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Susan M. Morgan, CFCS
County Extension Agent
Family and Consumer Education
Bolivia, NC 28422
April 6, 2000

Stroke is one of the most preventable of all life-threatening health problems. There are two types of risk factors for stroke--controllable and uncontrollable. It's important to remember that having one or more uncontrollable stroke risk factors DOES NOT MEAN YOU WILL DEFINITELY HAVE A STROKE. With proper attention to controllable stroke risk factors, even the impact of uncontrollable factors can be greatly reduced.

Uncontrollable Stroke Risk Factors Include:

1. Age
   The chances of having a stroke go up with age. Two-thirds of all strokes happen to people over age 65. Stroke risk doubles with each decade past 55 years of age.
2. Gender
   Males have a slightly higher stroke risk than females. But, because women in the United States live longer than men, more stroke survivors over age 65 are women.
3. Race
   African-Americans have a higher stroke risk than most other racial groups.
4. Family History of Stroke or TIA
   Risk is higher for people with a family history of stroke or TIA.
5. Personal History of Diabetes
   People with diabetes have a higher stroke risk. This may be due to circulation problems that diabetes can cause. In addition, brain damage may be more severe and extensive if blood sugar is high when a stroke happens. Treating diabetes may delay the onset of complications that increase stroke risk. However, even if diabetics are on medication and have blood sugar under control, they may still have an increased stroke risk simply because they have diabetes.

Treatable (Controllable) Medical Disorders that Increase Stroke Risk Include:

1. High Blood Pressure or Hypertension
   Having high blood pressure, or hypertension, increases stroke risk four to six times. It is the single most important controllable stroke risk factor. High blood pressure is often called "the silent killer" because people can have it and not realize it, since it often has no symptoms. Hypertension is a common condition, affecting approximately 50 million Americans, or one-third of the adult population. Blood pressure is high if it is consistently more than 140/90. Between 40 and 90 percent of all stroke patients had high blood pressure before their stroke. Hypertension puts stress on blood vessel walls and can lead to strokes from blood clots or hemorrhage.

   According to the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, Heart Disease, Atrial Fibrillation and Other Heart Diseases, heart disease increases stroke risk up to six times. About 15 percent of all people who have a stroke have a heart disease called atrial fibrillation (AF). AF affects more than 1 million Americans and is caused when the atria (the two upper chambers of the heart) beat rapidly and unpredictably, producing an irregular heartbeat. AF raises stroke risk because it allows blood to pool in the heart. When blood pools, it tends to form clots which can then be carried to the brain, causing a stroke.

   Normally, all four chambers of the heart beat in the same rhythm somewhere between 60 and 100 times every minute. In someone who has AF, the left atrium may beat as many as 400 times a minute. If left untreated, AF can increase stroke risk four to six times. Long-term untreated AF can also weaken the heart, leading to potential heart failure. The prevalence of AF increases with age.

   AF is found most often in people over age 65 and in people who have heart disease or thyroid disorders. Among people age 50 to 59, AF is linked to 6.7 percent of all strokes. By ages 80-89, AF is responsible for 36.2 percent of all strokes.

2. Coronary Heart Disease and High Cholesterol
   High cholesterol can directly and indirectly increase stroke risk by clogging blood vessels and putting people at greater risk of coronary heart disease, another important stroke risk factor. A cholesterol level of more than 200 is considered "high." Cholesterol is a substance in the blood that our bodies make on their own, but we also get it from fat in the foods we eat. Certain foods (such as egg yolks, liver, or foods fried in animal fat or tropical oils) contain cholesterol. High levels of cholesterol in the blood stream can lead to the buildup of plaque on the inside of arteries, which can clog arteries and cause heart or brain attack (stroke).

3. Personal History of Stroke or TIA
   People who have already had a stroke or TIA are at risk for having another. After suffering a stroke, men have a 42 percent chance of recurrent stroke within five years, and women have a 24 percent chance of having another stroke. TIAs are also strong predictors of stroke because 35 percent of those who experience TIAs have a stroke within five years.
Lifestyle Factors that Increase Stroke Risk Include:
1. Smoking
   Smoking doubles stroke risk. Smoking damages blood vessel walls, speeds up the clogging of arteries by deposits, raises blood pressure, and makes the heart work harder.
2. Alcohol
   Excessive consumption of alcohol is associated with stroke in a small number of research studies. Its specific role in stroke has not yet been determined or proven. Recent studies have also suggested that modest alcohol consumption (one 4 oz. glass of wine or the alcohol equivalent) may protect against stroke by raising levels of a naturally occurring "clot-buster" in the blood.
3. Weight
   Excess weight puts a strain on the entire circulatory system. It also makes people more likely to have other stroke risk factors such as high cholesterol, high blood pressure and diabetes.
Susan Morgan is Extension Agent for Family and Consumer Education for the North Carolina Cooperative Extension Service in Brunswick County. For more information or questions, contact Susan at 253-2610 or
P. O. Box 109, Bolivia, NC 28422.

The information presented is for educational purposes only. References to trade names is made with the understanding that no discrimination is intended and no endorsement by North Carolina Cooperative Extension Service is implied.

Please e-mail Susan Morgan, CFCS, County Extension Agent, Family and Consumer Education for further information or assistance.

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Date Created 4/6/99
Last Revised 4/6/99