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Risk Factors for Stroke

Evaluating the risk for stroke is based on heredity, natural processes, and lifestyle. Many risk factors for stroke can be changed or managed, while others that relate to hereditary or natural processes cannot be changed.

Risk factors for stroke that can be changed, treated, or medically managed:
  • high blood pressure
    The most important controllable risk factor for brain attack is controlling high blood pressure.
  • diabetes mellitus
    Diabetes is treatable, but having it increases the risk for stroke. However, persons with diabetes are at higher risk of having a stroke as a result of the long-term effects of diabetes.
  • heart disease
    Heart disease is the second most important risk factor for stroke, and the major cause of death among survivors of stroke.
  • cigarette smoking
    The use of oral contraceptives, especially when combined with cigarette smoking, greatly increases stroke risk.
  • history of transient ischemic attacks (TIAs)
    A person who has had one (or more) TIA is almost 10 times more likely to have a stroke than someone of the same age and sex who has not had a TIA.
  • high red blood cell count
    A moderate increase in the number of red blood cells thickens the blood and makes clots more likely, thus increasing the risk for stroke.
  • high blood cholesterol and lipids
    High blood cholesterol and lipids increase the risk for stroke.
  • lack of exercise, physical inactivity
    Lack of exercise and physical inactivity increases the risk for stroke.
  • obesity
    Excess weight increases the risk for stroke.
  • excessive alcohol use
    More than two drinks per day raises blood pressure, and binge drinking can lead to stroke.
  • drug abuse (certain kinds)
    Intravenous drug abuse carries a high risk of stroke from cerebral embolisms (blood clots). Cocaine use has been closely related to strokes, heart attacks, and a variety of other cardiovascular complications. Some of them, even among first-time cocaine users, have been fatal.
  • abnormal heart rhythm
    Various cardiac diseases have been shown to increase the risk of stroke. Atrial fibrillation is the most powerful and treatable cardiac precursor of stroke.
  • cardiac structural abnormalities
    New evidence shows that cardiac structure abnormalities including patent foramen ovale and atrial septal defect increase risk for embolic stroke.
Risk factors for stroke that cannot be changed:
  • age
    For each decade of life after age 55, the chance of having a stroke more than doubles.
  • race
    African-Americans have a much higher risk of death and disability from a stroke than Caucasians, in part because the African-American population has a greater incidence of high blood pressure.
  • gender
    Stroke occurs more frequently in men, but more women than men die from stroke.
  • history of prior stroke
    The risk of stroke for someone who has already had one is many times that of a person who has not had a stroke.
  • heredity/genetics
    The chance of stroke is greater in people who have a family history of stroke.
Other risk factors of stroke to consider:
  • where a person lives
    Strokes are more common among people living in the southeastern United States than in other areas. This may be due to regional differences in lifestyle, race, cigarette smoking, and diet.
  • temperature, season, and climate
    Stroke deaths occur more often during periods of extreme temperatures.
  • socioeconomic factors
    There is some evidence that strokes are more common among low-income people than among more affluent people.

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