Certain tendencies, health conditions, and lifestyle habits can substantially raise your risk of having a brain stroke. In other words, they make you more prone than the general population to developing a stroke.

Such factors that increase your risk potential are seemingly unimportant and most people tend to take them for granted.

For example, I have seen patients with hypertension who do not take their medication regularly and have not checked their blood pressure for weeks!

If you harbor any of the risk factors mentioned below, make sure you undergo regular checkups and take the prescribed treatment regularly. Always remember these risk factors can give you a stroke, which can cripple and kill.

Some of the risk factors are within your control while some are not.

Stroke risk factors you cannot control

Age

Though stroke can occur at any age, the risk increases with age. Nearly 75% of the strokes occur in people over the age of 65 years.

Gender

The male gender is more prone to develop a stroke than the female gender. However, women are more likely to die from strokes. Women who take birth control pills are at a slightly higher risk of stroke.

Family history

If there is a history of stroke in your family, your risk increases.

Fibromuscular dysplasia

This is a rare genetic disorder, which is a non-atherosclerotic disease of the blood vessels that causes abnormal growth of the arterial wall.

Risk factors you can control

  • Hypertension
  • High Cholesterol
  • Diabetes
  • Smoking
  • Overweight and obesity
  • Lack of exercise
  • Too much alcohol
  • Heart health

How can you control these stroke risk factors?

  1. You must keep other comorbidities you may have such as hypertension or diabetes under control
  2. Stick to a healthy diet
  3. Maintain a healthy weight
  4. Have regular moderate physical activity, which includes a 30-minute workout of aerobic activity such as walking every day.
  5. Follow a healthy lifestyle, which simply means no tobacco and no harmful use of alcohol.
  6. Take your medicines as prescribed regularly

Following these guidelines will significantly reduce your risk.

Stroke risk factors common in men and women

Let us take these stroke risk conditions one by one, which are common in both men and women.

Hypertension

High blood pressure is the most common cause of a hemorrhagic stroke,

Very high blood pressure can lead to a rupture of a weakened artery or its branches, which cannot withstand the pressure of the flowing blood within.

Blood pressure is considered high when it stays above 140/90 mm of Hg over a period of time.

If you have hypertension you should know how to manage it.

Diabetes

You are said to have diabetes when your blood sugar is above the normal levels

Diabetes is an independent risk factor for stroke. And, when it is accompanied with high cholesterol and hypertension (which is quite often the case), the risk increases manifold.

High cholesterol increases the risk of thrombotic stroke while hypertension increases the risk of hemorrhagic stroke.

Sedentary lifestyle 

If you lead a life of physical inactivity, you are inviting a lot of chronic health conditions and all of them greatly increase your risk of stroke.

Such conditions include hypertension, obesity, diabetes, high cholesterol and heart diseases. Al these can independently give you a stroke. With an inactive lifestyle, you can be associated with one or more of these conditions.

Regular physical activity helps control blood cholesterol, blood pressure, diabetes and any excess weight in most people.

You must get at least 30 minutes of aerobic exercises every day.

Obesity and excess weight

Obese and overweight people with excess body fat — especially with a lot of it around the waist area (apple type obesity) are more likely to develop heart disease and stroke even without the presence of any other risk factor.

Excess weight on the body increases the workload on the heart putting it under more strain

Excess weight also makes you a potential candidate for hypertension, raised blood cholesterol and triglyceride levels and diabetes.

Therefore, besides being an independent risk factor for stroke, it can make you prone to develop other stroke risk factors.

How can high blood cholesterol cause a stroke?

High blood cholesterol levels lead to the formation of cholesterol plaques on the inner walls of the arteries. This is called atherosclerosis.

These plaques go on becoming bigger in size with time and progressively harden the walls of the arteries and narrow their lumen.

They can block the lumen of an artery in the brain and interrupt blood supply to part of the brain causing a thrombotic stroke.

Carotid and vertebral artery disease

Cholesterol plaques can also build up in the carotid and vertebral arteries and interfere with the blood supply to the brain.  This is called carotid artery disease.

The plaque can break loose from the arterial wall and travel to an artery in the brain causing an embolic stroke or TIA.

It is necessary, therefore, to keep your blood cholesterol under control and within normal range.

