Risk Factors
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Risk Factors

Some of the most important treatable risk factors for stroke are:

blood pressureHigh blood pressure or hypertension is by far the biggest risk factor for stroke. It increases your risk of stroke before age 80 by two to four times. If you have high blood pressure, you need to work with your doctor to lower it. Some proven ways to do that include:

  • Maintaining a healthy weight
  • Avoiding drugs known to raise blood pressure
  • Eating right—cut down on caffeine and salt and eat more fruits and vegetables
  • Increasing physical activity

Your doctor may prescribe medicines that help lower blood pressure. You must take your blood pressure medicine as directed, even if you feel fine. High blood pressure has no symptoms. Controlling blood pressure will also help you avoid heart disease, diabetes and kidney failure.

Smoking doubles the risk of ischemic (blockage) stroke and quadruples the risk of hemorrhagic (bleeding) stroke. It has been linked to the buildup of fatty substances in the carotid artery, the main artery in the neck that delivers blood to the brain. Blockage of this artery is the leading cause of stroke in the U.S. Other negative effects of smoking include raised blood pressure, carbon monoxide from smoking reduces the amount of oxygen blood can carry to the brain, and cigarette smoke makes your blood thicker and more likely to clot and it also promotes the formation of aneurysms. Your doctor can recommend programs and medications that may help you quit smoking. By quitting, at any age, you also reduce your risk of lung and heart disease, and a number of cancers including lung cancer.

Heart disease—such as coronary artery disease, valve defects, irregular heartbeat (atrial fibrillation) and enlargement of one of the heart’s chambers that causes clots to form and break loose, blocking vessels in or leading to the brain—can increase your risk for stroke. Atrial fibrillation is an irregular heartbeat that is responsible for about 25 percent of strokes in older adults. Your doctor will treat you for heart disease as well as evaluate your risk for stroke and decide if you will benefit from aspirin or other blood-thinning medications.

Warning signs or history of TIA (Transient Ischemic Attack) or stroke are significant risk factors. If you have had a TIA or stroke, your risk of having another stroke is many times greater than someone who has never had one. In addition, if you’ve had a stroke in the past, it’s especially important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by making areas of the brain not affected by the stroke work harder—so a second stroke can be twice as bad. If you are at high risk for stroke or have already had an ischemic stroke or TIA, your doctor will most likely prescribed medications to lower your risk. Blood-thinning medications, such as aspirin, keep platelets in the blood from sticking together and forming clots. Anti-clotting drugs, such as warfarin, may be needed to help ward off stroke in some people. If your doctor prescribes one of these types of medications for you, it is important to take it exactly as directed.

Diabetes is equal to aging 15 years in terms of stroke and cardiovascular disease. Diabetes not only affects the body’s ability to regulate sugar (glucose), but it also damages blood vessels throughout the body, including in the brain. When blood sugar levels are high at the time of a stroke, brain damage is usually more severe than when blood sugar is under control. High blood pressure is common among people with diabetes, accounting for much of their increased risk for stroke. Treating and managing your diabetes can delay the onset of complications that increase the risk of stroke.


saladCholesterol imbalance occurs when low-density lipoprotein cholesterol (LDL) is too high. LDL carries cholesterol (a fatty substance) through the blood and delivers it to cells. Excess LDL can cause cholesterol to build up in blood vessels (atherosclerosis) and is the major cause of blood vessel narrowing, leading to both heart attack and stroke. Ways to control cholesterol levels include choosing foods that are low in fat, and taking cholesterol-lowering medication as directed by your physician.

Physical inactivity and obesity often lead to high blood pressure (hypertension), diabetes and heart disease. Regular, moderate exercise helps you maintain healthy blood pressure and blood sugar levels and benefits your heart, reducing your risk of stroke.

There are only four risk factors that are beyond your control.

  • Age. Stroke occurs in all age groups. Studies show the risk of stroke doubles for each decade between the ages of 55 and 85.
  • Gender. Men have a higher risk for stroke, but more women die from stroke.
  • Race. African Americans and Hispanic Americans have about twice as many strokes as Caucasians.
  • Family history of stroke. Members of a family might have genetic stroke risk factors, such as high blood pressure or diabetes. An unhealthy lifestyle among family members can also increase this risk.

A risk factor increases your likelihood of getting a disease or condition. The more risk factors you have, the greater your chances of having a stroke. If you have risk factors, ask your doctor what you can do to reduce your risk.