Stroke Risk and You

With new research showing that nearly 25% of people globally over the age of 25 will have a stroke at some point, it’s more important than ever to be informed about the risk factors.  Strokes can be fatal, but they are also the leading cause of long-term disability and cost billions of dollars each year worldwide. While there are some risk factors that you cannot control, there are many that can be modified.

RISK FACTORS YOU CANNOT CONTROL

  • Genetics/Family History – There are some genetic disorders that block blood flow to the brain and cause a stroke. But for most people, their risk from family history is higher if a sibling, parent or grandparent has had a stroke – especially at a younger age (under 65).
  • Age – Although stroke is more likely to occur in those over the age of 65, it is possible to have a stroke at any age. As age increases, though, so does the risk of stroke. This is true for both men and women.
  • Gender – According to the American Stroke Association, in most age groups more men than women will have a stroke in a given year. However, women account for more than half of all stroke deaths. Women have additional risk factors that men do not have, including pregnancy, taking oral contraceptive pills, and post-menopausal hormone therapy.
  • Race – The risk of stroke can vary with race and ethnic background, and some of this has to do with the associated risk factor of higher blood pressure. African-Americans, Latinos, Native Americans, and Alaskan Natives are a few of the specific ethnicities who have a higher risk of stroke.
  • Personal Health History (previous strokes & heart attacks) – If you have already had a stroke or a transient ischemic attack there is a much higher risk that you will experience a stroke. A previous heart attack is another risk factor when considering your future stroke risk.

RISK FACTORS YOU CAN CONTROL

  • Your Overall Health (weight, activity, diet, BP, cholesterol) – Some of the most modifiable risk factors for stroke involve things your doctor recommends doing for your overall health. These include keeping your weight in a healthy range, staying active, eating healthfully and keeping your blood pressure and cholesterol in recommended ranges.

Oftentimes, these risk factors are linked to one another. Hypertension, or high blood pressure, is the single most important risk factor for stroke. Carrying extra weight, leading a sedentary lifestyle, and eating a diet high in sodium may increase your risk of developing hypertension. When it comes to cholesterol, a diet high in saturated fat, trans fat, and cholesterol can raise blood cholesterol levels. So eating properly and staying active can start a domino affect that can reduce your risk in a variety of ways.

  • Your Habits (Smoking, Drugs & Alcohol) – According to the World Health Organization, 2 out of 5 stroke deaths of those under the age of 65 are linked to smoking. So quitting smoking (or not starting in the first place!) is in your best interests when it comes to reducing stroke risk. For females who smoke in addition to using birth control bills, the risk is even higher.

Drinking more than one alcoholic beverage per day is also associated with stroke risk. And street drug use, even marijuana, has been shown to increase the risk of stroke. Some of these drugs can cause a stroke by directly affecting the brain’s blood vessels, while others cause damage to the heart, which can indirectly lead to stroke.

  • Other Health Conditions – Heart disease, especially atrial fibrillation (a type of irregular heartbeat), is a significant risk factor for stroke. Diabetes mellitus increases stroke risk, especially for strokes due to damage of small blood vessels. If you have Type 1 or 2 diabetes, control your blood sugar. Diabetes mellitus is an independent risk factor for stroke. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight — increasing their risk even more.

Other conditions that increase your risk include heart valve disease, coronary artery disease, carotid artery disease, peripheral artery disease (PAD), and atrial fibrillation (Afib). Those who have heart failure, enlarged hearts, and some types of congenital heart defects are at higher risk of stroke than people who have healthy hearts.

OTHER POTENTIAL RISK FACTORS

  • Socioeconomic and Geographic – While researchers are still investigating the direct causation, strokes tend to be more common in the southern states and among those with lower income levels. This could be due to a variety of things, including diet/lifestyle and access to healthcare.
  • Medical Procedures – Certain types of procedures carry an additional risk of stroke because of the way they are performed. One example is TAVR (Transcatheter Aortic Valve Replacement), a procedure in which a catheter is used to replace a damaged aortic valve. The use of the catheter rather than a surgical method to replace the valve is less invasive, but during the process debris (check out this article on what debris is) can break loose and travel through the blood stream. Should this debris travel to the brain, it could cause a stroke.

 If you are undergoing any procedures, be sure to ask your doctor about the risk of stroke and if there are any ways you can protect yourself. He or she may recommend reducing your risk through lifestyle factors, or in the case of a TAVR procedure, you may have the option to use an embolic protection device. This device is deployed during the procedure and captures nearly all debris that might break loose before it can reach your brain.

WHAT YOU CAN DO

Your best course of action is to discuss your specific situation with your healthcare professional. Be completely forthcoming about any of the above factors that may increase your risk. Armed with information, your doctor can help you develop a plan to lower your risk and stay as healthy as possible.

References:

Accessed Jan. 28, 2019.

This educational blog was provided by Boston Scientific.     SH-609520-AA