Additional Factors That May Be Linked to Higher Stroke Risk

How COVID-19 Impacts the Whole Body

Dr. Mitch Elkind, a past president of the American Heart Association and a stroke neurologist at Columbia University, explains how the virus that causes COVID-19 can impact the whole body, including the heart and brain.


An increase in blood clot formation is a complication of COVID-19 that can result in a stroke. Read more COVID-19 resources.

Where you live

Strokes are more common in Southeastern states — the “stroke belt” states. Check out your state and consider how it supports healthy habits.

There is a three-year life expectancy gap between rural and urban populations. Rates of physical inactivity, obesity and tobacco use are all higher in rural areas. These have given rise to higher rates of diabetes and high blood pressure. Rural communities have higher death rates from cardiovascular disease and stroke. They also see higher maternal death rates due in part to cardiovascular deaths.

According to an advisory from the American Heart Association, innovative approaches are needed to remove barriers to health care and improve health equity for rural residents.

Lack of means

Strokes may be more common among those with lower incomes. Access to quality food, health care and other social support is often limited for lower-income people. Support quality health care for all.

Alcohol abuse

Alcohol abuse can lead to medical complications, including stroke. The American Heart Association recommends no more than two drinks per day for men and no more than one drink per day for non-pregnant women. Pregnant women should not drink alcohol. Speak with your doctor or a local support group if you need help overcoming an addiction to alcohol.

Drug abuse

Use of illegal and highly addictive substances, including cocaine, heroin and amphetamines, have been associated with an increased risk of stroke. These substances can speed up the heartbeat and raise blood pressure, causing damage to the blood vessels in the brain, ultimately leading to a stroke.

Misusing prescription drugs, especially those used for pain relief (oxycodone, fentanyl), or to relax (like sedatives), can also pose a risk. When misused, these drugs can slow down breathing and reduce the amount of oxygen the brain needs to function properly.

Try to avoid addicting substances, and seek professional help if you need support to overcome substance abuse.