Stroke risk factors are conditions that increase a person’s chances of having a stroke. Treatments that reduce these risk factors can reduce the risk of stroke.
Ways to reduce the risk of stroke include:
Treat high blood pressure (Hypertension)
Stop Smoking
Get treatment for heart diseases
Control diabetes
Consider surgery for severe narrowing of large blood vessels supplying the brain
Treat high cholesterol levels
Treat medical conditions that increase a person’s tendency to form blood clots
Take medications that prevent the formation of blood clots that can lead to stroke
Maintain a healthy lifestyle
A blood pressure reading of 140/90 mm Hg or higher is considered hypertension, the medical term for high blood pressure. High blood pressure is the number one cause of stroke. If present, high blood pressure considerably increases the risk of both ischemic stroke and hemorrhagic stroke. Some estimates suggest that if high blood pressure could be eliminated, the number of strokes that occur would be cut in half.
High blood pressure is under-recognized and under-treated. The only way to find out if you have high blood pressure is to have it checked! If you want to find out, go to your doctor’s office, a local drug store, or, in many towns, a local fire department and ask to have your blood pressure measured.
Links of Interest
Hypertension Information Web Site (NHLBI)
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Smoking is a major cause of stroke. A smoker increases the risk of both ischemic stroke and hemorrhagic stroke. The longer you have smoked and the more you smoke per day, the greater your risk of stroke.
The advice is easy, QUIT NOW!
Links of Interest
Tobacco Information and Prevention Source (from the Centers for Disease Control)
Harborview Smoke-Free Program
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Heart attack and stroke have many of the same causes. The disease of the blood vessels called atherosclerosis is the most common cause of heart attacks and also causes most strokes. Treating a person to reduce their risk of a heart attack will also decrease the risk of a stroke.
Heart disease can cause a stroke when a blood clot forms in, or passes through the heart. The blood clot can travel to the brain, block an artery, and cause an embolic stroke.
A number of conditions increase a person’s chances of having a blood clot form in their heart. These include:
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An irregular heart beat (the most common form is atrial fibrillation)
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A serious heart attack (myocardial infarction)
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PFO (Patent Foramen Ovale) is a hole connecting the right (venous) and left (arterial) sides of the heart that could allow blood clots that form in the veins of the legs to get into the arterial circulation and cause strokes. The best treatment for this type of stroke is not clear. Research is comparing closing the hole versus blood thinning in the prevention of further strokes in patients with PFO (
click here for link to Research to find out more)
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An infection on a heart valve (endocarditis)
Depending on which heart problem is the cause, different treatments may be used to prevent stroke, including:
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Lifelong blood thinning (using warfarin, aspirin, or clopidogrel) for atrial fibrillation and heart attack)
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closure of a PFO (not of clearly proven benefit, research ongoing)
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antibiotics and/or valve replacement surgery for endocarditis
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All people with diabetes have an increased risk of stroke. Research tells us that complications of diabetes such as stroke and kidney disease can be reduced by improved control of blood sugar.
There are two types of diabetes, referred to as Type I and Type II, which both result from a deficiency of insulin, a hormone produced by the pancreas gland.
Type I diabetes (insulin-dependent diabetes or juvenile diabetes) is less common than Type II diabetes and most often begins in childhood. It is caused by damage to the pancreas, which leads to insulin deficiency. These patients need to receive insulin throughout their lives. Good control of their diabetes and reduction of other risk factors will lower their stroke risk.
Type II diabetes is more common, and usually starts later in life. It arises because the body can’t use the insulin it makes (also known as “insulin resistance”). Good control of their diabetes and reduction of other risk factors will also lower their stroke risk.
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Strokes related to severe narrowing of either the left or right internal carotid artery (a form of Large Artery Stroke) may indicate the need for surgery to open up the narrow section. Surgery for severe narrowing without stroke is of less clear benefit.
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A high blood cholesterol level is associated with an increased risk of ischemic (non-hemorrhagic) stroke. This is because the cholesterol causes “plaques” that can narrow and block blood vessels in the brain, increasing the chance of both large artery stroke and small artery stroke.
Numerous studies have shown that lowering high cholesterol levels, especially with medications known as Statins, leads to a decreased risk of having a stroke or a heart attack. Cholesterol treatment guidelines to prevent heart attack apply equally well to stroke prevention.
Links of Interest
High Blood Cholesterol - What you Need to Know (from the National Cholesterol Education Program)
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The greater than normal tendency to form blood clots is known as a “hypercoaguable state”. There are many such conditions, listed below. Most cause blood clots in the venous side of the blood circulation (on the way back to the heart) while only a few are known to cause arterial blood clots (leading away from the heart to the body’s parts).
If a person has a stroke where no other clear cause is found, many of the following conditions, will be explored by doing blood tests.
Venous Hypercoaguable Conditions
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Clotting Factor V Leiden genetic mutation
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Clotting Factor II genetic mutation (Prothrombin gene)
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Increased clotting Factor VIII activity
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Clotting Protein C deficiency
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Clotting Protein S deficiency
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Clotting protein Anti-thrombin III deficiency
Arterial Hypercoaguable Conditions
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Blood pressure lowering medications
More information about these medications (National Heart, Lung and Blood Institute)
Blood thinning medications
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Platelet inhibitors
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Aspirin
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Clopidogrel
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Aspirin/Dipyridamole
Coagulation Inhibitors
What are anticoagulants and antiplatelet agents? (American Heart Association)
Cholesterol Lowering Medications
Cholesterol Lowering Medications (National Heart, Lung and Blood Institute)
Statins: Powerful Drugs for Cholesterol Lowering (printable version, .pdf)
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The following behaviors lower the risk of stroke:
Links of Interest
HealthierUS.gov (National guidelines for healthier living)
Nutrition.gov (National Nutrition Information web site)
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