Carotid and vertebral artery dissection

There are two carotid arteries in the front of the neck and two vertebral arteries in the back, which supply the brain with blood.

A dissection can occur, which splits the lining of the arterial wall of these arteries making their walls weak. Such a condition causes an ischemic stroke due to the occlusion of the artery by a clot.

Heart disease

Heart diseases that slow down the blood circulation and cause pooling of blood in the heart can cause clot formation. This clot can travel to the brain and cause an embolic stroke.

Such heart conditions include coronary heart disease, heart failure, dilated cardiomyopathy, atrial fibrillation, heart valve disease and certain congenital heart diseases.

Sickle cell anemia

Sickle cell anemia or disease is a genetic blood disorder that is seen mainly in African-American and Hispanic children.

In this disorder, the red blood cells suffer a hereditary dysfunction due to which they are not able to carry enough oxygen to the tissues in the normal fashion.

Oxygen supply to the brain tissues suffers and can result in stroke. These cells also tend to stick to arterial walls, which can narrow the lumen and block the brain arteries and cause a stroke.

Smoking

You should know that the risk of heart disease is about two to four times higher in smokers. This is a proven fact. And as mentioned above, heart disease is an independent risk factor contributing to stroke.

The carbon monoxide in cigarette smoke reduces the oxygen in the blood, which causes an inadequate supply of oxygen to the brain cells.

The toxins such as nicotine and carbon monoxide present in cigarette smoke damage the inner lining of the blood vessels. This makes it easier for the excess cholesterol to stick to the arterial wall (including those in the brain) and for the plaques to build up (atherosclerosis).

Smoking makes the blood platelets stickier, which makes it easier for clots to form, block the arterial lumen and cause a stroke.

Fibromuscular dysplasia

Fibromuscular dysplasia is a rare genetic disorder in which there is narrowing (stenosis) and/or enlargement (an aneurysm) of the medium-sized arteries in your body.

This can reduce the blood flowing through the arteries. When such a condition develops in the arteries of the neck such as the carotid artery, blood flow to the brain is hampered and results in a hemorrhagic stroke.

Race and ethnicity

Strokes are seen to occur more often in African Americans, Alaska Natives, and American Indian adults than in white, Hispanic, or Asian American adults.

Unique stroke risk factors in women

In addition to the general risk factors like family history, high blood pressure, high cholesterol, diabetes, smoking, lack of exercise, and being overweight, a woman faces unique risk factors which include:

Taking birth control pills

Women with additional risk factors, such as age, cigarette smoking, high blood pressure or diabetes and are on oral contraceptives are highly susceptible to developing a stroke. Even a low-estrogen birth control pill doubles the risk of developing an ischemic stroke.

Being pregnant

Stroke risk increases during a normal pregnancy due to the natural changes of pregnancy in the body such as elevated blood pressure and increased load on the heart.

Using Hormone Replacement Therapy (HRT)

HRT is a combined hormone therapy of progestin and estrogen, to relieve menopausal symptoms.Women who are on HRT may be at an increased risk.

Migraine headaches with aura

Migraines can increase a woman’s stroke risk two and a half times and women are the greatest sufferers of migraine in the United States.

History of Preeclampsia/Eclampsia

Women with a history of preeclampsia and/or eclampsia are at an additional risk of developing hypertension and stroke one to 30 years after delivery.

Risk factors in the elderly

Of all the factors explained above, the most common risk factors prevalent in the elderly population were found to be

  • hypertension (64%)
  • diabetes mellitus (29%)
  • smoking (29%)
  • heart disease (23%)
  • obesity (17%)
  • hypercholesteremia (15%)

Risk factors in young adults

Young adults who suffer a stroke are associated with the following risk factors:

  • Essential hypertension
  • Juvenile diabetes
  • Hypercholesteremia
  • Systemic lupus erythematosus
  • Arterial-venous malformation
  • Brain aneurysm
  • Congenital muscular hypoplasia of the carotid and middle caliber cerebral arteries (multiple progressive intracranial arterial occlusion)
  • Congenital or early acquired (rheumatic fever) heart valve defects

What are the risks of a second stroke in a stroke survivor?

The overall risk of a second stroke is highest immediately after the first stroke. Three percent of stroke survivors suffer a second stroke within the next 30 days, and one-third will suffer another stroke within next two years.

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