What to Do to Reduce Your Risk
Nobody sees a stroke coming, but signs of danger are usually there. You could be at risk...
Stroke is sometimes called a “brain attack” because what usually occurs is similar to what happens during a heart attack. In the most common form of stroke, an obstruction blocks flow in a blood vessel that supplies the brain.
A fatty deposit on blood vessel walls often gets the obstruction started. Blood clots can then form at the site of the deposit and make the obstruction worse.
Clots also can form elsewhere in the body, break free and migrate through the circulatory system toward the brain, where they can cause a stroke.
Strokes from clots (ischemic strokes) account for 87% of strokes. They also occur when a blood vessel ruptures and bleeds into the brain (hemorrhagic strokes).
Knowing the underlying cardiovascular factors that put you at risk for stroke can help you avoid its potential disabilities or death. Here are the top stroke risks and what you can do to improve your odds.
1. Being a woman
The stroke risk: “There’s a misconception that stroke is a disease of old men,” says Larry B. Goldstein, M.D. He is the Ruth L. Works professor, chairman of the Department of Neurology and director of the Kentucky Neuroscience Institute at the University of Kentucky.
The truth: Women have a higher incidence of stroke than men.
“Women account for 60% of stroke deaths,” Dr. Goldstein adds.
Reduce it: You’ve cut your risk just by reading this because knowledge is power. Next, lower your chances of having a stroke by focusing on factors you can control, especially if you didn’t think you had anything to worry about.
2. Your family tree
The stroke risk: If your mother, father, sister or brother already has had a stroke, your risk of stroke is one-third higher.
In some cases, the risk lies in a genetic disorder that can lead to stroke. Sickle cell disease is one example. A gene mutation called CADASIL (cerebral autosomal dominant arteriopathy with sub-cortical infarcts and leukoencephalopathy) is another.
Your ethnicity also plays a role. African Americans have a much higher risk of stroke than Caucasians, partly because they’re more likely to have a range of cardiovascular risks that contribute to stroke.
The odds of having a first stroke are twice as high for African Americans as they are for Caucasians; they also die of their strokes more often as well.
Reduce it: You can’t change your genes, so do everything you can to change bad lifestyle habits.
3. Smoking
The stroke risk: Smoking damages cells that line blood vessels, thickens and narrows arteries and encourages the formation of clots.
It also boosts blood pressure, lowers HDL (“good”) cholesterol and raises triglycerides — all of which can make strokes more likely.
Reduce it: Avoid all tobacco smoke — both your own and other people’s.
Exposure to second-hand smoke increases the risk of stroke by 30%, even among nonsmokers, according to a paper published in the July 2015 issue of the American Journal of Preventive Medicine.
“If you find it hard to quit smoking for your own sake, do it for the sake of the people around you, especially children,” Dr. Goldstein advises.
4. Multiple drinks
The stroke risk: Heavy drinking is associated with unhealthy changes in blood pressure and can make blood clots more likely.
In fact, alcohol may raise stroke risks even higher than other cardiovascular risk factors in middle-aged heavy drinkers. Their risks are 34% higher than those of light drinkers, according to research in the January 2015 American Heart Association journalStroke.
Regardless of genetic and early-life risk factors, people in their 50s and 60s who drink too heavily are likely to have a stroke five years sooner than they would have otherwise, according to the National Stroke Association.
Reduce it: Women should have no more than one drink per day. That’s 12 ounces of beer, 5 ounces of wine or no more than 1.5 ounces of liquor.
“Don’t think that avoiding alcohol all week means you can binge on Friday night,” Dr. Goldstein warns. “If you drink excessively, you’re at much higher risk of having a stroke in the next 12 hours.”
5. Excess weight
The stroke risk: Having a body mass index (BMI) of 25 or higher boosts cardiovascular risks, according to the National Stroke Association. These include:
- High blood pressure
- Insulin resistance
- High triglycerides
(Find out your BMI, a number determined by your weight and height.)
Weight-related risks tend to occur together in metabolic syndrome — which is a cluster of these and other conditions — and stroke is one of the key dangers of having it.
Reduce it: Losing as little as 10 pounds can significantly reduce stroke risk factors, such as lowering blood pressure and improving cholesterol levels.
Eating more fruits and vegetables is key in any weight-loss plan. A Mediterranean diet that includes nuts, olive oil and whole grains may also help reduce your risk of stroke.
