Prevention

Prevention is the number one way to disrupt stroke. The best way to prevent stroke is by lowering your risk. You’re at higher risk for stroke if you smoke, have obesity or are physically inactive, or have high blood pressure, high cholesterol, heart disease, or diabetes. Many of these risk factors can be controlled through medications and healthy lifestyle choices. The sooner you start taking steps to lower your risk, the better.

In recent years, a better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half. Researchers at NINDS predict that, with continued attention to reducing risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes.

 

Risk Factors for Stroke

Stroke occurs in all age groups, sexes, and races in every country. Stroke can even occur before birth, when the fetus is still in the womb. This is a common cause of cerebral palsy.

A risk factor is a condition of behavior that occurs more frequently in those who have, or are at greater risk of getting, a disease than in those who don't. Having a risk factor for stroke doesn't mean you'll have a stroke, and not having a risk factor doesn't mean you won't have have a stroke. But your risk of stroke grows as the number and severity of risk factors increases.

Some risk factors for stroke can be changed, and some cannot. Understanding and working to address the risk factors you can change may help prevent a stroke. Generally, stroke risk factors call into two categories: unmodifiable and modifiable.

1. Unmodifiable: Risk factors that cannot be changed or controlled
2. Modifiable: Risk factors that can be changed or controlled, typically through medical care and/or lifestyle changes

Unmodifiable Risk Factors:

Age

Stroke affects people of all ages, but risk increases with age.

Biological sex

Stroke is more common in men than women. men have a higher risk of stroke in young and middle age, but rates even out at older ages, and more women die from stroke.

Family history

Having a parent, grandparent, or sibling who has had a stroke puts a person at greater risk for stroke.

Race and ethnicity

The incidence of stroke among Black and Hispanic Americans is almost double that of White people. Black and Hispanic Americans tend to have strokes at a younger age. The death rate from stroke is higher in Black people than in other groups.

Prior stroke or heart attack

Someone who has had a stroke or heart attack has a higher risk of having another one. Individuals who have had a heart attack also have a higher stroke risk.

 

Modifiable Risk Factors:

High blood pressure

High blood pressure (hypertension) is the number one risk factor for stroke. For people with high blood pressure, the risk for stroke before age 80 is two to four times higher than the risk for those without high blood pressure.

Cholesterol levels

Many people do not realize that high cholesterol can increase a person's risk of stroke. Cholesterol can build up in blood vessels, leading to stenosis and atherosclerosis. This excess plaque blocks blood vessels and helps to form blood clots.

Diabetes

Diabetes can damage the blood vessels in the brain and increase a person's risk for stroke. High blood pressure is common among people with diabetes and accounts for much of their increased stroke risk.

Smoking

Smoking by itself (without the presence of other risk factors) almost doubles a person's risk for ischemic stroke. This risk for stroke decreases significantly about two years after a person quits smoking; by five years, the risk decreases to the level of nonsmokers.

Substance use disorder

Using illicit substances or medications other than as prescribed greatly increases the risk of stroke. The risk of a drug use-related stroke increases each time the drug is used, especially if other risk factors are present.

 

Other Risk Factors:

Living in the "stroke belt"

Eleven states have unusually high rates of death from stroke. The states are: Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia. Several of these states also have the highest death rates for cerebrovascular disease. This increased risk may be caused by geographic or environmental factors or by regional lifestyle differences, such as higher rates of cigarette smoking or a preference for salty, high-fat foods.

Atrial fibrillation

Atrial fibrillation, a rapid, irregular, weak beating of the heart, can cause blood clots which can lead to ischemic stroke.

Cerebral amyloid angiopathy

This buildup of the protein amyloid on the inside wall of blood vessels can cause them to burst, leading to hemorrhagic stroke. Irregularities in the brain's vascular system (the network of arteries, veins, and smaller blood vessels) can also cause hemorrhagic stroke.

Aneurysm

An aneurysm is a weak or thin spot on the artery wall. Over time, these weak spots stretch or balloon out. The thin walls of ballooning aneurysms can rupture, causing blood to gush into the space next to the brain and raise the intracranial pressure, causing inflammation, and even cause ischemic strokes. Small cerebral aneurysms, less than three millimeters in diameter, are common and usually do not cause symptoms. The risk of bleeding is increased if the aneurysms are large (greater than seven millimeters in diameter). In those instances, surgery and other procedures to repair the aneurysm may be necessary.

Arteriovenous malformations (AVMs)

AVMs increase the risk of hemorrhagic stroke. An AVM is an abnormal, snarled tangle of defective blood vessels within the brain that cause multiple irregular connections between the arteries and veins. The irregular connections allow blood from the arteries to travel directly to veins instead of first passing through a fine web of tiny capillaries. Veins are weaker than arteries, and their exposure to the higher blood pressures in the feeding artery can cause the vessels to rupture.

 

You can help prevent stroke by making lifestyle changes to reduce your risk factors. These include:

Managing your blood pressure, diabetes, and cholesterol

Make a plan with your doctor to keep your blood pressure, blood sugar, and cholesterol at healthy levels. if you take medicine for one of these conditions, make sure to take it as directed and make regular appointments with your doctor to monitor any changes. Know your target numbers for blood pressure and blood sugar. If you have high blood pressure, check your blood pressure with an automated monitor and share the results regularly with your doctor. This will help ensure you find the best treatment option for you.

Taking care of your heart

If you have a heart condition, including atrial fibrillation (a risk factor for  stroke), work with your healthcare team to develop a plan to manage it. Whether the plan includes surgery, medications, or lifestyle changes, make sure you stick to it.

Eating well

Eating a diet that includes a variety of fruits, vegetables, whole grains, and healthy proteins and fats can help you maintain a healthy weight and get the nutrients you need. Cutting down on salt and getting plenty of potassium can help manage high blood pressure, a major rick factor for stroke. It can also help with controlling other stoke risk factors, like heart problems or diabetes.

Quitting smoking

Smoking increases your risk for stroke - and many other diseases. Quitting smoking, no matter how long you've been smoking, will help reduce your risk.

Exercise and being active

Being physically active and getting exercise supports the health of your brain and the rest of your body. Aim for 30 minutes of moderate physical activity or exercise most days of the week. If that feels overwhelming, start by taking short walks around the block, or carrying a basket in the store instead of pushing a shopping cart.

Avoiding drugs and alcohol

Using drugs and alcohol can increase your risk of stroke. Work with your doctor to reduce your intake. If you are dependent on drugs or alcohol, a doctor can help you get the treatment you need.

 

Stroke Can Happen to Anyone - Even if Your Are Young

About 800,000 people have a stroke each year in the United States, and the stroke rate is rising in adults under the age of 49. While nearly three-quarters of strokes occur in people over 65, the risk about doubles each decade after age 55.

 

 

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Everyone is at risk for stroke and dementia, but if you’re a Black man 28–45, you have a higher risk. Take charge of your health! Learn how at Mind Your Risks.

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