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STROKE RISK FACTORS

The American Heart Association has identified several factors that increase the risk of stroke. The more risk factors a person has, the greater the chance that he or she will have a stroke. Some of these you can't control, such as increasing age, family health history, prior stroke, race and gender. But you can modify, treat or control most risk factors to lower your risk of stroke. Factors resulting from lifestyle or environment can be modified with a healthcare provider's help.

What are the risk factors for stroke?

  • Increasing age - The chance of having a stroke more than doubles for each decade of life after age 55. While stroke is common among the elderly, substantial numbers of people under 65 also have strokes.
  • Sex - The latest data show that, overall, the incidence and prevalence of stroke are about equal for men and women. However, more than half of total stroke deaths occur in women.
  • Heredity (family history) and race - The chance of stroke is greater in people who have a family history of stroke. African Americans have a much higher risk of death and disability from a stroke than whites, in part because blacks have a greater incidence of high blood pressure and diabetes. Asian-Pacific Islanders and Hispanics also have a high risk of stroke.
  • Prior stroke - The risk of stroke for someone who has already had one is many times that of a person who has not.
  • High blood pressure - High blood pressure is defined in an adult as a systolic pressure of 140 mm Hg or higher and/or a diastolic pressure of 90 mm Hg or higher for an extended time. It's the most important risk factor for stroke. Many people believe the effective treatment of high blood pressure is a key reason for the accelerated decline in the death rates for stroke.
  • Cigarette smoking - In recent years studies have shown cigarette smoking to be an important risk factor for stroke. The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways. Using birth control pills and smoking cigarettes greatly increases stroke risk.
  • Diabetes mellitus - Diabetes is an independent risk factor for stroke and is strongly correlated with high blood pressure. While diabetes is treatable, having it still increases a person's risk of stroke. People with diabetes often also have high cholesterol and are overweight, increasing their risk even more.
  • Carotid artery disease - The carotid arteries in your neck supply blood to your brain. A carotid artery damaged by arteriosclerosis (a fatty buildup of plaque in the artery wall) may become blocked by a blood clot, causing a stroke. If you have a diseased carotid artery, your healthcare provider may hear an abnormal sound in your neck called a bruit when listening with a stethoscope. People with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke. Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles. It's caused by arteriosclerosis.
  • Heart disease - A diseased heart increases the risk of stroke. In fact, people with heart problems have more than twice the risk of stroke as people whose hearts work normally. Atrial fibrillation (the rapid, uncoordinated quivering of the heart's upper chambers), in particular, raises the risk for stroke. Heart attack is also the major cause of death among stroke survivors
  • Transient ischemic attacks (T.I.A.s) - TIAs are "mini-strokes" that produce stroke-like symptoms but no lasting damage. They're strong predictors of stroke. A person who's had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't. Don't ignore TIAs - get medical help immediately!
  • High red blood cell count - A moderate or marked increase in the red blood cell count is a risk factor for stroke. The reason is that more red blood cells thicken the blood and make clots more likely.
  • Sickle cell anemia - This genetic disorder mainly affects African-American and Hispanic children. "Sickled" red blood cells are less able to carry oxygen to the body's tissues and organs. They also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke.

What other factors can affect the risk of stroke?

  • Socioeconomic factors - There's some evidence that people of lower income and educational levels have a higher risk for stroke.
  • Excessive alcohol intake - Excessive drinking (an average of more than one drink per day for women and more than two drinks per day for men) and binge drinking can lead to stroke. It can also raise blood pressure, contribute to obesity, high triglycerides, cancer and other diseases, and cause heart failure.
  • Certain kinds of drug abuse - Intravenous drug abuse carries a high risk of stroke from a cerebral embolism . Cocaine use has been closely related to strokes, heart attacks and a variety of other cardiovascular complications. Some of them have been fatal even in first-time cocaine users.

How are heart disease risk factors related to stroke or stroke ?

Some risk factors affect the risk of stroke indirectly by increasing the risk of heart disease:

  • High blood cholesterol and lipids - A high level of total cholesterol in the blood (240 mg/dL or higher) is a major risk factor for heart disease, which raises the risk of stroke. Recent studies show that in people with prior coronary heart disease, ischemic stroke or transient ischemic attack (TIA), high levels of LDL ("bad") cholesterol (greater than 100 mg/dL) directly increase the risk of stroke. High levels of HDL ("good") cholesterol (35 mg/dL or more) lower your risk of heart disease and stroke. People with a low level of HDL cholesterol (less than 35 mg/dL) have a higher risk of heart attack and stroke.

  • Physical inactivity - Physical inactivity increases the risk of heart disease, which raises the risk of stroke. Regular physical activity helps reduce your risk of heart disease, heart attack and stroke. You can gain health benefits from doing moderate-intensity physical activity for a total of 30 minutes a day on most days.

  • Obesity or overweight - If you have too much fat, especially in the waist, you're at higher risk for health problems. These include high blood pressure, high blood cholesterol, high triglycerides (blood fats), diabetes, heart disease and stroke. A high-risk waistline is defined as more than 35 inches for women, more than 40 inches for men. Obesity is defined as a body mass index (BMI) of 30 or greater, or about 30 pounds or more overweight. (To find your body mass index, multiply your weight in pounds by 705, divide by your height in inches, then divide again by your height in inches.)

For stroke information, call the American Stroke Association at 1-888-4STROKE.

If you or someone you know has experienced stroke, please call our Stroke Family "Warmline" at 1-800-553-6321.


© 2000 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited.

The information contained in this American Heart Association (AHA) Web site is not a substitute for medical advice or treatment, and the AHA recommends consultation with your doctor or health care professional.