In 2022, 1 in 6 deaths in the United States (U.S.) related to cardiovascular disease was a result of a stroke. Annually, more than 795,000 people in the U.S. have a stroke, and of these cases, over 600,000 are a first occurrence. These statistics underscore the widespread burden of this condition, but considering the global aging population, its prevalence is expected to increase by another 3.4 million people affected between 2012 and 2030.

Physiologically, a stroke occurs when blood flow to a part of the brain is fully or partially blocked, or a blood vessel inside or on the surface of the brain bursts. Also known as a “brain attack,” strokes are considered a serious medical emergency, especially given that they are the leading cause of disability and death in the US. Up to 80% of all strokes can be prevented, which only further highlights the importance of increasing awareness of stroke education in the general population, including its risk factors and key prevention strategies.

Each year, World Stroke Day is observed to motivate the global community to take action every day to reduce our individual stroke risk. In support of this year’s campaign, this article from TFS HealthScience’s Internal Medicine CRO (Contract Research Organization) sheds light on the importance of understanding individual risk levels, from genetics to lifestyle factors, and emphasizes preventative actions that can reduce stroke incidence. This piece aims to empower readers with actionable steps to protect their health. Continue reading to learn more about the life-saving importance of early intervention and stroke prevention!

 

Understanding Stroke Types and Common Effects

The human brain contains a rich network of blood vessels which provide a constant source of nutrients and oxygen, but an interruption to this supply will cause the cells in the affected region to die subsequently from a lack of nourishment. The vast majority of strokes (80%) are classified as ischemic, meaning there is a blockage in an artery that supplies blood to the brain. In the remaining cases (20%), the stroke is considered hemorrhagic, occurring when a blood vessel bursts, causing bleeding into the brain. Mini strokes are termed “transient ischemic attacks (TIAs),” wherein blood flow to the brain is temporarily blocked by a small clot that later dissipates, causing stroke symptoms to resolve. Although less damage is caused, TIAs should be seen as an indicator that a larger, more serious stroke could occur in the future.

Because each area of the brain controls different functions across the body, the effects of a stroke will depend on its type, severity, and location. These could include one or more of the following:

• Motor sensory impairment to limit muscle movement
• Impaired cognition, thinking, or memory
• Trouble speaking or understanding speech
• Poor emotional control or displays of inappropriate emotions in certain situations
• Feelings of pain, uncomfortable numbness, or strange sensations

 

Non-Modifiable Stroke Risk Factors

Some stroke risk factors are beyond our control, but by becoming aware of them, people can take additional measures to reduce their influence on the chances of a stroke occurring.

 

Age

As discussed in this published article, the risk of stroke increases with age, doubling every 10 years after the age of 45 years. Over 70% of all strokes occur in adults older than 65 years, but younger adults and adolescents are still at risk, likely due to diseases such as obesity, high blood pressure, and diabetes.

 

Gender

Men and women have similar lifetime risks for stroke (1 in 6 for men vs. 1 in 5 for women), but because women tend to live longer, approximately 55,000 more women will have a stroke each year than men. Interestingly, stroke incidence was found to be higher in younger years for men and older ages for women. Pregnancy and use of birth control pills also increase the risk of stroke for women.

Visit the US Centers for Disease Control and Prevention (CDC) website to learn more about stroke in men and in women.

 

Genetics and Family History

Genetics are believed to play some role in conditions like high blood pressure and stroke. These genes are shared and passed along between family members, meaning individuals should account for their family history when assessing their risk of stroke. Some hereditary disorders are also known to cause strokes, such as sickle cell anemia.

‘My Family Health Portrait’ is a digital tool developed by the CDC’s Office of Genomics, in collaboration with the U.S. Surgeon General and other federal agencies. This tool was designed to help people collect and organize their family medical history. Learn more here.

 

Race

Individuals belonging to certain racial and ethnic minority groups may have a higher risk of death from stroke. For example, non-Hispanic Black or Pacific Islander people are more likely to die from stroke relative to those who are non-Hispanic White, Hispanic, American Indian or Alaska Native, or Asian. Black people are also twice as likely to experience a first stroke compared to White people.

 

Modifiable Stroke Risk Factors

Other factors related to certain lifestyle behaviors and comorbidities also pose an increased risk for stroke, but these can be changed, treated, and controlled with patient education and several key prevention measures.

 

High Blood Pressure

According to the American Stroke Association (ASA), high blood pressure (i.e., hypertension) is the most important controllable risk factor for stroke, as well as the leading cause for it. The threshold for normal, healthy blood pressure is 120/80 mmHg. Regular check-ups with your general practitioner can ensure close monitoring of potential hypertension, which can be treated with lifestyle changes (e.g., diet, exercise, meditation) or through anti-hypertensive medications.

 

Smoking and Vaping

This lifestyle behavior can lead to damage to the blood vessels by promoting plaque build-up, increasing the risk of a blood clot. Secondhand smoke has similar effects on the body and should be avoided where possible. By quitting tobacco, the risk of heart attack and stroke decrease immediately and will resemble that of a non-smoker after five years of no smoking. Learn more about smoking and tobacco here.

