A stroke can happen to anyone, but certain factors can increase your risk, says Antonio Culebras, MD, FAAN, professor of neurology at SUNY Upstate Medical University in Syracuse. Some are related to age, sex, and ethnicity, but many are also preventable, he says. Talk to your doctor about lowering your odds of stroke if you have any of these risk factors.
High blood pressure is the single greatest risk factor for stroke and the number one cause, says Dr. Culebras. Normal blood pressure is 120 over 80 and anything over that is considered elevated, says Sarah Song, MD, FAAN, a stroke specialist at Rush University in Chicago. A reading of 140 over 80 is considered high and damages the arterial walls, causing them to narrow, rupture, or leak. It also can cause blood clots to form, she says.
Smoking not only increases stroke risk, it increases the likelihood of death from stroke. It can lower good cholesterol (HDL), make your blood more likely to clot and block blood flow, damage the cells that line blood vessels, and cause blood vessels to narrow. “Cigarette smoke contains several toxins that damage blood vessel walls [to] a point where a blood clot forms, which can then lead to a stroke,” explains Mitchell S. Elkind, MD, FAAN, professor of neurology and epidemiology at Columbia University in New York.
Obesity raises stroke risk due to inflammation caused by excess fatty tissue, particularly in the abdomen, says Dr. Elkind. “This can lead to difficulty in blood flow and an increased risk of blockage, both of which can cause strokes,” he says.
Older age is “a risk marker rather than a risk factor,” says Dr. Elkind. “As we age, tissues suffer and the proteins in our cells don’t function as well.” A stroke can happen at any age, but the chances double every decade after 55.
Sex is also associated with stroke risk. Each year, 55,000 more women than men experience a stroke, and because they tend to have them later in life and more often live along, they are less likely to have a full recovery, according to statistics from the American Heart Association.
Diabetes causes metabolic abnormalities that lead to dysfunction of the cells that line the blood vessels, allowing in toxic, inflammatory, or blood-clotting proteins that injure blood vessel walls, says Dr. Elkind. In addition, the body’s inability to create insulin or use it properly is a factor, he says. Since insulin plays an important role in pulling glucose into cells from the bloodstream, people with diabetes often have too much sugar in their blood—which can contribute to the buildup of clots or fat deposits inside vessels and impede blood flow. That, in turn, can lead to a stroke.
Ethnicity/race affects risk. African Americans have nearly double the stroke risk compared with whites, according to a 2017 report compiled on behalf of the American Heart Association. Hispanic adults who live in communities densely populated with other Hispanics are about 60 percent more likely to die of heart disease and stroke than those who don’t, according to a report in the September 2018 Journal of the American Heart Association.
Read stories from stroke survivors in "The Many Faces of Stroke."
