17 Surprising Things That Affect Stroke Risk
What causes a stroke?
Stroke occurs when a blood vessel carrying blood and oxygen to the brain becomes blocked (ischemic stroke) or bursts (hemorrhagic stroke).
“Stroke is scary for many people because it seems—and often is — an unpredictable and mysterious event,” said Amy L. Doneen, medical director of the Heart Attack & Stroke Prevention Center in Spokane, Wash. “The good news is these events are preventable.”
Basically a heart-healthy lifestyle cuts your stroke risk too. So get a veggie wrap instead of the pastry, take a bike ride, and quit smoking. But there are many other things you can do to lower your stroke risk. Here are a few ideas to get you started:
As part of a fruit-and-veggie-rich diet, think about loading up on lycopene, the antioxidant that gives tomatoes their red hue.
In a recent study, men with the greatest blood levels of lycopene were 55% less likely to have any kind of stroke—and 59% less likely to have an ischemic stroke, in particular—than men with the lowest lycopene levels.
The highest concentrations of this micronutrient are found in intensely red products such as tomato paste and tomato puree. Other good sources include vegetable juice cocktail, watermelon, pink grapefruit, and guava.
Get checked for A-fib
People who have atrial fibrillation, or A-fib, have a fivefold higher stroke risk than those who don’t—but many people don’t know they have it.
A common heart rhythm problem (about 5% of people over 65), A-fib occurs when the upper heart chambers (the atria) don’t beat in coordination with the rest of the heart.
Symptoms can include a rapid pulse or feeling like your heart is pounding, dizziness, confusion, fainting, fatigue, or no obvious symptoms at all.
A-fib ups your clot risk, so treatment can include medication to thin the blood or slow the heart rate. Get more info from the
Break a sweat
Vigorous exercise is a great way to ward off and reduce the effects of stroke.
One recent study found that moderate to intense exercise, like jogging or cycling, lowered the risk of silent stroke, which can lead to memory problems, while an older, international study found that people who exercised the most prior to having a stroke tended to have less severe strokes and better prospects for long-term recovery.
Maintaining a healthy lifestyle that includes daily exercise, not smoking, a healthy diet, a normal weight and moderate alcohol intake can reduce stroke risk by up to 80%, an older study found.
Slash salt intake
Americans consume an average of 3,436 milligrams, or about 1-1/2 teaspoons, of salt a day, more than twice the amount that the American Heart Association recommends. In some people, salt drives up blood pressure, a major risk factor for stroke.
Independent of high blood pressure, people who consume a lot of salt (more than 4,000 milligrams a day) have more than double the risk of ischemic stroke than those who consume less than 1,500 milligrams, or about 2/3 of a teaspoon, a day.
Have an apple a day
Not all white foods are nutritional wastelands. In a Dutch study, people who consumed the most white-fleshed fruits and veggies each day (more than 171 grams, or 6 ounces) were 52% less likely to have a stroke than those who ate little white produce (78 grams, or less than 3 ounces).
Apples and pears (the most frequently consumed of the pale produce) pack fiber and quercetin, an inflammation-fighting antioxidant.
Other white foods to try: Bananas, cauliflower, chicory, cucumber, garlic, and onions.
Drink coffee in moderation
In a recent analysis, moderate daily coffee consumption (1-3 cups) actually protected against ischemic stroke. Downing six or more cups a day had no effect on stroke risk.
“Coffee in moderation (1-2 cups) is OK,” says Wayne M. Clark, MD, director of the Oregon Stroke Center and professor of neurology at Oregon Health & Science University in Portland. “More may increase blood pressure,” a major risk factor for stroke.
On the other hand, if you know you have a brain aneurysm, lay off the joe because it could temporarily raise your blood pressure, increasing the risk that the weakened artery will burst.
Amp up the antioxidants
The cocoa in chocolate contains flavonoids, antioxidants that fight blood vessel damage and prevent blood clots, which may lead to stroke.
A Swedish study found that men who ate the most chocolate (2.2 oz) had a 17% lower risk of stroke than men who didn’t indulge at all or very little. While the research did not explore the type of chocolate consumed, dark chocolate contains more cocoa than milk chocolate.
Chocolate’s not your thing? Green and black tea, red wine, blueberries, strawberries and garlic are also rich in flavonoids.
Weigh surgery risks
Each year more than 300,000 Americans have hip replacement surgery to ease hip pain and restore mobility, but there is a significant downside, especially for the elderly.
