by EBSCO Medical Review Board

A risk factor is something that raises the chances of getting a health problem. A person can get a stroke with or without the ones listed below. The chances of getting a stroke are greater in people who have many risk factors.

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. Normal blood pressure is less than 120/less than 80 mm Hg. Hypertension is when it is 130 to 139/80 to 89 mm Hg.

Hypertension can harm blood vessels walls and cause them to weaken. People who do not keep their blood pressure in a target range are at higher risk of stroke.

Some risks can be lowered through lifestyle changes, while others cannot be lowered.

Risks That Can Be Changed

Smoking

Smoking can:

  • Narrow blood vessels and reduce blood flow
  • Lead to plaque buildup in the arteries
  • Raise heart rate and blood pressure and put extra pressure on weakened blood vessel walls

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 stroke risk. It can lead to high cholesterol , obesity , and problems like diabetes. These are all risks for stroke.

Inactivity

Not being active raises the risk of heart attack and stroke. Working out helps the heart work better and helps arteries stay healthy. It also helps lower the chance of other stroke risks like hypertension, high cholesterol, and diabetes.

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. Limiting alcohol can lower the risk.

Drug Use

Using illegal drugs, mainly cocaine, can cause blood vessel harm. This can lead to blood clots and spasms in the arteries.

Risks in Women

There are risks that 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:

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).

Neurological Diseases

Some neurological 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.
  • Past 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 when a person has times of complete or partial airway obstruction during sleep. It interrupts sleep and lowers oxygen supply. It has been linked to many health problems, such as heart disease. It is also a risk for hypertension, heart failure, diabetes, and heart attack.

Risks That You Cannot Change

Age

Brain function lowers as we age. This often is not 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 we 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 who have had a stroke or heart disease raises a person's risk, too. Some genetic problems also raise the risk. For example, blood that clots more easily 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

Brain basics: Preventing stroke. National Heart, Lung, and Blood Institute website. Available at: https://www.stroke.nih.gov/materials/brainbasics.htm. Accessed March 14, 2022.

Risk factors for stroke or transient ischemic attack. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/risk-factors-for-stroke-or-transient-ischemic-attack. Accessed March 14, 2022.

Stroke. National Heart, Lung, and Blood Institute website. Available at: https://www.nhlbi.nih.gov/health-topics/stroke. Accessed March 11, 2022.

Stroke risk factors. National Stroke Association website. Available at: https://www.stroke.org/en/about-stroke/stroke-risk-factors. Accessed March 14, 2022.

Revision Information

  • Reviewer: EBSCO Medical Review BoardRimas Lukas, MD
  • Review Date: 11/2021
  • Update Date: 03/14/2022