While some risk factors for stroke aren’t in your control, you may be able to change others, such as high blood pressure, smoking, and your diet. A doctor can help you take steps to understand and reduce your stroke risk.

An estimated 795,000 people in the United States have a stroke each year, according to the Centers for Disease Control and Prevention (CDC). Stroke was the fifth leading cause of death in the United States in 2021.

Several factors can increase your risk of having a stroke. Understanding these risk factors and taking steps to manage them where possible can help reduce your stroke risk.

Controllable vs. uncontrollable risk factors

Some stroke risk factors are out of your control. These are things that you can’t take steps to manage or change, such as your age or your family medical history. However, many stroke risk factors are controllable.

Controllable risk factors are health conditions you can aim to prevent or manage, as well as healthy lifestyle choices you may be able to make. Researchers estimate that the following 5 controllable factors account for 82–90% of stroke risk:

  • blood pressure
  • diet
  • physical activity
  • smoking
  • obesity
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Hypertension (high blood pressure) is the most important risk factor for stroke. According to the CDC, close to half of U.S. adults have high blood pressure, and the condition is properly managed in only about a quarter of those people.

The effects of high blood pressure cause damage to your arteries, including those in your brain. This can make those arteries more prone to clogging or bursting, resulting in a stroke.

You can manage hypertension with medications to lower your blood pressure. Healthy lifestyle habits are also a big part of reducing blood pressure. Many of these habits can also help manage other stroke risk factors.

High cholesterol, specifically high low-density lipoprotein (LDL) cholesterol, boosts stroke risk. High LDL, or “bad” cholesterol, contributes to atherosclerosis, a buildup of plaque on artery walls.

As plaque builds up, arteries narrow and are more likely to become blocked. If this happens in your brain, it can cause an ischemic stroke.

As with high blood pressure, you can manage high cholesterol with lifestyle habits and medications.

A 2021 study found that 58.8% of people who survived a stroke had a history of smoking. Smoking can contribute to stroke risk by damaging artery walls, raising blood pressure, and reducing the amount of oxygen your blood can carry.

If you currently smoke, quitting smoking can decrease your risk of stroke. Several options are available to help you quit. You can work with a doctor to develop a smoking cessation plan you can stick to.

Based on data from 2021, the CDC estimates that 11.6% of people in the United States — roughly 38.4 million people — have diabetes. If diabetes isn’t properly managed, high blood sugar can contribute to the narrowing of blood vessels via atherosclerosis, boosting the risk of blockage and stroke.

Additionally, people with diabetes often have one or more additional stroke risk factors, such as high blood pressure, high cholesterol, or obesity.

If you have diabetes, several medications are available to help you manage your blood sugar. Healthy lifestyle habits are also important for managing diabetes and preventing complications.

Obesity is a chronic condition involving excess body fat. Experts estimate that 41.9% of U.S. adults have obesity.

Obesity can increase your risk of having other stroke risk factors such as high blood pressure, high cholesterol, and diabetes.

You can treat obesity by taking steps to manage your weight. This can mean different things for different people but may include lifestyle changes, medications, or bariatric surgery.

According to some research, only 8.3% of Americans consume a somewhat healthy diet. An unhealthy diet is a significant risk factor for stroke.

This is because diets high in cholesterol, trans fats, and saturated fats can increase cholesterol levels. Further, high salt intake can boost your blood pressure. An unhealthy diet can also contribute to obesity and diabetes.

The American Heart Association (AHA) recommends limiting your consumption of processed foods, added sugars, salt, and alcohol. Instead, the AHA recommends a diet focusing on fruits, vegetables, whole grains, and healthy proteins. Two diets that fit this description are the Mediterranean diet and the DASH diet.

Low levels of physical activity can increase the risk of several stroke risk factors, such as high blood pressure, diabetes, and obesity.

Engaging in moderate- or vigorous-intensity activities can reduce your risk of stroke.

The Physical Activity Guidelines for Americans recommend that adults get at least 150 minutes of moderate-intensity exercise each week. Examples include walking briskly, playing tennis, and even raking the yard.

Medical conditions that increase your risk of stroke

In addition to what we’ve mentioned above, several other medical conditions can boost your stroke risk. These include:

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Several stroke risk factors are beyond your control, including:

  • Age: Your risk of stroke goes up as you get older.
  • Personal history: If you’ve already had a stroke or a transient ischemic attack, your risk of stroke is higher.
  • Family history: Having a close relative who has had a stroke, especially before 65 years of age, increases your risk of stroke.
  • Sex: Compared to males, females have more strokes and more often die from strokes.
  • Race and ethnicity: The risk of a first stroke is twice as high for Black people in the United States as for white people. This is likely due to inequities in healthcare and barriers to healthcare access.

How do doctors screen for stroke risk?

A doctor can use your personal and family medical history and tests for stroke risk factors to help determine your stroke risk. It’s important to see a doctor for regular checkups to ensure that you’re managing any controllable risk factors.

Are risk factors for hemorrhagic stroke the same as for ischemic stroke?

The risk factors for ischemic and hemorrhagic stroke are similar. However, depending on the type of stroke, some factors may play a larger role.

For example, high blood pressure is particularly important in managing the risk of hemorrhagic stroke, while high cholesterol is more important for ischemic stroke.

What are the warning signs of a stroke?

The warning signs of a stroke come on suddenly and include:

If you notice any of these sudden symptoms in yourself or another person, call 911 or your local emergency services right away.

Some risk factors for stroke, such as age and family history, are out of your control. But you may be able to manage other risk factors and help lower your stroke risk.

Examples of controllable stroke risk factors include high blood pressure, high cholesterol, and unhealthy diet.

Be sure to see a doctor to get a better idea of your personal stroke risk, especially if you have a family history or other uncontrollable risk factors. A doctor can work with you to develop strategies to help lower your risk of having a stroke.