Who Is at Risk for a Stroke?

HCA imageA stroke occurs when an artery in the brain becomes blocked or a blood vessel carrying blood to the brain bursts. Either way, the brain does not receive enough blood and oxygen and brain cells begin to die.

Many of the risk factors for stroke can be lowered or treated. Others, such as increasing age, family history of stroke, African American race, or prior stroke cannot be.

Developments in Prevention

High Blood Pressure

The most common and most preventable risk factor for stroke is high blood pressure. The National Stroke Association recommends all adults have their blood pressure checked every year. High blood pressure is defined as having a systolic pressure greater than 140 mmHG and diastolic pressure greater than 90 mmHg. If you have a certain condition, like diabetes, your doctor may have stricter blood pressure goals for you.

High Cholesterol

Lowering cholesterol levels with diet, exercise, and medicine may help reduce the build-up of fatty arterial plaque that can trigger a stroke. The American Heart Association (AHA) recommends adults have a fasting cholesterol check at least once every five years. A desirable total cholesterol level is less than 200 mg/dl.. If you have cardiovascular disease or diabetes, your doctor will have you follow stricter cholesterol guidelines.

Heart Arrhythmias

If you have atrial fibrillation (an irregular heart rhythm) and using a blood thinner such as warfarin may be able to lower your risk for stroke. However, your doctor should monitor your condition carefully if you are taking warfarin therapy to watch for possible bleeding.


If you have diabetes, keeping your blood pressure low (eg, 130/85 mmHg) can reduce your risk of stroke. Blood pressure drugs called angiotensin-converting enzyme (ACE) inhibitors can be helpful for this purpose. Control of blood sugar is important, as well, in decreasing stroke risk.


Smokers have twice the risk of suffering a stroke as nonsmokers. However, if you stop smoking, your risk of stroke will fall—within about five years—to the same level as someone who never smoked. There are many smoking cessation aids available today, including online support groups, nicotine patches, sprays, gum, or certain antidepressant drugs.


Aspirin makes blood platelets less sticky and, therefore, less likely to form clots that can lead to strokes. Some people who have already suffered a stroke or a transient ischemic attack (TIA) may benefit from taking an anti-platelet agent. Medicines like clopidogrel (Plavix), or the combination of aspirin plus dipyridamole (Aggrenox) are usually reserved for patients at high risk for stroke because they may have adverse effects, such as bleeding.

Carotid Artery Surgery

If you have fatty arterial deposits in their neck, which can lead to stroke, you may benefit from carotid artery surgery. If you have severe arterial blockage and a history of previous stroke or TIA, this surgery may significantly reduce your risk of a second stroke.


Exercising regularly can reduce your risk of stroke. Researchers found that people who participate regularly in sports had a lower incidence of having a stroke. Work with your doctor to create an exercise routine that is safe for you.

Today we are much better prepared than in the past to prevent strokes. If you are at increased risk for stroke, discuss your options with your doctor. If you do experience symptoms of a stroke, it is important to immediately undergo medical evaluation. For acute strokes, the time to diagnosis and treatment is extremely important. If you think you are having a stroke, call 911 right away.