What Causes Strokes—and 6 Ways to Prevent Them

There are many risk factors in terms of what causes strokes, but you can reduce your risk with a healthy lifestyle and hypertension control.

what causes strokes

Research indicates that strokes among U.S. millennials—ages 18 to 34—have increased significantly in recent years.

© Puwadol Jaturawutthichai | Dreamstime

A stroke occurs in the brain, but it can affect your body from head to toe. What causes strokes is a partial or total interruption of the blood supply to your brain. Suffering a stroke can be fatal, or it can cause brain damage, paralysis, and other complications.

“A stroke’s possible effects include being unable to speak, walk, or care for yourself, which is why stroke is a leading cause of nursing home admissions,” says Dana Leifer, MD, a neurologist at Weill Cornell Medicine. “That’s why it is very important to address any stroke risk factors you have, so you can avoid these life-changing consequences. Control of high blood pressure, high cholesterol, and diabetes can significantly reduce the risk of stroke. If you smoke, it is essential to stop smoking. Proper treatment of atrial fibrillation is also very important.”

Dr. Leifer also emphasizes, “If you develop any of the symptoms of stroke, such as sudden onset of weakness or numbness on one side, speech difficulty, sudden changes in vision, or sudden severe headache or dizziness, you should get to an emergency room as quickly as possible.”

What Causes Strokes: The Risk Factors

Certain risk factors are involved in 90 percent of strokes. Addressing these factors with medications and lifestyle changes can lower the risk and also blunt the effect of other risk factors that are specific to women, including the use of oral contraceptives and hormone replacement therapy.

Common risk factors for stroke include:

  • Having high blood pressure
  • Being overweight
  • Eating an unhealthy diet
  • Getting little or no exercise
  • Having atrial fibrillation
  • Smoking tobacco
  • Having high total and/or LDL cholesterol
  • Having diabetes
  • Having cardiovascular disease, including coronary artery disease and peripheral artery disease

Focus on Prevention

The keys to reducing your stroke risk include making healthy lifestyle choices, combined with using medications appropriately for any health conditions you have.

1. Choose an eating pattern that supports heart and artery health.

Diets that are high in sodium (salt) increase stroke risk; so do diets that are low in fruits (particularly citrus) and vegetables. A Mediterranean-style diet, which contains plenty of whole foods such as legumes, fruits, vegetables, fish, olive oil, and nuts, has been shown to lower stroke risk.

Conversely, some foods and dietary patterns are associated with poorer cardiovascular health and higher stroke risk. Foods to avoid or minimize include:

  • Foods high in sodium, such as canned soups, frozen meals and pizzas, condiments and marinades, and restaurant meals, including fast foods
  • Foods high in saturated fat, including fatty cuts of beef and pork, butter, and full-fat milk, yogurt, and cheese
  • Foods that contain refined grains, usually in the form of white flour, such as breads, rolls, baked goods, crackers, bagels, and pasta
  • Foods and beverages high in added sugar, including soft drinks, many bottled tea, coffee, and fruit drinks, candies, and desserts.

2. Get and stay physically active.

Physically active women have a 25 to 30 percent lower risk of stroke than inactive women. Guidelines recommend moderate-to-vigorous aerobic activity for 30 or more minutes a day on five or more days of the week.

Choose activities that you enjoy; for example, if you’ve previously joined a gym but didn’t stick with it, try another approach. Remember that any activity that gets your heart rate up and keeps it up will be beneficial. If you enjoy socializing and you’d like to meet some new people, join a women’s walking group, a tennis club, or a dance class, and check online or in your local newspaper for upcoming events.

3. Control blood pressure, cholesterol, and blood glucose.

Following a healthy, balanced diet (see #1) and getting regular physical activity (see #2) will help you lower your blood pressure, your total and LDL cholesterol, and your blood glucose level. However, for many people, medication is also necessary to get their numbers to healthy levels.

The most important strategy with medication is to take it exactly as it’s prescribed. If you have troublesome side effects, report them to your doctor and investigate what other options are available, but don’t give up on medication altogether. It’s also critical to have regular follow-up visits with your doctor so he or she can monitor your progress and determine if your medication needs any adjustment. If you cannot afford your medication, tell your doctor; he may have samples or coupons. For information on patient assistance programs, go to needymeds.org. Some medications are provided free or at low cost by the pharmaceutical companies.

4. Get treatment for atrial fibrillation (AFib) and any other cardiovascular conditions.

Having AFib, an irregular heart rhythm, can increase the risk of stroke by as much as 500 percent. If you have AFib, follow your cardiologist’s instructions. The same recommendation applies if you have any type of heart or vascular disease and/or you’ve previously had a heart attack or a transient ischemic attack (a mini-stroke). Once again, being physically active and choosing healthy foods should be included in your treatment program.

5. If you’re overweight, lose some weight.

If you struggle with your weight and you’ve repeatedly tried to lose weight without success, see a doctor or a registered dietitian nutritionist who specializes in weight loss. Getting professional help is often more effective than going it alone. Depending on your weight, your insurance may cover weight-loss treatment; ask your doctor to help you find a provider or program that can provide you with the information, strategies, and ongoing support you need to succeed.

6. If you smoke, quit.

The more cigarettes you smoke, the higher your risk of stroke. If you’ve been smoking for decades, quitting now will still provide significant health benefits. Don’t go it alone; ask your doctor for a referral to a smoking cessation program, and utilize free programs (go to https://smokefree.gov) that are available to help you quit.

It’s true that making these changes may be challenging—but it’s nowhere near as challenging as adapting to the changes a stroke will cause in your life. When you have difficulty passing up that cheeseburger, taking that medication, or getting outside to take that walk, remind yourself that you are reducing your chances of having long-term disabilities, and you may even be saving your own life.


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Dawn Bialy

Dawn Bialy has been executive editor of Weill Cornell Medicine’s Women’s Health Advisor newsletter since 2007. Bialy also has served as managing editor for a variety of special health reports, … Read More

View all posts by Dawn Bialy

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