Risk Factors Under Your Control

Group of senior retirement friends exercising outdoors

Stroke is dangerous and deadly, but you can control and treat several risk factors for it.

High Blood Pressure

High blood pressure, or hypertension, is a leading cause of stroke and the most significant controllable risk factor. Know your numbers and keep them low. Manage HBP.


The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system and pave the way for a stroke. The use of birth control pills combined with cigarette smoking can greatly increase the risk of stroke. Quit smoking now and lower risks. Downloadable PDF.

WilliamSherman/iStock, Getty ImagesSmoking may double stroke risk for African Americans

The risk of stroke more than doubles for African Americans who smoke compared to their nonsmoking peers, according to a new study. The study, published in the Journal of the American Heart Association, found stroke risk was 2.5 times higher for current smokers compared with never smokers. The number of daily cigarettes made a difference. The risk increased 2.3 times for people who smoked one to 19 cigarettes a day and 2.8 times for those who smoked more than 20.

Read more about how Blacks are disproportionately affected by smoking.


If you have Type 1 or 2 diabetes, control your blood sugar. Diabetes mellitus is an independent risk factor for stroke. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight — increasing their risk even more. While diabetes is treatable, the presence of the disease still increases your risk of stroke. Learn how to lower risks with diabetes and pre-diabetes.  


Diets high in saturated fat, trans fat and cholesterol can raise blood cholesterol levels. Those high in sodium (salt) can increase blood pressure. And those with high calories can lead to obesity. But a diet containing five or more servings of fruits and vegetables per day may reduce the risk of stroke. The American Heart Association Diet and Lifestyle Recommendations outlines a healthy diet. based on these recommendations. 

These diets helped women with diabetes cut heart attack, stroke riskInna Chernish/EyeEm, Getty Images

Diabetes afflicts one-quarter of Americans 65 and older. An estimated 68% of these patients will die of heart disease, and 16% will die of stroke. Read how eating patterns similar to the Mediterranean diet and the blood pressure-lowering DASH may help older women with Type 2 diabetes ward off heart attacks, strokes and related problems.

Physical Inactivity

Physical inactivity can increase your risk of stroke, heart disease, overweight/obesity, high blood pressure, high blood cholesterol and diabetes. Aim for being active at least 150 minutes a week, but if you don’t want to sweat the numbers, just move more and sit less. Learn about the new AHA Physical Activity recommendations. 


Excess body weight and obesity are linked with an increased risk of high blood pressure, diabetes, heart disease and stroke. Losing as little as 5 to 10 pounds can make a significant difference in your risks. Even if weight control has been a lifelong challenge, start by taking small steps today to manage your weight and lower risks.

Obesity, other factors may speed up brain aging alvarez/E+, Getty Images

The brains of middle-age adults may be aging prematurely if they have obesity or other factors linked to cardiovascular disease.  

Almost one-quarter of adults have metabolic syndrome, a set of factors that in combination amplify a person's risk of heart disease, diabetes, stroke and other illnesses. In the new research, participants were considered metabolically unhealthy if they had two or more such factors: high blood pressure; high blood sugar; high blood triglyceride levels; or low levels of HDL, the "good" cholesterol – or if they took medicine for diabetes, high blood pressure or cholesterol.

Learn more about how those who were metabolically unhealthy, obese or both showed evidence of brain decline.

High Blood Cholesterol

Large amounts of cholesterol in the blood can build up and cause blood clots — leading to a stroke. Also, it appears that low HDL ("good") cholesterol is a risk factor for stroke in men, but more data is needed to verify if this is true for women as well. Take control of your cholesterol.

Carotid Artery Disease

The carotid arteries in your neck supply blood to your brain. A carotid artery narrowed by fatty deposits from atherosclerosis (plaque buildups in artery walls) may become blocked by a blood clot, causing a stroke.

Peripheral Artery Disease

Peripheral artery disease, or PAD, is the narrowing of blood vessels carrying blood to leg and arm muscles. It's caused by fatty buildup of plaque in artery walls. People with PAD have a higher risk of carotid artery disease, which raises their risk of stroke.

Atrial Fibrillation

Atrial fibrillation, or AFib (a heart rhythm disorder) clot can travel to the brain and cause a stroke. If you have AFib, know your stroke risks and get treatment to keep your risks low. Also, sleep apnea can be linked to AFib and is associated with increased stroke risks.

Other Heart Disease

People who have coronary heart disease or heart failure are at higher risk of stroke than people who have healthy hearts. Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects can also raise the risk of stroke. Work with your health care provider to manage these related conditions.

Sickle Cell Disease (Sickle Cell Anemia)

Sickle cell disease is a genetic disorder that mainly affects African American and Hispanic children. It causes “sickled” red blood cells, which are less able to carry oxygen to the body’s tissues and organs. These cells tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke. Although you can’t control whether you have sickle cell disease (SCD), you can work with your health care professional to prevent flare-ups and manage them carefully to reduce your risk of having a stroke. 

The highest rates of stroke caused by SCD occur during childhood. Therefore, the American Stroke Association and the National Institutes of Health recommend that children with SCD between the ages of 2 and 16 be screened annually with transcranial doppler ultrasound. TCD is a simple, painless test that can determine whether children with SCD are at a high risk for stroke. Children who are at high risk for stroke who receive regular blood transfusions can reduce their stroke risk by more than 90%.

Learn more about uncommon causes of stroke.

Stroke Risk Quiz

Take the Stroke Risk Quiz now. If you scored high for risk factors or are unsure of your risk score, talk with your health care professional about how you can reduce your risk.

Heart disease and Stroke

The link between heart disease and stroke is significant. Several types of heart disease are risk factors for stroke. Likewise, stroke is a risk factor for coronary heart disease. People with coronary heart disease, angina or who have had a heart attack due to atherosclerosis (hardening of the arteries) have more than twice the risk of stroke.

Blood Pressure Monitor

High Blood Pressure is the No. 1 Controllable Risk Factor for Stroke

Nearly half of American adults have high blood pressure, or hypertension. Work with your doctor to keep your blood pressure in a healthy range (under 120/80).