Stroke: What Increases Your Risk

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What Increases Your Risk

Risk factors for stroke include those you can change and those you can't change.

Certain diseases or conditions increase your risk of stroke. These include:

• High blood pressure (hypertension). High blood pressure is the second most important stroke risk factor after age. ⁵ It is a risk factor you can change.
• Diabetes. Having diabetes doubles your risk of stroke because of the circulation problems associated with the disease. ⁵
• High cholesterol. High cholesterol can lead to hardening of your arteries ( atherosclerosis). Hardening of the arteries can cause coronary artery disease and heart attack, which can damage the heart muscle and increase your risk for stroke.
• Coronary artery disease, which can lead to heart attack and stroke.
• Other heart conditions, such as atrial fibrillation, endocarditis, heart valve conditions, patent foramen ovale, or heart failure.
• Peripheral arterial disease, for example narrowing of the carotid artery (carotid artery stenosis).

Certain behaviors can increase your risk of stroke. These include:

• Smoking, including secondhand smoke.
• Physical inactivity.
• Being overweight.
• Diet with few fruits and vegetables. Research suggests that people who eat more fruits, vegetables, fish, and whole grains (for example, brown rice) may have a lower risk of stroke than people who eat lots of red meat, processed foods such as lunch meat, and refined grains (for example, white flour). ⁶
• Diet with too much salt. A healthy diet includes less than 2,300 mg of sodium a day (about one teaspoon).
• Use of some medicines, such as birth control pills—especially by women who smoke or have a history of blood-clotting problems—and anticoagulants or steroids. In postmenopausal women, hormone replacement therapy has been shown to slightly increase the risk of stroke. ⁷
• Heavy use of alcohol. People who drink alcohol excessively, especially people who binge drink, are more likely to have a stroke. Binge drinking is defined as drinking more than 5 drinks in a short period of time.
• Illegal drug use (such as a stimulant, like cocaine).

Risk factors you cannot change include:

• Age. The risk of stroke increases with age.
• Race. African Americans, Native Americans, and Alaskan Natives have a higher risk than those of other races. Compared with whites, young African Americans have 2 to 3 times the risk of ischemic stroke , and African-American men and women are more likely to die from stroke. ⁴
• Gender. Stroke is more common in men than women until age 75, when more women than men have strokes. ² At all ages, more women than men die of stroke. ⁴
• Family history. The risk for stroke is greater if a parent, brother, or sister has had a stroke or transient ischemic attack (TIA). For more information, see the topic Transient Ischemic Attack (TIA).
• History of stroke or TIA.

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Last updated:	March 6, 2007
Author:	Robin Parks, MS
Reviewed By:	Anne C. Poinier, MD - Internal Medicine, Richard D. Zorowitz, MD - Physical Medicine and Rehabilitation
Editors:	Kathleen M. Ariss, MS, Pat Truman