What Puts You at Risk for a Stroke?

A stroke, sometimes called a "brain attack," happens when blood flow is cut off to a part of your brain, stopping the cells from getting the blood they need to live. Brain cells may recover, but after a few minutes, they could die, resulting in permanent damage.

You can change or manage some things that put you at risk for a stroke, such as high blood pressure and smoking. Others, including age and race, you can't. The National Institute of Neurological Disorders and Stroke estimates that 8 out of 10 strokes can be prevented.

Talk to your doctor about your medical history and your lifestyle. He can help you treat any diseases or conditions and lower your risk for having a stroke.

Types of Strokes

Most common is an ischemic stroke. It happens when a blood vessel that takes blood to your brain gets blocked. Often, it's by a blood clot that traveled from another part of your body. For example, fatty deposits in arteries can break off, flow to the brain, and cause blood clots. And sometimes clots form in the heart when you have poor blood flow because of an irregular heartbeat, called atrial fibrillation.

A hemorrhagic stroke happens when a blood vessel in your brain bursts and bleeds, which can damage the tissue. They're less common but more serious. Uncontrolled high blood pressure and over-using blood thinners can lead to this kind of stroke.

A transient ischemic attack (TIA) is a "mini stroke" from a temporary blockage. Although it doesn't cause permanent brain damage, it may cause stroke symptoms that could last minutes or hours.

Medical Conditions You Can Control

Make sure you're working with your doctor to treat these conditions, which make a stroke more likely.

High blood pressure, 140/90 or higher, is the leading risk for stroke. When blood pushes too forcefully against the walls of your arteries, it can damage or weaken them and lead to stroke. Ideally, try to keep your blood pressure below 120/80.

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AFib makes you five times more likely to have a stroke, according to the National Stroke Association.

Coronary artery disease, heart failure, an enlarged heart, and other heart diseases make you more likely to have a stroke.

Too much cholesterol raises your chances of both heart disease and atherosclerosis. High cholesterol contributes to plaque buildup in arteries, which can block blood flow to the brain.

People with diabetes face a higher risk of stroke because they often have other health problems as well as stroke risk factors, including high blood pressure, high cholesterol, and heart disease.

Extra weight, along with the less-active lifestyle that can come with it, raises the chances of high blood pressure, heart disease, and diabetes.

Medications

The blood thinners used to prevent blood clots and lower your risk of stroke can also raise the risk if used incorrectly. Check with your doctor to make sure you need to take the medicine and that you're taking the right dose.

Hormones in birth control pills and patches and postmenopausal therapy place some women at greater risk for stroke. If you're over 35 or have high blood pressure, diabetes, or high cholesterol, or if you smoke, ask your doctor about your risk and your options.

Unhealthy Lifestyle

Eating a lot of saturated and trans fats, cholesterol, and salt makes you more likely to have a stroke and the conditions that put you at risk. Not getting regular exercise will also lead to health problems that can increase the chance of a stroke.

Other "bad habits" for stroke include:

  • Alcohol
  • Recreational drugs
  • Smoking

Smoking lowers oxygen levels in your blood, forcing your heart to work harder and making it easier for blood clots to form. Nicotine raises your blood pressure. Cigarette smoke can also damage your arteries and make atherosclerosis worse. According to the National Stroke Association, smokers have twice the risk of stroke as nonsmokers. Even secondhand smoke can have an effect.

Some research has linked too much alcohol to a higher risk of stroke. It can raise your blood pressure and boost the level of certain fats in your blood, which can harden your arteries. Women should have no more than one drink a day; men, two.

Illegal drugs, including cocaine, heroin, and amphetamines, increase your chances, too.

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What You Can't Control

  • Age
  • Family history
  • Gender
  • Race or ethnicity

Anyone could have a stroke, even children, but it becomes more common as people get older. For each decade after age 55, your chance of stroke roughly doubles. They're more common in men, but over half of people who die from a stroke are women.

If your parent, grandparent, brother, or sister has had one, or if a family member had a heart attack at an early age, your chances of having a stroke go up.

People of African, Hispanic, Native American, and Alaska Native heritage are at greater risk than non-Hispanic white and Asian people. African-Americans are almost twice as likely to have a first stroke and much more likely to die from strokes than whites, partly because they have a higher risk of high blood pressure, diabetes, and obesity.

Some medical problems set you up for a stroke, too:

  • Previous stroke, heart attack, or TIA
  • Problems with how your arteries are formed
  • A hole or flap in your heart

The risk of a second stroke is much higher if you've already had one. TIA is also a warning sign you shouldn't ignore. Up to a third of people with these "mini-strokes" will go on to have a more severe stroke, according to the National Institutes of Health.

The chance of a hemorrhagic stroke goes up if you have blood vessels that aren't structurally sound or that developed wrong. It could be a bulge in a weak area of an artery's wall within the skull. Doctors call that ballooning bump an aneurysm. Or you could have an abnormal connection between your arteries and veins, called arteriovenous malformation.

If you have fibromuscular dysplasia, stringy tissue grows in your artery walls, making them narrower. The lessened blood flow can lead to stroke.

About 15% to 20% of people have a hole or flap-like opening between the two upper chambers of their heart. This condition doesn't cause any symptoms, so they may not realize they're at risk of stroke or TIA. A blood clot can pass through this opening and travel to the brain.

WebMD Medical Reference Reviewed by Suzanne R. Steinbaum, MD on August 04, 2015

Sources

SOURCES:

CDC: "Stroke."

National Institute of Neurological Disorders and Stroke: "Brain Basics: Preventing Stroke."

Cleveland Clinic: "Understanding Stroke," "What is a Stroke?" "Know Your Risk Factors for Stroke," "Transient Ischemic Attack."

Merck Manuals Online: "Stroke: Introduction."

National Stroke Association: "Am I at risk for a stroke?"

Womenshealth.gov: "Stroke."

American Heart Association: "Stroke Risk Factors."

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