Alex Alikiotis
Strokes are often associated with elderly patients, but they can happen to anyone at any age. While age is a significant risk factor, certain lifestyle choices and underlying health conditions can also increase the chances of having a stroke. In this article, we will explore the various factors that contribute to strokes in healthy individuals and discuss ways to reduce the risk of experiencing one.
| Characteristics | Values |
|---|---|
| Age | Age is one of the biggest risk factors for strokes, with the chance of having a stroke more than doubling for each decade of life after age 55. However, strokes can occur at any age, even in children and babies. |
| Race | African Americans have a much higher risk of death and disability from strokes than whites, due in part to a greater incidence of high blood pressure in the African-American population. |
| Gender | Stroke occurs more frequently in men, but more women than men die from stroke. |
| Prior Stroke History | The risk of having a second stroke is higher after a person has already had one. |
| Heredity or Genetics | The chance of stroke is greater for people with a family history of stroke. |
| Region | Strokes are more common among people living in the southeastern U.S. than in other areas, possibly due to regional differences in lifestyle, race, smoking habits, and diet. |
| Temperature, Season, and Climate | Stroke deaths are more prevalent during extreme temperatures. |
| Socioeconomic Factors | Strokes may be more common among low-income individuals. |
| Lifestyle Choices | Lifestyle choices such as smoking, heavy drinking, physical inactivity, and unhealthy eating habits can increase the risk of stroke over time. |
| Medical Conditions | Certain medical conditions can increase the risk of stroke, including high blood pressure, high cholesterol, diabetes, heart disease, abnormal heart rhythm, cardiac structural abnormalities, high red blood cell count, and polycystic kidney disease. |
| Oral Contraceptives | Birth control pills (oral contraceptives) slightly increase the risk of stroke in women. |
| History of TIAs | Transient ischemic attacks (TIAs) or "mini-strokes" increase the likelihood of a subsequent stroke. |
| Stress | Stress can raise blood pressure to levels that may trigger a stroke. |
Genes and family history
Genes can influence stroke risk in several ways. Some genetic disorders can cause or increase the risk of stroke. For example, single-gene disorders can cause rare, hereditary disorders for which stroke is a primary manifestation. Sickle cell anemia is one such disorder, where cerebrovascular complications result from polymerized red blood cells at low oxygen tensions, leading to small vessel occlusion and sickle-related arterial disease.
Genetic disorders can also increase the risk of stroke by including stroke as a complication. For instance, sickle cell anemia can cause painful crises, vascular crises, and bacterial infections, which can lead to a stroke.
Additionally, genetic mutations can increase the risk of stroke by causing stroke risk factors, like hypertension or diabetes.
Knowing your family history may help prevent a stroke. If you have a medical condition that can lead to a stroke, working with a doctor to manage your condition can help reduce your risk. While heredity is generally considered a non-modifiable risk factor, genetic factors may be modifiable through dietary and lifestyle changes.
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High blood pressure
Additionally, high blood pressure can increase the risk of aneurysms, which are weakened, ballooned areas on artery walls that are at risk of bursting and bleeding into the brain, causing a hemorrhagic stroke. People with polycystic kidney disease, for example, are at a 50% higher risk of aneurysms and are encouraged to receive regular medical care to control high blood pressure.
While age is a factor in strokes, it is not the only one, and high blood pressure can affect people of all ages. In fact, about 10 to 15% of strokes occur in children and adults under 45, and that number is rising. Furthermore, strokes can be caused by sudden peaks in blood pressure, which can affect younger people, especially if they already have high blood pressure.
To reduce the risk of stroke, it is important to maintain a healthy weight, exercise regularly, and see your doctor for regular check-ups, who can prescribe medication to help manage high blood pressure.
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Heart disease
Healthy blood vessels are flexible, but they can become thickened and stiffened due to age and unhealthy lifestyle choices, restricting blood flow. This process is known as arteriosclerosis or "hardening of the arteries," with atherosclerosis being a specific form involving plaque build-up. Atherosclerosis can occur anywhere in the body, blocking blood vessels or triggering blood clots that obstruct blood flow. When it affects the arteries supplying blood to the heart muscle, it can cause angina or a heart attack. In the case of arteries supplying blood to the brain, it can lead to a thrombotic stroke or an embolic stroke, both of which fall under the most common type of stroke, the ischaemic stroke.