A recent study found people who had hip replacement surgery faced a heightened risk of stroke, particularly in the first two weeks after the procedure. Ischemic stroke risk rose 4.7 times and hemorrhagic stroke was up 4.5-fold. The risk of stroke remains elevated for the first six to twelve weeks after surgery.
Study authors caution elderly patients to weigh the benefits of surgery against the risk of stroke.
Lower blood pressure
Normal blood pressure is lower than 120 mmHg (systolic pressure) over 80 mmHg (diastolic pressure). Keep those numbers tightly in check to help avoid a stroke.
A study found people with even slightly elevated blood pressure—a condition known as prehypertension—have a 55% greater risk of having a future stroke. Prehypertension is defined as a systolic pressure between 120 and 139 or a diastolic pressure between 80 and 89. People at the top range of those numbers have a 79% greater risk of stroke.
To control blood pressure, exercise regularly, eat healthier, drop a few pounds, don't smoke, and take your blood pressure medication. You can’t feel high blood pressure, so you may be tempted to skip it—Don’t!
Beware of anxiety, depression
A stroke can sink you into depression, but did you know that depression can influence your risk of having a stroke? In one recent study, people with depression were 45% more likely to have a stroke and 55% more likely to die from it.
People who are depressed are more likely to smoke, eat poorly and shirk physical activity—all risk factors for stroke. Even low levels of anxiety or depression can boost the risk of death from cardiovascular events, another study found.
Make time to quiet your mind and body because it may promote internal healing.
In a small study, black Americans with heart disease who practiced Transcendental Meditation twice daily were 48% less likely to have a stroke, heart attack or die than those who took a health education class. After five years of follow-up, people who mediated saw significant reductions in anger and blood pressure.
Avoid bad air
In a recent study, Boston-area residents were 34% more likely to have an ischemic stroke on “moderate” versus “good” air quality days, especially after being exposed to traffic-related emissions. The link was strongest within 12 hours after the exposure.
The theory is that inhaling air particulates makes the coronary arteries less elastic.
Tip: If you have other risk factors for stroke, don’t get caught in traffic on days when air quality is diminished.
Take meds as directed
Some popular prescription and over-the-counter medicines are linked to a higher stroke risk.
If you regularly take ibuprofen, your stroke risk is three-fold higher than someone taking a placebo pill, a recent study found. Some arthritis pain relievers boost stroke risk, too.
Women who smoke and take birth control pills can develop blood clots that can lead to stroke, and some women who take hormone replacement therapy face a slightly higher risk of stroke than women not taking hormones.
One less worry: A study found adults taking stimulant medications for attention deficit hyperactivity disorder do not face a higher stroke risk, even though these drugs are known for raising blood pressure and heart rate.
Brush and floss
Healthy mouth, healthy heart and brain, right? Studies show an association between periodontal disease and cardiovascular disease. The theory is that gnarly gums breed bacteria that invade the coronary arteries, fostering the development of sticky plaques that block blood flow. But in a recent scientific statement, the American Heart Association cited a lack of conclusive evidence that gum disease causes heart disease or stroke, or that treating a person’s gum disease reduces the risk of those events. Doneen’s advice? “Brush and floss your teeth and see your dentist regularly.”
If you smoke, drop that cigarette. Smokers are twice as likely to have an ischemic stroke and four times as likely to have hemorrhagic stroke as non-smokers. Plus, they’re almost a decade younger when they have a stroke.
Smoking reduces oxygen in the blood, making it easier for clots to form, while inhaled smoke irritates the arteries, allowing fatty plaques to accumulate in the arteries.
Ask about vitamin D
Vitamin D is well known for its bone-building properties, but can it protect the brain?
A study presented at a recent stroke conference found that people who consumed higher amounts of D had an 11% lower risk of stroke, but the study relied on responses to questionnaires about how frequently people ate certain foods, not more accurate measurements of vitamin D in the blood. A more definitive answer may come from a large clinical trial examining whether taking daily vitamin D supplements reduces risk for stroke and other diseases.
Clean out your neck arteries
The carotid arteries in your neck can get clogged with fatty plaque, just like the ones that supply blood to your heart. This can increase your risk of stroke.
You can undergo surgery (called carotid endarterectomy) to get the fatty plaque removed, or have a stent (a tiny metal tube) inserted, which allows more blood to reach the brain.
But these procedures can be risky too (in terms of actually causing a stroke), so your doctor will carefully analyze your vessels, usually with ultrasound, to make sure the benefits outweigh the risk.