What Increases Your Risk

Risk factors for stroke include those you can change and those you can't change.

Certain diseases or conditions increase your risk of stroke. These include:

• High blood pressure (hypertension). High blood pressure is the second most important stroke risk factor after age. It is a risk factor you can change.
• Diabetes. Having diabetes doubles your risk of stroke because of the circulation problems associated with the disease.
• High cholesterol. High cholesterol can lead to hardening of your arteries (atherosclerosis). Hardening of the arteries can cause coronary artery disease and heart attack, which can damage the heart muscle and increase your risk for stroke.
• Coronary artery disease, which can lead to heart attack and stroke.
• Other heart conditions, such as atrial fibrillation, endocarditis, heart valve conditions, patent foramen ovale, or heart failure.
• Peripheral arterial disease, for example narrowing of the carotid artery (carotid artery stenosis).

Certain behaviors can increase your risk of stroke. These include:

• Smoking, including secondhand smoke.
• Physical inactivity.
• Being overweight.
• Diet with few fruits and vegetables. Research suggests that people who eat more fruits, vegetables, fish, and whole grains (for example, brown rice) may have a lower risk of stroke than people who eat lots of red meat, processed foods such as lunch meat, and refined grains (for example, white flour).²
• Diet with too much salt. A healthy diet includes less than 2,300 mg of sodium a day (about one teaspoon).
• Use of some medicines, such as birth control pills—especially by women who smoke or have a history of blood-clotting problems. In postmenopausal women, hormone replacement therapy has been shown to slightly increase the risk of stroke.³
• Heavy use of alcohol. People who drink alcohol excessively, especially people who binge drink, are more likely to have a stroke. Binge drinking is defined as drinking more than 5 drinks in a short period of time.
• Illegal drug use (such as a stimulant, like cocaine).

Risk factors you cannot change include:

• Age. The risk of stroke increases with age.
• Race. African Americans, Native Americans, and Alaskan Natives have a higher risk than those of other races. Compared with whites, African Americans have about 2 times the risk of a first ischemic stroke. And African-American men and women are more likely to die from stroke.⁴
• Gender. Stroke is more common in men than women until age 75, when more women than men have strokes. Because women live longer than men, more women than men die of stroke.⁴
• Family history. The risk for stroke is greater if a parent, brother, or sister has had a stroke or transient ischemic attack (TIA). For more information, see the topic Transient Ischemic Attack (TIA).
• History of stroke or TIA.