Stroke Risk Factors That You Can Control

Are you worried about your risk of stroke? Take control of your health by getting a handle on the stroke risk factors that you can manage.

Medically reviewed by Lindsey Marcellin, MD, MPH

The possibility of having a stroke is frightening for many people. However, many stroke risk factors— such as high blood pressure, cholesterol, and weight — can be minimized by making certain lifestyle changes.

Granted, there are some stroke risk factors that you just can’t do much about. “Some risk factors you can’t change include a personal or family history of stroke, increasing age, and race,” explains Susan A. Catto, MD, co-director of the Stroke Program at Beaumont Hospital in Royal Oak, Mich. “African Americans and American Indians for instance, have a higher risk for stroke, as do people with sickle cell anemia.”

On the flip side, many lifestyle factors are in your hands. So even if your age or race puts you at a greater risk of stroke, you can fight back by managing your weight, controlling your cholesterol levels, lowering your high blood pressure, and more.

Make these lifestyle changes to manage stroke risk factors:

  • Get a handle on high blood pressure. “Lowering blood pressure can reduce the risk of both hemorrhagic strokes (bleeding into the brain) and ischemic strokes (blocked arteries causing a lack of blood supply to brain tissue),” says Dr. Catto. “The mortality rates from stroke rise with each elevation in systolic (the top number) and diastolic (the bottom number) blood pressure. After a first stroke, the risk of a second stroke can be reduced by 28 percent by reducing blood pressure by 10 points systolic.”
  • Cut your cholesterol. “Elevated cholesterol levels are associated with increased atherosclerotic disease, which is when cholesterol plaques build up on the walls of medium-to-large arteries,” says Danielle Haskins, MD, medical director of the Stroke Center at Saint Barnabas Medical Center in Livingston, N.J. “This then narrows the arteries, which can cause blood clots to form.” If these clots were to break loose, they could travel through the arteries to the brain and potentially cause a stroke. A healthy diet, daily exercise, and medication can reduce blood cholesterol levels and help maintain healthy arteries, says Dr. Haskins. That, in turn, will decrease stroke risk as well as the risk of heart attack and peripheral arterial disease (reduced blood flow to the limbs due to narrowed arteries).
  • Manage your diabetes. Diabetes can increase your risk of developing many other dangerous health conditions, including stroke. “Elevated blood sugar damages the small vessels that carry blood to the brain,” says Haskins. “This damage is worsened if you also have uncontrolled high blood pressure. In addition, elevated blood sugars can accelerate the formation of cholesterol plaques in the larger arteries, further increasing stroke risk.”
  • Drop a few pounds. Carrying around excess weight is a risky proposition for virtually all of these medical conditions — blood pressure, cholesterol, diabetes, heart disease, and stroke. “Excess weight puts a strain on the body and on the heart,” says Daniel Labovitz, MD, an assistant professor of neurology at the Albert Einstein University College of Medicine/Montefiore Medical Center in New York. “Being overweight increases risk of diabetes, increases blood pressure, and often increases cholesterol levels, all of which increase the risk of stroke.”
  • Get some exercise. One of the best strategies to help you lose a few pounds is to exercise more — which has a direct positive impact on stroke risk as well. “Daily exercise reduces risk of stroke dramatically,” says Dr. Labovitz. “Exercising for 30 minutes a day — hard enough to breathe through the mouth and get a little sweaty — has powerful effects on the health of the heart, blood vessels, and brain.” In fact, regular exercise may be just as important as any medication you can take to maintain a healthy heart, says Dr. Labovitz.
  • Manage atrial fibrillation. The rapid, irregular heartbeat that is known as atrial fibrillation is a major risk factor for stroke. When you have this condition, it’s important to work closely with your doctor to manage it. “Because blood flow through the heart is affected by the irregular rhythm, clots can form within the heart and then break loose and travel into the bloodstream,” says Labovitz. “If they travel into the brain, they can block an artery and cause a stroke. Older people with atrial fibrillation usually have to take medication to prevent the formation of dangerous blood clots.”
  • Quit smoking. Matthew D. Vibbert, MD, assistant professor of neurology and neurological surgery at Thomas Jefferson University in Philadelphia, puts it best: “It is the single most important thing that you can do to reduce stroke risk and extend your life!”

These lifestyle changes might seem daunting at first, but you can helpprevent stroke and improve your overall health by making one change at a time and adopting more changes as time goes on. Build on these good health principles and you’ll enjoy their cumulative effects for a long time to come.

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