Risk Factors

Prevention of Stroke is an important public health concern due to the high occurrence. Primary prevention is less successful than secondary prevention however a stroke may underlie another disease such as atherosclerosis or other cardiovascular diseases. On the other hand aspirin helps prevent a stroke in patients that have suffered a myocardial infarction.

The most important modifiable risk factors for stroke are high blood pressure and atrial fibrillation. Other modifiable risk factors include high blood cholesterol levels, diabetes, cigarette smoking (active and passive), heavy alcohol consumption and drug use, lack of physical activity, obesity and unhealthy diet. The drugs most commonly associated with stroke are cocaine, amphetamines causing hemorrhagic stroke.

Blood pressure

Hypertension accounts for 35-50% of stroke risk. Studies suggest that even a small blood pressure reduction (5 to 6 mmHg systolic, 2 to 3 mmHg diastolic) would result in 40% fewer strokes. Lowering blood pressure has been conclusively shown to prevent both ischemic and hemorrhagic strokes. It is equally important in secondary prevention.

Atrial fibrillation

Patients with atrial fibrillation have a risk of 5% each year to develop stroke, and this risk is even higher in those with valvular atrial fibrillation. Depending on the stroke risk, anticoagulation with medications such as coumarins or aspirin are warranted for stroke prevention.

ECG courtesy of Wikimedia commons under the terms of the GNU free documentation licence.

Blood lipids

High cholesterol levels have been associated with (ischemic) stroke. High cholesterol may indirectly increase stroke risk by increasing your risk for heart disease – an important stroke risk factor. In addition, plaque formation in the carotid arteries to the brain may also block normal blood flow and cause a stroke.

Smoking

Smoking can increase the risk of a stroke because it causes atherosclerosis and increases the likelihood coagulation. Stopping smoking can cut the risk of a stroke in half with passive smoking also increasing the risk of a stroke.

Smoking image courtesy of Wikimedia commons under the creative commons licence.