 

Diabetes

The inability to make or respond to insulin properly can cause sugar in the blood to build up, causing prolonged damage to the blood vessels. Individuals with diabetes have more than double the risk of experiencing a stroke.

 

High Cholesterol

Also known as hypercholesterolemia, this condition contributes to plaque build-up and atherosclerosis in arteries and veins, increasing the risk of a full or partial block that can result in a stroke.

 

Physical Inactivity and Obesity

A lack of exercise or excess weight can contribute to unhealthy levels of fat built up in the body. Obesity and sedentary lifestyles are associated with an increased risk of heart disease and stroke.

 

Excessive Alcohol Consumption

The recommended limit of alcohol intake is one drink per day for women and two drinks a day for men, on average. Drinking more than these amounts on a regular basis considerably increases the risk of stroke, as does binge drinking.

Other treatable risk factors linked with greater chances of stroke include any carotid or artery diseases, frequent occurrence of TIAs, atrial fibrillation or other heart disease, certain blood disorders (e.g., sickle cell anemia), illegal drug use, and sleep apnea. Read more about these on the ASA website here.

 

Effective Prevention Strategies to Reduce the Risk of Stroke

As mentioned earlier, as many as 80% of strokes can be prevented simply by adopting healthy lifestyle changes and working with your physician to manage health conditions that could increase your risk.

 

1. Choose healthy foods and drinks

Maintain a balanced diet that includes fresh fruits and vegetables. Foods high in saturated fats, trans fat, and cholesterol and high in fiber can contribute to high cholesterol, while excessive sodium (salt) in your diet causes high blood pressure. Both are key risk factors for stroke and can be controlled by avoiding processed foods.

 

2. Keep a healthy weight

Tracking your weight to avoid obesity or excess fat levels can significantly lower the risk of heart disease and stroke. The body mass index (BMI) can be calculated to determine if your weight is within a healthy range. Learn more here or visit the CDC’s Assessing Your Weight website.

 

3. Get regular physical activity

Regular exercise helps control and prevent high blood pressure and high cholesterol levels. The US Surgeon General recommends that adults get 2 hours and 30 minutes of moderate-intensity aerobic physical activity, such as a brisk walk, each week. Children and teens should get 1 hour of physical activity every day.

Learn ways you can get regular physical activity from the “Live to the Beat” campaign here.

 

4. Avoid smoking

Cigarette smoking greatly increases your chances of having a stroke, as well as other serious conditions including lung cancer, and quitting can have benefits within as little as 24 hours of stopping. If you are currently a smoker, consider discussing what strategies for quitting are the best fit with your healthcare provider.

Visit the CDC’s Smoking & Tobacco Use website to learn more about quitting smoking.

 

5. Limit alcohol intake

Alcohol consumption raises the blood pressure, which is a leading risk factor for stroke. Limit your intake to the recommended drink amounts to control this risk factor:

• Men: No more than two drinks per day
• Women: No more than one per day

 

6. Manage high-risk medical conditions

Examples of high-risk medical conditions that predispose individuals to stroke are diabetes, hypertension, hypercholesterolemia, and heart disease, among others. Taking steps to manage these conditions greatly reduces the chances of a stroke occurrence.

Important measures include getting regular check-ups from your physician, monitoring blood sugar and cholesterol levels with regular blood tests, taking your prescribed medications as instructed, and adopting healthier lifestyle changes to improve these conditions.

Visit stroke.org to learn more about stroke or find local support groups.

 

Recognizing Warning Signs of Stroke

Being aware of common signs and symptoms of an impending stroke is crucial for getting help in time and preventing lasting damage or disability. To remember the four most important signs, use the acronym “F.A.S.T.”.

• Face: Try smiling. Does one side of the face droop?
• Arms: Try raising both arms. Does one arm drift downward?
• Speech: Try repeating a simple phrase. Is the speech slurred or strange?
• Time: If you observe any of these signs, call for emergency medical help immediately. Do not attempt to drive yourself to the hospital.

Conclusion

In conclusion, understanding the risk factors of stroke and implementing prevention strategies can significantly reduce your risk of experiencing this life-threatening condition. Remember that most strokes are preventable with a few simple measures, including getting regular check-ups with your doctor, maintaining a healthy lifestyle, and being aware of the signs of stroke. Adopting these strategies long-term will significantly lower the risk of experiencing a stroke, while protecting your brain and heart health for years to come.

 

About TFS CRO: Your Industry Partner in Internal Medicine Clinical Trials

TFS HealthScience is a global CRO pioneering the future of internal medicine under the leadership of Vice President Anne-Marie Nagy, Ph.D., a specialist in internal medicine indications in women’s health and pulmonary inflammatory diseases. Named one of the top 10 influential women in clinical research, Dr. Nagy has guided the Internal Medicine CRO at TFS to amass an impressive track record, including over 350 clinical studies conducted in just the past five years and nearly 500 phase I-IV clinical trials supported in internal medicine and related areas.

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