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Risk Factors for Stroke

A risk factor is something that raises your chances of getting a disease or health problem.
You could have a stroke without the risks below. The more risks you have, the greater your chances are. If you have many, ask your doctor what you can do to lower them.
Hypertension is the biggest risk for stroke. Blood pressure is the force of blood on the arteries. High blood pressure is when it is higher than it should be for a long time. When it is normal, it is 120/80 mm Hg. Hypertension is when it is 140/90 mm Hg. If you have diabetes or kidney disease, it is 130/80 mm Hg.
Hypertension can harm blood vessels walls and cause them to weaken. If you aren't keeping your blood pressure in a target range, you have a higher risk of stroke. There aren't any symptoms. Get your blood pressure checked often.
Some risks can be lowered through lifestyle changes. Others can't be lowered, but you should still know about them.

Risks That Can Be Changed

Smoking
Smoking can:
  • Narrow blood vessels and reduce blood flow
  • Lead to plaque buildup in the arteries
  • Raise your heart rate and blood pressure and put extra pressure on weakened blood vessel walls
People who smoke are two to four times as likely as nonsmokers to have a stroke.
Nonsmokers who are exposed to smoke are also at risk.
Food Choices
Eating foods that are high in fat, and low in fruits, veggies, whole grains, and fiber raises your risk. It can lead to high cholesterol , obesity , and problems like diabetes. These are all risks for stroke.
Inactivity
Not being active doubles your risk for a heart attack or stroke. Working out helps your heart work better and helps your arteries stay healthy. It also helps lower the chance of other stroke risks like hypertension, high cholesterol, and diabetes.
Talk to your doctor before you start a workout program. Don't do too much too quickly.
Too Much Alcohol
Drinking too much alcohol can raise blood pressure, blood triglycerides that lead to plaque build up, and raise the risk of heart rhythm problems. It can also lead to other heart problems.
Some studies say moderate drinking lowers your risk of heart disease. This means one drink per day for women or two drinks per day for men. Doing so can affect your health. You don't need to start drinking since it does not lower it by a lot.
Drug Use
Using illegal drugs, mainly cocaine, can cause blood vessel harm. This can lead to blood clots and spasms in your arteries. Drug users also have a higher risk of dying from a heart attack.

Risks in Women

There are risks that are only women have. This may be due to health problems or treatments. In some women, it may lead to a higher risk of blood vessel harm or blood clots that can block blood flow to the brain. These risks are:
The risk of stroke is higher when you also have other risk factors, such as smoking.

Health Problems

Heart Diseases
Many heart problems, such as coronary artery disease or atrial fibrillation , change how the heart works and make it hard to meet the body's demands. Long term problems cause harm to blood vessels, raising the risk of blockage (ischemic stroke) or bleeding (hemorrhagic stroke).
Some heart issues are:
  • Transient ischemic attacks (TIA)—Sometimes called mini-strokes, TIAs are when blood flow is lowered by narrowing or blockage of blood vessels that lead to the brain. It often goes away on its own in 24 hours. TIAs are often a warning of a future stroke.
  • Brain aneurysm —An outpouching of a blood vessel wall in the brain that form in places where the artery wall is weak or thin. It can put pressure on parts of the brain and burst in some people.
  • Ateriovenous malformations (AVM)—A rare problem marked by unusual links between arteries and veins. Instead of an artery bringing blood to the brain, it is linked to a vein that takes it away, going past the parts of the brain that need it.
  • Vasculitis —Swelling of the blood vessels. Over time it may harm blood vessels, which may bleed or burst.
  • Silent stroke —Brain tissue damage found during imaging tests may be a sign of places where earlier strokes happened. They can be a warning for future stroke.
  • Prior heart attack or stroke
Vascular Dementia
Vascular dementia is caused by problems with blood getting to the brain. It may be caused by more than one TIA. Both are signs of a higher risk of having a major stroke.
Mental Health Problems
Having certain mental health problems, such as depression and anxiety are linked to a higher risk of stroke. Some of these problems and treatments may lead to poor lifestyle choices, such as smoking, weight gain, or lack of activity.
Sleep Apnea
Obstructive sleep apnea (OSA) is marked by many episodes of full or partial airway blockage while you sleep. It causes problems sleeping and lowers the amount of oxygen in your blood. It has been linked to many health problems, such as heart disease. It is also an risk for hypertension, heart failure, diabetes, and heart attack.

Risks That You Can't Change

Age
Brain function lowers as we age. This often isn't enough to cause problems. But it can raise the risk of getting heart disease, which can lead to a stroke. Some changes are stiffer blood vessels, small breaks in them, and thinking problems and memory loss.
Sex
The risk of stroke gets higher as you age. Men are more likely to have a stroke at a younger age. But women have more strokes and die from them. This may be due to the added risks that women have.
Genes
Having family members that have had a stroke or heart disease raises your risk, too. You are also at a higher risk if you have some genetic problems. For example, your blood may have a tendency to clot, which can raise the risk of narrowed or blocked arteries.
People who are Black have hypertension more often, so they are at higher risk of stroke. Stroke risk is also higher among American Indians and Native Alaskans.

References

Lifestyle risk factors. National Stroke Association website. Available at: https://www.stroke.org/understand-stroke/preventing-a-stroke/lifestyle-risk-factors/. Accessed January 17, 2019.
Esse K, Fossati-Bellani M, Traylor A, Martin-Schild S. Epidemic of illicit drug use, mechanisms of action/addiction and stroke as a health hazard. Brain Behav. 2011;1(1):44-54.
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2011;42(1):227-276. Available at: http://stroke.ahajournals.org/content/early/2010/10/21/STR.0b013e3181f7d043.full.pdf. Accessed January 16, 2018.
Risk factors for stroke or transient ischemic attack. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T361037/Risk-factors-for-stroke-or-transient-ischemic-attack. Updated October 1, 2018. Accessed January 17, 2018.
Stroke. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/stroke/atrisk. Accessed January 17, 2018.
Winstein CJ, Stein J, Arena R, et al, American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on Quality of Care and Outcomes Research.. Guidelines for Adult Stroke Rehabilitation and Recovery: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2016 Jun;47(6):e98-e169 full-text, corrections can be found in Stroke 2017 Feb;48(2):e78 and Stroke 2017 Dec;48(12):e369.
6/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Myint PK, Cleark AB, Kwok CS. Bone mineral density and incidence of stroke: European prospective investigation into cancer-norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014;45(2):373-382.
6/2/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Imfeld P, Bodmer M, Schuerch M, Jick SS, Meier CR. Risk of incident stroke in patients with Alzheimer disease or vascular dementia. Neurology. 2013;81(10):910-919.
6/18/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Bushnell C, McCullough LD, Awad IA, et al. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(5):1545-1588. Available at: http://stroke.ahajournals.org/content/early/2014/02/06/01.str.0000442009.06663.48.full.pdf. Accessed June 19, 2014.
1/18/2017 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T113766/Coronary-artery-disease-possible-risk-factors: Emdin CA, Odutayo A, Wong CX, Tran J, Hsiao AJ, Hunn BH. Meta-analysis of anxiety as a risk factor for cardiovascular disease. Am J Cardiol. 2016;118(4):511-519.

Revision Information

  • Reviewer: EBSCO Medical Review BoardRimas Lukas, MD
  • Review Date: 12/2018
  • Update Date: 01/17/2019
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