Stroke
Causes
Anyone can have a stroke—you don’t have to be old. But some people are more at risk for a stroke than others. Your risk of having a stroke depends on many factors, some of which are controllable, such as eating a heart-healthy diet and exercising regularly. Other risk factors, such as age and family history, are predetermined and uncontrollable. That’s why 80 percent of strokes are considered to be preventable.1 Talk with your doctor about your risk factors and ask for help to reduce the ones you can.
Controllable or treatable risk factors
Like other forms of cardiovascular disease, most strokes are caused by atherosclerosis, the buildup of fatty deposits (plaque) in the arteries that carry blood throughout your cardiovascular system to key organs—your heart, legs, kidneys, and brain. When the plaque builds up to the point of blocking or restricting the blood flow to the brain, it can cause a stroke.
Most of the risk factors you can control for stroke are the same as the risk factors for heart attack and peripheral artery disease (PAD) because they contribute to the atherosclerosis disease process. The good news is that the atherosclerosis disease process is one you can help to slow down.
- High blood pressure (hypertension) – High blood pressure is one of the greatest risk factors for stroke. Reducing salt in your diet, exercising, and taking medications can lower your blood pressure. But don’t try to figure it out on your own. Talk to your doctor about treating your high blood pressure, as you may need medication.
- Smoking – Smoking doubles your risk of stroke. If you’re a woman who smokes, taking oral contraceptives puts you at even greater risk. If you’ve had trouble quitting before, don’t give up. Your chances of quitting for good improve every time you try.
- Diabetes – People with diabetes are twice as likely to have a stroke. That could be because some of the health problems related to diabetes are also risk factors for stroke such as high blood pressure, high levels of “bad” (LDL) cholesterol, heart attack, and atrial fibrillation (Afib).
- Cholesterol – People with high blood cholesterol have an increased risk for stroke. Talk with your doctor about controlling your cholesterol with changes in your diet and possibly medication
- Diet – The foods you choose to eat are another factor that determines your risk for stroke. A balanced diet low in saturated fat and trans fat and high in monounsaturated fat, omega-3 fatty acids, fruits, vegetables, and whole grains can slow the buildup of plaque in your arteries and reduce your risk of stroke.
- Exercise – Not getting regular exercise can contribute to high blood pressure, high cholesterol, diabetes, and heart disease—all risk factors for stroke. Ask your doctor about starting an exercise program.
- Coronary artery disease (CAD) – If you’ve been diagnosed with CAD and have narrowed or blocked arteries in one part of the body, then it's likely that other arteries are narrowed or blocked with plaque, too. The brain, just like the heart, can be cut off from the blood it needs, causing a stroke.
- Heart disease – The presence of heart disease and atrial fibrillation (Afib) raises the risk of stroke. The fast and irregular heartbeat of AFib can cause blood to pool and clot in the heart. This raises the risk that a blood clot will break loose, travel to the brain, and cause a stroke. Talk with your doctor about treatment options for your heart disease so that you can reduce your risk of stroke.
- Sickle cell disease – People who inherit sickle cell disease are at higher risk for stroke. Blood cells affected by sickle cell disease are stickier and can attach to the walls of the arteries that supply blood to the brain. While there is no cure for this disease, there are some treatment options for reducing symptoms and complications.
- Where you live – Is it time to move? Some evidence suggests that more strokes occur in the southeastern U.S.: Alabama, Arkansas, Georgia, Louisiana, Mississippi, North and South Carolina, and Tennessee. No one knows why for sure, but studies continue to look at other factors in the area such as rural populations and race.
Uncontrollable risk factors
Some risk factors can’t be controlled, but it’s good to keep them in mind as you weigh all of your risks for having a stoke and make a plan to reduce them:
- Age – People of any age can have a stroke, including children. But the older you are, the higher your risk for stroke. Nearly 75 percent of all strokes happen to people over 65.2
- Family history – If someone in your family had a stroke, then you’re at a greater risk.
- Race – People who are Hispanic, African American, or Asian/Pacific Islander are more likely to have a stroke than someone who is Caucasian.
- Sex – Males are more likely to have a stroke than females, but females account for more deaths due to stroke than males.
- A previous stroke, transient ischemic attack (TIA or “mini-stroke”), or heart attack – Your chance of stroke is greater if you’ve already had one (including a TIA) or if you’ve had a heart attack.
The more you know and understand your risk factors and the symptoms of stroke, the more prepared you will be to care for yourself and your loved ones. A stroke is an emergency that requires immediate medical attention, which is why it's important to know the symptoms and when to call for help.