Strokes: Frequency And Risk Factors You Should Know

how often can strokes occur

Strokes, or brain attacks, occur when the blood supply to the brain is blocked by a clot or ruptured blood vessel. Every year, about 795,000 people in the United States and 15 million people worldwide have a stroke. In the US, this works out to someone having a stroke every 40 seconds, and someone dying from a stroke every 4 minutes. While stroke risk increases with age, it can occur at any age.

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Stroke risk factors

Stroke is a leading cause of death and disability in the United States. While anyone can have a stroke at any age, certain factors can increase the risk of having one. Understanding these risk factors is crucial for taking preventive measures and lowering the chances of experiencing a stroke. Here are some key stroke risk factors to be aware of:

Medical Conditions

Several common medical conditions can significantly increase the likelihood of having a stroke. These include:

  • High blood pressure: High blood pressure is a leading cause of stroke. It occurs when the pressure of blood in the arteries is too high, and it often shows no noticeable symptoms. However, regular check-ups and lifestyle changes or medication can help lower blood pressure and reduce stroke risk.
  • High cholesterol: Cholesterol is a waxy, fat-like substance produced by the liver. Consuming too much cholesterol from food can lead to a build-up in the arteries, including those in the brain, increasing the risk of stroke.
  • Heart disorders: Common heart conditions such as coronary artery disease, heart valve defects, irregular heartbeat (including atrial fibrillation), and enlarged heart chambers can increase the risk of blood clots, which may cause a stroke.
  • Diabetes: Diabetes causes a build-up of sugars in the blood, preventing oxygen and nutrients from reaching the brain. Additionally, people with diabetes often have high blood pressure, further increasing their stroke risk.
  • Obesity: Excess body fat is linked to higher levels of "bad" cholesterol and lower levels of "good" cholesterol. Obesity can also lead to high blood pressure and diabetes, both of which are risk factors for stroke.
  • Sickle cell disease: This blood disorder is linked to ischemic stroke, particularly in Black children. It causes red blood cells to form an abnormal sickle shape, which can block blood flow to the brain and result in a stroke.

Lifestyle Choices

Lifestyle choices and behaviours can also increase the risk of stroke. However, the good news is that adopting healthy behaviours can lower this risk:

  • Diet: Consuming a diet high in saturated fats, trans fat, and cholesterol has been linked to stroke and related conditions like heart disease. Excess salt (sodium) in the diet can also raise blood pressure levels, contributing to stroke risk.
  • Physical inactivity: Lack of physical activity can lead to health conditions such as obesity, high blood pressure, high cholesterol, and diabetes, all of which are risk factors for stroke. Regular physical activity can help lower the chances of having a stroke.
  • Alcohol consumption: Drinking excessive alcohol can raise blood pressure and triglyceride levels, leading to hardened arteries and an increased risk of stroke.
  • Tobacco use: Smoking cigarettes can damage the heart and blood vessels, increasing the risk of stroke. Nicotine raises blood pressure, and carbon monoxide from cigarette smoke reduces the oxygen-carrying capacity of the blood. Even exposure to secondhand smoke can increase stroke risk.
  • Illegal drug use: Using illegal drugs, such as cocaine, may also raise the risk of experiencing a stroke.

Demographic Factors

Certain demographic factors, such as age, race, ethnicity, and gender, can influence stroke risk:

  • Age: While a stroke can occur at any age, the risk increases with advancing age. The chance of having a stroke doubles about every 10 years after the age of 55.
  • Race and Ethnicity: In the United States, stroke occurs more frequently in Black, Alaska Native, American Indian, and Hispanic adults compared to White adults. The risk of a first stroke is nearly twice as high for non-Hispanic Black adults as for White adults.
  • Gender: Men are generally more likely than women to have a stroke, especially at younger ages. However, since women tend to live longer, their lifetime risk of having a stroke is higher. Additionally, pregnancy, use of birth control pills, and hormone replacement therapy are associated with higher stroke risk in women.

Genetic and Family History

Genetics and family history also play a role in stroke risk:

  • Family history: Individuals with a family history of stroke, particularly at a younger age, are at a higher risk.
  • Genetics: Certain genetic factors and disorders, such as blood-clotting or vascular disorders, can increase stroke risk. Additionally, specific genes, including those determining blood type, can influence stroke susceptibility. People with blood type AB have a higher risk.

Environmental Factors

Environmental factors, such as air pollution and social determinants of health, can also impact stroke risk:

  • Air pollution: Living or working in areas with air pollution has been linked to an increased risk of stroke.
  • Social determinants: The cumulative effect of social factors, such as living in a poor or rural area, low education or income level, and lack of access to quality healthcare, can more than double the risk of stroke in people under 75.

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Stroke occurrence by age

Strokes can occur at any age, but the risk increases with age. The average age of stroke is in the 70s, and they are most common among people in their 90s. The risk of a stroke appears to increase most after the age of 60, with the overall most common age being 71.4 years for men and 76.9 years for women. Older adults are more likely to have strokes due to a combination of multiple health and lifestyle factors.

In the early years of adulthood, the rate of ischemic stroke begins to rise, and the prevalence of strokes in younger adults is increasing. Ischemic strokes are the most common type of stroke in young adults, accounting for about 75% of strokes among people aged 18 to 45. While strokes in young adulthood are often less severe than those in older adults, they can still have serious consequences.

