Stroke risk factors

A risk factor is something that increases your chance of getting a disease or health problem. Some risk factors for stroke you cannot change. Some you can. Changing the risk factors that you have control over will help you live a longer, healthier life.

You cannot change these stroke risk factors:

• Your age. The risk of stroke goes up with age.
• Your sex. Men have a higher risk of getting heart disease and stroke than women, except in older adults.
• Your genes and race. If your parents had a stroke, you are at higher risk. African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk. Also, some families pass on traits that make them more likely to have blood clots.
• Diseases such as cancer, chronic kidney disease, autoimmune diseases, and some types of arthritis.
• Prior stroke. If you have already had one or more strokes or transient ischemic attacks (TIAs) you are at greater risk of having another stroke.
• Weak areas in an artery wall or abnormal arteries and veins.
• Pregnancy. Both during and in the weeks right after the pregnancy.

Blood clots from the heart may travel to and block the blood vessels in the brain and cause a stroke. This may happen in people with manmade or infected heart valves. It may also happen because of a heart defect you were born with.

A very weak heart and abnormal heart rhythm, such as atrial fibrillation, can also cause blood clots.

Some risk factors for stroke that you can change are:

• Not smoking. If you do smoke, quit. Ask your health care provider for help quitting.
• Controlling your blood cholesterol and lipids (fats) through diet, exercise, and medicines, if needed.
• Controlling high blood pressure through diet, exercise, and medicines, if needed. Ask your provider what your blood pressure should be.
• Controlling diabetes through diet, exercise, and medicines, if needed.
• Exercising at least 30 minutes every day.
• Maintaining a healthy weight. Eat healthy foods, eat less, and join a weight loss program, if you need to lose weight.
• Limiting how much alcohol you drink. Women should have no more than 1 drink a day, and men no more than 2 a day.
• Not using cocaine and other recreational drugs.
• Seeking medical care for problems that increase risk of stroke, such as atrial fibrillation and sleep apnea.

Birth control pills (particularly those with higher estrogen content) can raise your risk of blood clots. Clots are more likely in women who also smoke and who are older than 35. Talk with your provider about other birth control options that do not increase the risk of blood clots.

Good nutrition is important to your heart health. It will help control some of your risk factors.

• Choose a diet rich in fruits, vegetables, and whole grains.
• Choose lean proteins, such as chicken, fish, beans, and legumes.
• Choose low-fat dairy products, such as 1% milk and other low-fat items.
• Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods.
• Eat fewer animal products and fewer foods with cheese, cream, or eggs.
• Read food labels. Stay away from saturated fat and anything with partially-hydrogenated or hydrogenated fats. These are unhealthy fats.

Your provider may suggest taking aspirin or another blood thinner to help prevent blood clots from forming. Do not take aspirin without talking to your doctor first. If you are taking these medicines, take steps to prevent yourself from falling or tripping, which can lead to bleeding.

Follow these guidelines and the advice of your provider to lower your chances of stroke.

Preventing stroke; Stroke - prevention; CVA - prevention; TIA - prevention

American Diabetes Association website. Standards of medical care in diabetes - 2023. Diabetes Care. 2023;46(Suppl 1):S1-S284. diabetesjournals.org/care/issue/46/Supplement_1.

Biller J, Schneck MJ, Ruland S. Ischemic cerebrovascular disease. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 65.

Centers for Disease Control and Prevention website. Know your risk for stroke. www.cdc.gov/stroke/risk_factors.htm. Updated March 23, 2023. Accessed April 7, 2023.

Updated by: Joseph V. Campellone, MD, Department of Neurology, Cooper Medical School of Rowan University, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.