Stroke rates all over the world are on the rise, as the condition becomesone of the leading causes of death and disability worldwide. Globally, 1 in 4 adults over the age of 25 will have a stroke in their lifetime. The incidence of stroke increases significantly with age. However, over 60% of strokes happen to people under the age of 70, whereas 16% happen to those under the age of 50. Over half a million Americans have a first stroke every year. However, up to 80% of strokes may be preventable. Hence, it is crucial to understand and mitigate your risk factors.
The American Stroke Association this week released its first new clinical guidelines for strokes in a decade.
The ‘2024 Guideline for the Primary Prevention of Stroke’, which replaced the 2014 version, published in the journal Stroke, focuses on identifying and managing risk factors—particularly in women. The updated guideline also highlights healthy lifestyle behaviours that can lower stroke risk.
As per the guideline, the most effective way to reduce the occurrence of a stroke and stroke-related death is to prevent the first stroke—referred to as primary prevention. According to the guideline, some populations have an elevated risk of stroke – whether it is due to genetics, lifestyle, biological factors and/or social determinants of health. However, in some cases, people fail to receive appropriate screening to identify the risk factors that might lead them to stroke.

What is a stroke?

A stroke is what happens when a blood vessel ruptures or is blocked by a blood clot, interrupting blood flow to the brain. In other words, a stroke is a sudden blockage of blood flow to the brain or sudden bleeding in the brain. During a stroke, the brain doesn’t receive enough oxygen to function properly, resulting in brain damage that, depending on the severity, can lead to trouble

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thinking, talking, walking, or other disability. It is a leading cause of death in the United States, and the incidence has been rising even among adults 49 and younger.

What are the causes leading to stroke?

A stroke typically occurs when blood flow to the brain is disrupted or stopped. There are two main types of strokes:
Ischemic stroke: The most common type of stroke, caused by a blocked blood vessel in the brain. This can be due to a blood clot, a buildup of plaque, or a narrowing of the blood vessel.
Hemorrhagic stroke: A burst blood vessel in the brain that causes blood to leak into the brain or surrounding tissues. This can be caused by high blood pressure or an aneurysm, which is a bulge in an artery that can burst.

What are the risk factors for a stroke?

A stroke can be triggered due to several factors, such as:
High blood pressure: High blood pressure, also known as hypertension, is one of the leading causes of stroke, that too – often with no symptoms. High blood pressure can damage artery walls, making them thinner and more likely to rupture. It can also cause a build-up of fatty material in the arteries, which can lead to blood clots. If a clot travels to the brain, it can cause an ischemic stroke. Besides, high blood pressure can damage blood vessels inside the brain, causing them to bleed which is known as a hemorrhagic stroke. Certain lifestyle changes and necessary medications can help lower the risk.
High cholesterol: High cholesterol can cause a build-up of cholesterol and other substances in the arteries, which is called atherosclerosis. This can narrow the arteries and make them stiff. The plaque build-up can reduce blood flow through the arteries. If a plaque ruptures, a blood clot can form, which can block blood flow to the brain and cause a stroke. The plaque buildup can reduce the amount of oxygen reaching the brain cells.
Smoking: Tobacco use doubles your risk of stroke. Nicotine in cigarettes raises blood pressure, and carbon monoxide reduces the amount of oxygen in your blood. Smoking can increase the risk of stroke by causing a number of changes in the blood vessels and heart that can lead to blood clots and block blood flow to the brain.
Lack of exercise: A study found that people who were inactive during leisure time had a 20–25% increased risk of stroke compared to those who were active.
Other risk factors include substance use, including alcohol and illicit drugs, and excessive stress. Family history and genetics also contribute to heightening the chances of a stroke.

Risk factors of a stroke in women:

Although risk factors of a stroke are not specific to any gender, women have unique risk factors for stroke:
Pregnancy: Pregnancy increases a woman’s risk of stroke for a number of reasons like blood clotting, hormonal changes, or hypertensive disorders of pregnancy. Pregnancy increases the likelihood of blood clotting, which can lead to stroke. This is due to swelling from pregnancy that reduces blood flow to the lower legs, and the body producing more of a substance that helps blood clot during late pregnancy. Changing hormones during pregnancy may contribute to a woman’s risk of stroke. Besides, high blood pressure during pregnancy is the leading cause of stroke in pregnant women. Preeclampsia and eclampsia are dangerous types of high blood pressure that can increase the risk of stroke. Apart from that, gestational diabetes causes high blood sugar that can increase the risk of stroke. Pregnancy causes the heart and blood vessels to remodel known as cardiovascular changes, which can increase the risk of stroke.
Birth control: Birth control pills can cause blood clots to form, which can travel to the brain and cause a stroke. Estrogen in birth control can impact blood-clotting proteins, which can increase the risk of stroke. Higher doses of estrogen in birth control are associated with a higher risk of stroke. Smoking while taking birth control can increase the risk of stroke and its severity.

What are the preventive measures of a stroke?

Stroke, with certain lifestyle changes, early diagnosis of risk factors and proper medication, is preventable. Here’s how:
Eat healthy: Eat a diet high in fruits and vegetables, and low in salt. You can also add herbs and spices like oregano, rosemary, thyme, chives, basil, cinnamon, turmeric, and ginger to your cooking.
Exercise regularly: Get at least 30 minutes of moderate-intensity aerobic activity at least five times a week. You can break up your activity into smaller times to fit your schedule.
Maintain a healthy weight: Being overweight or obese increases your risk for stroke.
Check your blood pressure: High blood pressure is the most potent risk factor for stroke. You can work with your doctor to bring your blood pressure down to a normal range.
Control your cholesterol: Your doctor should test your cholesterol levels at least once every 5 years.
Don’t smoke: Cigarette smoking greatly increases your chances of having a stroke.
Limit alcohol: Avoid drinking too much alcohol, which can raise your blood pressure.
Get enough sleep: Doctors recommend getting 7 to 8 hours of sleep each night.
Manage other medical conditions: If you have heart disease, diabetes, or other conditions, work with your doctor to manage them.
Get regular check-ups: Have a health check with your doctor regularly to make sure everything is on track.