Strokes in infants and children are also possible, with a risk of lifelong disability from congenital abnormalities and injuries. Strokes in this age group are considered perinatal strokes if they occur before delivery or within the first 28 days after birth. The majority of perinatal strokes are ischemic and caused by a sudden loss or disruption of blood supply to the brain. Arterial ischemic infarctions lead to more than 80% of strokes in this age group, while the remainder is usually caused by blood clots or bleeding within the brain.

Strokes that occur between the ages of 28 days and 18 years are considered childhood strokes, with males under the age of five being the most at-risk group. Risk factors for childhood stroke include sickle cell disease, blood clotting disorders, and heart and blood vessel problems. Ischemic strokes, caused by cardiac or vascular problems, make up about half of all childhood strokes.

While age is a significant factor in stroke risk, it is important to note that other factors such as obesity, high blood pressure, high cholesterol, smoking, and diabetes also play a crucial role. Addressing these risk factors through lifestyle changes and medical management can help reduce the likelihood of having a stroke, regardless of age.

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Stroke occurrence by gender

Women are more likely to have a stroke later in life, with those between the ages of 20 and 39 being twice as likely to have a stroke than men of the same age. Additionally, women are more likely to have another stroke within five years of the first one.

Women also have unique risk factors for stroke, such as pregnancy, hormonal birth control, and menopause. They are also more likely to have atrial fibrillation, diabetes, and migraines with aura, all of which are risk factors for stroke.

Women tend to have poorer outcomes after a stroke, with higher rates of disability and institutionalisation. They are also more likely to be widowed and live alone at the time of their stroke. However, this may be due to confounding factors such as older age and pre-existing disability.

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Stroke occurrence by geography

Stroke occurrence varies by geography, with several factors influencing the likelihood of strokes in different regions.

In the United States, about 795,000 people suffer a stroke each year, with someone experiencing a stroke every 40 seconds. Stroke is a leading cause of death and disability in the country. Notably, the southeastern United States has the highest stroke death rates. This may be attributed to regional differences in lifestyle, race, smoking habits, and diet.

Race and ethnicity play a significant role in stroke occurrence. In the US, African Americans have a higher risk of experiencing a first stroke compared to White people. They are almost twice as likely to have a stroke. Additionally, Hispanic Americans, American Indians, and Alaska Natives have a higher risk of stroke than White people but a lower risk than African Americans.

Gender also influences stroke occurrence, with men being more likely than women to experience a stroke. However, women tend to have a higher lifetime risk of stroke due to their longer life expectancy.

While stroke can occur at any age, the risk increases with advancing age. The likelihood of having a stroke more than doubles every decade after the age of 55.

Other factors that contribute to stroke occurrence include lifestyle choices, genetic predispositions, and environmental conditions. For example, living or working in areas with air pollution can increase the risk of stroke.

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Stroke prevention

Control High Blood Pressure

High blood pressure is the most significant risk factor for strokes, and it often has no signs or symptoms. It is crucial to have your blood pressure checked regularly by a healthcare professional or at home with a monitoring device. If your blood pressure is elevated, work with your doctor to develop a treatment plan. This may include lifestyle changes, such as reducing salt intake, increasing physical activity, and maintaining a healthy weight.

Maintain Healthy Cholesterol and Blood Sugar Levels

High cholesterol can increase the risk of stroke by contributing to plaque buildup in blood vessels. It is recommended to have your cholesterol levels checked regularly and take steps to lower them if they are high. Maintaining a healthy diet that includes fruits, vegetables, whole grains, and healthy proteins and fats can help manage cholesterol levels. Additionally, keeping blood sugar (glucose) within a healthy range is essential, especially for people with diabetes, as high blood sugar can damage blood vessels over time.

Address Lifestyle Factors

Several lifestyle factors can increase the risk of stroke. These include smoking, excessive alcohol consumption, physical inactivity, and obesity. Quitting smoking is one of the most effective ways to reduce stroke risk. It is also important to drink alcohol in moderation or not at all. Engaging in regular physical activity, such as walking or moderate-intensity exercises, for at least 30 minutes most days of the week, can help lower stroke risk and improve overall health. Maintaining a healthy weight through a balanced diet and regular exercise can also reduce the likelihood of stroke.

Treat Underlying Health Conditions

Certain underlying health conditions can increase the risk of stroke. These include heart disease, atrial fibrillation (irregular heartbeat), and previous stroke or transient ischemic attack (TIA). If you have any of these conditions, it is crucial to work with your healthcare team to manage them effectively. This may involve taking prescribed medications, making lifestyle changes, or undergoing recommended procedures or surgeries.

By actively addressing these risk factors and following the advice of healthcare professionals, individuals can significantly reduce their risk of experiencing a stroke.

Frequently asked questions

In the United States, about 795,000 people suffer a stroke each year. This means that someone has a stroke every 40 seconds.

Annually, 15 million people worldwide suffer a stroke. Of these, 5 million die and another 5 million experience permanent disability.

The risk of having another stroke is significantly increased for people who have previously had one. Nearly 1 in 4 people who survive a stroke will have another stroke within 5 years.

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