6. Lack of exercise
The stroke risk: A sedentary lifestyle increases your risk for stroke and a lot of the factors that contribute to it.
In fact, people who say they don’t work out in a typical week — one-third of the 27,000 people in a study at the University of Alabama at Birmingham — have a 20% higher risk of stroke. These findings were published in 2013 in Stroke.
Reduce it: Get 30 minutes of moderate exercise, such as brisk walking or biking, at least five days a week.
If you can’t squeeze a half-hour workout into your schedule almost every day, aim for 150 minutes of exercise a week in any combination. Even bouts of activity lasting as little as 10 minutes count.
7. High blood pressure
The stroke risk: High blood pressure may be the single most important treatable risk for stroke.
That’s because too much pressure inside blood vessels can damage their inner lining. That in turn can make artery walls thick and stiff, which can contribute to blockages and clots that lead to ischemic stroke.
High blood pressure can also cause weak spots in artery walls that can lead to ruptures and bleeding that are typical of hemorrhagic stroke.
Reduce it: High blood pressure has no symptoms, so you won’t know you have it unless you get it checked.
Make sure a doctor, nurse — or even a blood pressure machine in your local pharmacy — measures your blood pressure at least once a year.
Lifestyle measures such as a diet with lots of fruits and vegetables and minimal amounts of salt can help bring pressure down. If more action is needed, medications can help.
Discuss all your medications and symptoms with your doctor so that he or she can make sure you avoid adverse drug interactions and address any side effects.
8. A quivering heart
The stroke risk: With a condition called atrial fibrillation, or AFib, the top two chambers of the heart (the atria) quiver instead of contracting fully.
That can allow blood to pool and clump in the atria, increasing the risk of clots that could break loose, travel to the brain and cause a stroke.
Reduce it: Uncontrolled high blood pressure is a major cause of atrial fibrillation, so bringing blood pressure down can help lower stroke risk from AFib.
Blood-thinning medications, or anticoagulants, can also reduce risks specifically from AFib.
“All medications have pluses and minuses, but a general plus for newer anticoagulants is that they tend to be safer than older drugs in terms of bleeding complications,” Dr. Goldstein says.
9. Diabetes
The stroke risk: Having diabetes means having high blood sugar. And high blood sugar damages blood vessels throughout the body, causing numerous complications, including a higher risk for stroke.
In fact, people with diabetes have a 1.5 times higher risk of having a stroke than people without the disease.
Reduce it: Getting blood sugar under control includes many of the same steps that reduce risks for stroke — such as eating a healthy diet and staying physically active.
Whether taking diabetes medication lowers stroke risk has been less clear. But one of the most recent studies on that question found a stroke risk benefit in people who tightly regulated blood sugar through a combination of lifestyle and drugs.
Findings published in the June 2015 issue of the New England Journal of Medicine revealed that those who monitored their condition closely over a 10-year period didn’t necessarily live longer than those who managed their blood sugar less stringently, but they did have fewer cardiovascular problems — including stroke.
10. High cholesterol
The stroke risk: Excess cholesterol — a fatty, waxy substance that travels through the blood — can build up on artery walls to form deposits called plaque. Plaque can narrow blood vessels and create obstructions, but can also burst and send clots through the blood to the brain.
LDL (“bad”) cholesterol, which makes up most of the body’s cholesterol, is especially prone to build plaque.
HDL cholesterol gathers up bad cholesterol and ushers it to the liver, which excretes it from the body, so it’s good to have higher levels of HDL.
Reduce it: Get cholesterol checked at least every five years if you don’t have other cardiovascular risks — more often if you do.
As with high blood pressure, you can’t feel high cholesterol, so it’s important to have your cholesterol counts monitored.
Taking charge of other risk factors through healthy eating habits and physical activity will help bring cholesterol to healthier levels as well.
If you have an unhealthy balance of LDL and HDL, your doctor may also recommend taking medications such as statins to lower cholesterol — and bring down your risk of stroke.
For more information and expert advice, visit Lifescript’s Stroke Health Center, Atrial Fibrillation Health Center, Cholesterol Health Center, Diabetes Health Center and Hypertension Health Center.
How Much Do You Know About Strokes?Whether you call it a "stroke" or a "brain attack," it is a serious concern that strikes about 800,000 Americans each year. A stroke occurs when blood flow to a part of the brain is reduced or cut off completely. This can happen when a clot forms in an artery or a blood vessel ruptures. Take this quiz to see how much you know about preventing stroke and dealing with its outcomes.
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