Some risk factors for transient ischemic attack and stroke can't be changed. Others you can control.
Risk factors you can't change
You can't change the following risk factors for transient ischemic attack and stroke. But knowing you're at risk can motivate you to change your lifestyle to reduce other risks.
- Family history. Your risk may be greater if one of your family members has had a TIA or a stroke.
- Age. Your risk increases as you get older, especially after age 55.
- Sex. Men have a slightly higher likelihood of TIA and stroke, but more than half of deaths from stroke occur in women.
- Prior transient ischemic attack. If you've had one or more TIAs, you're 10 times more likely to have a stroke.
- Sickle cell disease. Also called sickle cell anemia, stroke is a frequent complication of this inherited disorder. Sickle-shaped blood cells carry less oxygen and also tend to get stuck in artery walls, hampering blood flow to the brain.
- Race. Blacks are at greater risk of dying of a stroke, partly because of the higher prevalence of high blood pressure and diabetes among blacks.
Risk factors you can take steps to control
You can control or treat a number of factors — including certain health conditions and lifestyle choices — that increase your risk of stroke. Having one or more of these risk factors doesn’t mean you’ll have a stroke, but your risk particularly increases if you have two or more of them.
- High blood pressure. Risk of stroke begins to increase at blood pressure readings higher than 110/75 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.
- High cholesterol. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaques in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a statin or another type of cholesterol-lowering medication.
- Cardiovascular disease. This includes heart failure, a heart defect, a heart infection or an abnormal heart rhythm.
- Carotid artery disease. The blood vessels in your neck that lead to your brain become clogged.
- Peripheral artery disease (PAD). The blood vessels that carry blood to your arms and legs become clogged.
- Diabetes. Diabetes increases the severity of atherosclerosis — narrowing of the arteries due to accumulation of fatty deposits — and the speed with which it develops.
- High levels of homocysteine. Elevated levels of this amino acid in your blood can cause your arteries to thicken and scar, which makes them more susceptible to clots.
- Excess weight. A body mass index of 25 or higher and a waist circumference greater than 35 inches (89 centimeters) in women or 40 inches (102 centimeters) in men increase risk.
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- Cigarette smoking. Smoking increases your risk of blood clots, raises your blood pressure and contributes to the development of cholesterol-containing fatty deposits in your arteries (atherosclerosis).
- Physical inactivity. Engaging in 30 minutes of moderate-intensity exercise most days helps reduce risk.
- Poor nutrition. Eating too much fat and salt, in particular, increases your risk of TIA and stroke.
- Heavy drinking. If you drink alcohol, limit yourself to no more than two drinks daily if you're a man and one drink daily if you're a woman.
- Use of illicit drugs. Avoid cocaine and other illicit drugs.
- Use of birth control pills. If you use any hormone therapy, talk to your doctor about how the hormones may affect your risk of TIA and stroke.
- TIA (Transient ischemic attack). American Stroke Association. http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/TIA/TIA-Transient-Ischemic-Attack_UCM_310942_Article.jsp#. Accessed Dec. 9, 2013.
- Transient ischemic attack information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tia/tia.htm. Accessed Dec. 9, 2013.
- Ferri FF. Ferri's Clinical Advisor 2014: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed Dec. 9, 2013.
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, Pa.: Mosby Elsevier; 2014. http://www.clinicalkey.com. Accessed Dec. 9, 2013.
- Furie KL, et al. Etiology and clinical manifestations of transient ischemic attack. http://www.uptodate.com/home. Accessed Dec. 9, 2013.
- Stroke risk factors. American Stroke Association. http://www.strokeassociation.org/STROKEORG/AboutStroke/UnderstandingRisk/Understanding-Risk_UCM_308539_SubHomePage.jsp#. Accessed Dec. 12, 2013.
- Furie KL, et al. Secondary prevention of stroke: Risk factor reduction. http://www.uptodate.com/home. Accessed Dec. 9, 2013.
- Assessing your weight and health risk. National Institute of Neurological Disorders and Stroke. http://www.nhlbi.nih.gov/health/public/heart/obesity/lose_wt/risk.htm. Accessed Dec. 12, 2013.
- Furie KL, et al. Initial evaluation and management of transient ischemic attack and minor stroke. http://www.uptodate.com/home. Accessed Dec. 9, 2013.
- Adams JG. Emergency Medicine. Philadelphia, Pa.: Saunders Elsevier; 2013. http://www.clinicalkey.com. Accessed Dec. 9, 2013.
- Swanson JW (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 12, 2013.
- Fulgham JR (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 24, 2013.