Stroke
Stroke risk builds quietly. You can change it.
Many strokes can be prevented. The conditions behind them, like high blood pressure, diabetes, and an irregular heartbeat, often cause no symptoms for years. This guide explains what raises your risk, what helps, and what to ask your doctor.
What a stroke is
A stroke happens when part of the brain loses its blood supply, either because a vessel is blocked or because it bleeds. Brain cells begin to die within minutes.
Ischemic stroke
The most common kind. A clot or narrowed vessel blocks blood flow to the brain. Often linked to high blood pressure, plaque in the arteries, or a clot that formed in the heart.
Hemorrhagic stroke
A weakened vessel bursts and bleeds in or around the brain. Long-term high blood pressure is the main cause.
Mini-stroke (TIA)
Symptoms appear, then fade within minutes to hours. No lasting damage is visible, but it is a strong warning that a larger stroke may follow.
Risk factors
Some risks you can change and some you can't. Knowing both helps you and your doctor decide where to focus.
High blood pressure
The biggest risk you can change. Over years it damages and weakens blood vessels, and it usually causes no symptoms. Only a measurement tells you.
Diabetes and high blood sugar
Extra sugar in the blood injures vessels over time and speeds up plaque buildup.
Irregular heartbeat (AFib)
Blood can pool in the heart and form clots that travel to the brain. It can be silent. Treatment, often a blood thinner, greatly lowers the risk.
High cholesterol
LDL (“bad”) cholesterol builds plaque that narrows the arteries feeding the brain.
Smoking
Damages vessel walls and makes blood more likely to clot. Risk drops after you quit.
Low activity and excess weight
Both make high blood pressure, diabetes, and high cholesterol more likely.
Heavy drinking
Raises blood pressure and can trigger an irregular heartbeat.
Sleep apnea
Repeated pauses in breathing at night strain the heart and raise blood pressure. Loud snoring, gasping, and daytime sleepiness are clues.
Daily habits that lower risk
The American Heart Association's Life’s Essential 8 names four habits and four health factors that shape heart and brain health. You don't need to change everything at once. Pick one habit to start.
Eat better
A Mediterranean or DASH-style pattern: vegetables, fruit, beans, whole grains, fish, nuts, and olive oil. Choose less processed meat, sodium, and sugary drinks. Most sodium comes from packaged and restaurant food, so read labels.
Be more active
Aim for at least 150 minutes a week of moderate activity, like brisk walking, unless your doctor advises otherwise. Short bouts count.
Avoid nicotine
The ideal is never using tobacco, and that includes avoiding secondhand smoke. If you smoke, quitting at any age helps. Ask about counseling and medicines.
Get healthy sleep
Adults do best with 7 to 9 hours a night. Tell your doctor about loud snoring, gasping, or long-term stress.
Limit alcohol
If you drink, keep it modest. Heavy drinking raises blood pressure and stroke risk.
Take medicines as prescribed
Blood pressure, cholesterol, diabetes, and blood thinner medicines only work if you take them. Don’t stop on your own. Call your doctor if side effects bother you.
Your health numbers
These are the other four Life’s Essential 8 measures, plus your heart rhythm. Ask your doctor for your results and your personal targets.
Blood pressure
The AHA’s ideal is below 120/80. Readings of 130/80 or higher count as high blood pressure under current US guidelines. Ask your doctor how often to check, and whether to check at home.
Cholesterol
A blood test. The AHA’s ideal is a non-HDL cholesterol below 130 mg/dL. Ask for your numbers and whether treatment would help you.
Blood sugar and A1C
The AHA’s ideal is an A1C below 5.7% with no diabetes. 5.7% to 6.4% suggests prediabetes, and 6.5% or higher suggests diabetes.
Weight
The AHA’s ideal is a body mass index (BMI) below 25. BMI is only a guide, so ask your doctor what a healthy weight means for you. Even a modest loss helps blood pressure and blood sugar.
Heart rhythm
Ask whether your pulse is regular, and mention fluttering or skipped beats. A pulse check or ECG can look for AFib.
Talking with your doctor
Appointments are short. Arrive with your questions and write down the answers.
Build your question list
Tick what applies to you.
For everyone
- What is my overall stroke risk, and how was it estimated?
- What one change would help me most?
- When should I come back, and what should I do before then?
- Which warning signs should my family know?
Bring to your visit
- A list of all medicines and supplements, with doses
- Home blood pressure readings, if you have them
- Family history of stroke, heart disease, and diabetes
- Your top three questions, written down
Know the warning signs
Prevention lowers risk but doesn't remove it. If you notice any of these, call 911 right away, even if they fade. Don't drive yourself, and note when symptoms began.
Face drooping
Arm weakness
Speech trouble
Time to call 911
Also watch for sudden trouble seeing, the worst headache of your life, dizziness or loss of balance, and confusion.
Share this with the people you live with, so they know too.