overall health and preventing stroke. Set boundaries in your personal and professional life to avoid being overwhelmed. Whether through mindfulness practices, exercise, hobbies, or simply taking time for yourself, find ways to de-stress. Remember that you are in control of your life—don’t let others impose stroke risk upon you by adding unnecessary stress or pressure. Learn to say “no” and prioritize your health over external demands.
Reference: https://pubmed.ncbi.nlm.nih.gov/30878142/
By following these preventive measures, you can take charge of your health and significantly reduce your stroke risk. Knowing your numbers, eating well, staying active, quitting smoking, guarding against medicine-induced hypertension, and managing stress are all within your control. Take ownership of your health journey, and don’t let external pressures derail your efforts.
