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Stroke risk factors and prevention

  • Risk factors increase your chance of having a stroke. If you get rid of or control them, your odds of having another stroke will go down.

    The sooner you control your risk factors, the better off you will be. Your doctor can help you learn what your risk factors are and how you can control them. This may mean seeing your doctor more often.

    The National Stroke Association and American Stroke Association list eight risk factors that you can control.

    Risk factors you can control

    1. High blood pressure

    This is the leading cause of stroke. You are more likely to have high blood pressure as you get older. Your blood vessels become stiffer as you age, which can make your blood pressure go up.

    Prevention: If your blood pressure is higher than 140/90, work with your doctor to control it. Have your blood pressure checked at least once a year.

    High blood pressure

    • The top number (systolic) shows the pressure in your arteries when your heart beats.
    • The bottom number (diastolic) shows the pressure in your arteries when your heart rests.

    Normal blood pressure is a top number lower than 120 and a bottom number lower than 80.

    2. Smoking

    Tobacco use doubles your stroke risk. It damages blood vessel walls, speeds up clogging of your arteries, raises your blood pressure and makes your heart work harder.

    Prevention: If you currently smoke, stop! Ask your doctor for information about quitting smoking.

    3. Atrial fibrillation

    This is a heart rhythm that increases your risk for stroke. Your heart's upper chambers quiver instead of beating in a regular rhythm. Blood pools in your heart and can form clots. These clots can travel through your bloodstream to your brain.

    Prevention. Your doctor will talk with you about how to treat atrial fibrillation, and heart disease caused by the build-up of plaque (a fatty substance) in heart blood vessel walls.

    4. High cholesterol

    High cholesterol increases your risk for heart disease ,which increases your risk for stroke.

    Prevention: Lowering your cholesterol may reduce your risk for stroke. You can control cholesterol with the foods you eat and exercise. You may also need medicine.

    5. Alcohol

    Drinking too much alcohol is linked to strokes. It can raise your blood pressure.

    Prevention: Do not drink excessively. Ask for help if needed. 

    6. Physical inactivity and obesity

    Being obese (having a body mass index of 30 or higher), inactive or both increases your changes for high blood pressure, high cholesterol, diabetes, heart disease and stroke.

    Prevention: Try to get at least 30 minutes of activity each day.

    7. Carotid artery disease

    Your carotid arteries carry blood to your brain. When plaque (a fatty substance) builds up in these neck arteries, you are at risk for an ischemic stroke.

    Prevention: Your doctor may order a carotid ultrasound and other tests to find out how much plaque you have. Angioplasty or surgery to remove the plaque may help prevent stroke in some cases. Sometimes, tubes (stents) are placed in the artery to help keep it open.

    8. Food

    Eating foods high in saturated fat, trans fat and cholesterol can make your blood cholesterol levels go up. Eating foods high in sodium (salt) can raise your blood pressure. Eating foods high in calories can make you gain weight.

    Prevention: Cut down on salt, saturated fats, trans fats and foods high in cholesterol. Eat at least five servings of fruit and vegetables each day. For more information, visit

    Risk factors you can't control

    There are other risk factors you cannot control. These are part of your genetic makeup (who you are).


    Rates of stroke vary among races. The reasons are not known. Lifestyle and environment can have an effect. In the U.S., African-Americans have twice the risk of stroke than whites.


    A stroke can happen to anyone. It is more common in older adults. Your chances of having a stroke double every 10 years after age 55.


    Men have more strokes than women. More women will die from a stroke than men.

    Family history (genetics)

    A history of heart disease and brain vessel disease can be a stroke risk factor. By watching your diet, leading a healthful lifestyle and exercising, you may reduce your chances of stroke.

    Transient ischemic attack (TIA) or stroke

    Your risk for stroke goes up if you've already had a stroke. A transient ischemic attack (TIA, 'mini-stroke') is a warning sign that a stroke is about to happen. If you have had a TIA, get medical help right away. (See stroke warning signs.)

    Bleeding disorders

    Some people have abnormal amounts of different proteins in their blood that can change the way blood clots and increase the risk of stroke. Certain diseases and medicines can also affect how blood clots.

    Your stroke prevention plan

    Blood pressure control

    Medicines: _________________________________________________________________________

    Blood pressure range: ________________________________________________________________

    Reduce cholesterol, fats and salt

    Medicines: _________________________________________________________________________

    LDL:________ Diet:__________________________________________________________________


    Blood thinners you take:










    Call your doctor or go to the Emergency Department right away if you have black or tarry-looking stools.

    Increase activity

    How will you increase your activity level? What did Physical Therapy suggest?


    No smoking/drug abuse

    What is your plan to quit smoking or using drugs?


    Blood glucose control

    Medicines: _________________________________________________________________________

    Hemoglobin A1c: ___________ Your target range: ________________________________________

  • Source: Allina Health Patient Education, Understanding Stroke: Information about Stroke and Recovery, fourth edition, ISBN 1-931876-13-4
    Reviewed by: Allina Health Patient Education experts
    First published: 02/01/2006
    Last reviewed: 04/02/2013