To reduce the risk of heart disease and stroke, individuals can make healthy lifestyle choices, such as avoiding smoking, eating healthy and unprocessed foods, exercising, maintaining a healthy weight, and managing stress through techniques like muscle relaxation and breathing exercises. Additionally, regular medical check-ups are important for early detection and management of conditions that increase the risk of cardiovascular disease.
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Diabetes
The connection between diabetes and stroke lies in how the body handles blood glucose to make energy. Most food we eat is broken down into glucose, which enters the bloodstream and travels to cells throughout the body. For glucose to enter cells and provide energy, it needs a hormone called insulin. The pancreas is responsible for producing this insulin. However, in people with Type 1 diabetes, the pancreas does not make insulin, and in people with Type 2 diabetes, the pancreas either makes too little insulin or the muscles, liver, and fat do not use insulin correctly. As a result, untreated diabetes leads to excessive blood glucose, causing fatty deposits or clots in blood vessels that may lead to stroke.
To manage diabetes and lower the risk of stroke, it is important to get tested regularly and maintain a heart-healthy diet. It is recommended to eat at least 14 grams of fibre daily for every 1,000 calories consumed and keep cholesterol down to 300 milligrams per day. Maintaining a healthy weight and engaging in physical activity are also crucial. Additionally, not smoking, drinking alcohol in moderation, and managing stress can help reduce the risk of stroke.
How to Reduce the Risk of Stroke
- Stop smoking.
- Maintain a healthy weight to control blood pressure, cholesterol, and diabetes.
- Exercise regularly to protect your heart, brain, and bones. Aim for 30 minutes of moderate exercise most days of the week.
- See your doctor regularly to check for "silent" stroke risk factors and manage any chronic illnesses such as diabetes.
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Smoking
The harmful substances in tobacco increase the risk of stroke by causing inflammation and damage to blood vessels, increasing the risk of blood clots, and reducing the oxygen in the blood. Tobacco smoke contains thousands of toxic and cancer-causing chemicals that pass from the lungs into the bloodstream when inhaled. These chemicals alter and damage cells and increase the risk of stroke and other cardiovascular diseases.
Quitting smoking significantly reduces the risk of stroke. Studies have shown that the risk of stroke in ex-smokers becomes similar to that of people who have never smoked within five to ten years.
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Frequently asked questions
While older age is a risk factor for strokes, anyone can have a stroke at any age. Strokes occur when blood flow to the brain is stopped or disrupted, starving the brain of oxygen and causing brain cells to die. There are two types of stroke: ischemic and hemorrhagic. Ischemic strokes are the most common and are caused by a blocked blood vessel in the brain, often due to a blood clot or a buildup of fatty deposits and cholesterol. Hemorrhagic strokes occur when a blood vessel in the brain bursts, causing blood to spill into nearby tissues. Risk factors for strokes include high blood pressure, heart disease, diabetes, smoking, birth control pills, a history of transient ischemic attacks (TIAs), high red blood cell count, high cholesterol, excessive alcohol use, illegal drug use, abnormal heart rhythm, and cardiac structural abnormalities.
Symptoms of a stroke may include weakness or numbness in the face, arm, or leg, usually on one side of the body, difficulty speaking or understanding, problems with vision, dizziness, or problems with balance or coordination. The acronym BE FAST can help you remember the signs of a stroke: Balance (sudden dizziness or loss of balance or coordination), Eyes (sudden trouble seeing), Face (sudden weakness or drooping on one side of the face), Arm (weakness in one arm), Speech (difficulty speaking), and Time (call 911 right away).
If you think someone is having a stroke, call 911 or your local emergency number immediately. Treatment is most effective when started as soon as possible.
Emergency treatment for a stroke may include clot-busting medicines, medicines and therapy to reduce or control brain swelling, neuroprotective medicines, and life support measures such as a ventilator, IV fluids, proper nutrition, and blood pressure control. In some cases, surgery, such as a craniotomy, may be required to remove blood clots, relieve pressure, or repair bleeding in the brain.
While some risk factors for stroke are uncontrollable, such as age, gender, and genetics, there are lifestyle changes you can make to reduce your risk. These include maintaining a healthy weight, exercising regularly, quitting smoking, drinking alcohol in moderation, and seeing your doctor regularly for check-ups and management of any chronic conditions.
