Summary: Stroke is a leading cause of death and disability in the US, yet it is highly preventable. Some people have a higher stroke risk because of family history or genes. You cannot change your genes. But a new study shows that a stronger push on lifestyle can still offset the risk your genes bring.
Stroke is the leading cause of death and disability in the US. It causes 1 in 6 deaths in the nation. Every year, about 800,000 people in the US have a stroke, and more than 600,000 have a new or first stroke. Despite much progress in treatment, it is still often deadly. Even when doctors save the patient, it often leaves long-term disability. Many people also have more than one stroke. There are other worrying trends in the US. Stroke is showing up more in young adults. For example, almost 40% of people who have a stroke are younger than 65. And people of color seem to be hit harder by stroke.
But there is good news too. Stroke is a heart and blood vessel disease caused mainly by poor lifestyle choices. That means lifestyle changes can prevent it. Stroke risk factors fall into two groups: ones you can change and ones you cannot. You can change some risk factors through lifestyle or medical care. Others are built in and cannot be changed.
Risk factors you can change include high blood pressure, smoking, not moving enough, poor diet, obesity, high cholesterol, atrial fibrillation, diabetes, and heavy drinking. High blood pressure is a leading cause of stroke. Lifestyle changes or medicine can manage it. Smoking can narrow blood vessels and raise the risk of blood clots and stroke. Sitting too much can raise stroke risk, while regular exercise can help lower it.
A diet high in salt, saturated fat, and cholesterol can raise stroke risk. A healthy diet can lower it. Being overweight raises the risk, and keeping a healthy weight can help lower it. High cholesterol can build fatty deposits in blood vessels and raise stroke risk. Controlling cholesterol can lower it.
Atrial fibrillation is a heart rhythm problem that can raise stroke risk. People with it can lower their risk by controlling heart rate, blood pressure, and cholesterol. People with diabetes are at higher risk of stroke. Controlling blood sugar can lower that risk. Heavy drinking can also raise stroke risk, while keeping alcohol to moderate levels can lower it.
Risk factors you cannot change include age, sex, family history, race and ethnicity, and a past stroke or transient ischemic attack (TIA, a “mini-stroke”). Stroke risk rises as people get older. Men have a slightly higher risk than women, but women are more likely to die from stroke.
A family history of stroke or other heart and blood vessel disease can raise stroke risk. Some racial and ethnic groups have a higher risk, such as African Americans, Native Americans, and Hispanic Americans. People who have had a stroke or TIA are also at higher risk of another one.
You cannot change your age or family history. But a new study shows you can offset even built-in risks like high genetic stroke risk. So researchers say even the factors you cannot change can be changed, though they take extra effort. The study, published in the Journal of the American Heart Association, shows that healthy lifestyle choices can cut stroke risk by as much as 43%.
To see whether lifestyle can offset genetic risk, researchers studied data on almost 12,000 people. Some followed the American Heart Association advice: quit smoking, eat better, stay active, and lower cholesterol and blood pressure. They had a significantly lower risk of stroke despite their family history.
So a family history of stroke is no longer an excuse. The study confirms you can offset genetic stroke risk through lifestyle changes. Risk factors you cannot change just ask for more effort.
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Frequently asked questions
Does stroke risk run in families?
Yes. A family history of stroke or other heart and blood vessel disease raises your own risk. So does a past stroke or TIA. Family history is a risk factor you cannot change. What the Journal of the American Heart Association study adds is that inherited risk is not the final word. People with a family history who kept healthy habits had a significantly lower risk of stroke.
How can you prevent a hereditary stroke?
Work harder on the risk factors you can change. In the study of almost 12,000 people, some followed the American Heart Association advice (quit smoking, eat better, stay active, and lower cholesterol and blood pressure). They had a significantly lower stroke risk despite their family history. Healthy lifestyle choices cut stroke risk by as much as 43%. A family history is not an excuse. It asks for more effort.
At what age are you most likely to have a stroke?
Stroke risk climbs as people get older. That is why age is a risk factor you cannot change. But stroke is not only an older person’s problem. It shows up more and more in young adults. Almost 40% of people who have a stroke are younger than 65. Men have a slightly higher risk than women, but women are more likely to die from a stroke.
What is the number one cause of stroke?
High blood pressure is a leading cause of stroke. Lifestyle changes or medicine can manage it. It sits with the other risk factors you can change: smoking, not moving enough, a diet high in salt and saturated fat, obesity, high cholesterol, atrial fibrillation, diabetes, and heavy drinking. So many of these respond to lifestyle change. That is why stroke is so preventable.
The content provided herein is not intended to provide assessment, diagnosis, treatment, or medical advice; it also does not constitute provision of healthcare services. No information in this content should ever be considered as a substitute for advice from a healthcare professional, it is provided for thoughtful discussion, informational and educational purposes only.
Dr. Gurpreet Singh Padda, MD, MBA, MHP
