Some risk factors for stroke can’t be controlled. But you may have some control over other risk factors, including your blood pressure, cholesterol levels, and many lifestyle choices.

Medical researchers have examined the main types of stroke to better understand who they impact, why, and what can be done to prevent them.

In this article, we’ll examine 10 important stroke prevention steps and how each strategy may help lower your stroke risk.

Stroke is an emergency

Symptoms of a stroke typically appear suddenly and include:

  • speech difficulty
  • face drooping or numbness
  • weakness/paralysis on one side of the body
  • difficulty seeing or walking
  • confusion
  • a severe headache (hemorrhagic stroke)

If you or someone you’re with experiences these symptoms call 911 immediately. Swift action during a stroke can prevent long-term disability and even death.

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The risk factors for stroke fall into two categories: those you can manage and those you can’t.

Risk factors you can’t change include:

Many other risk factors for stroke can be managed or influenced to reduce your risk.

Learn more about stroke risk factors.

Let’s look at these changes in more detail.

High blood pressure, or hypertension, is a major risk factor for stroke. High blood pressure significantly contributes to 90% of all strokes. The higher your blood pressure, the greater the risk.

Normal blood pressure is defined as 120/80 millimeters of mercury (mm Hg). Blood pressure measurements even slightly above that have an increased risk of stroke.

Managing blood pressure doesn’t get easier with age, and by age 65, 2/3 of people have hypertension.

You may be able to better manage your blood pressure by:

  • maintaining a moderate weight
  • getting regular exercise
  • following a heart-healthy eating plan, such as the Mediterranean diet or DASH (Dietary Approaches to Stop Hypertension) diet
  • reducing your sodium intake
  • medications

Some people may also need to take prescription medications to help lower their blood pressure and reduce stress on their blood vessels.

Good blood pressure management may prevent about 40% of strokes.

Diabetes is a significant risk factor for stroke. Stroke accounts for approximately 20% of deaths in people with diabetes, and people with prediabetes have a higher stroke risk, too.

Diabetes is also closely linked to other conditions that increase the risk of stroke, including:

  • high blood pressure
  • obesity
  • high blood cholesterol

Managing diabetes with lifestyle changes, such as exercise and diet changes, can help reduce the risk of stroke. Some people may also need medications to help keep their blood sugar within a healthy range.

Good blood cholesterol management isn’t just about lowering bad cholesterol (LDL). Boosting good cholesterol (HDL) numbers is also important.

People with high LDL cholesterol levels may have a greater risk of an ischemic stroke, but people with low HDL cholesterol levels may have a higher risk of hemorrhagic stroke.

A healthy diet of good fats and proteins may help balance these numbers. This can include:

  • olive oil
  • avocados
  • fish
  • nuts

Some people may need statins or other medications to reduce cholesterol and lower the risk of plaque buildup in the arteries. Plaque can form into a full blockage or break off and become a clot.

People who smoke have a 2 to 4 times greater risk of ischemic stroke than people who do not smoke. Smoking is a factor in nearly 15% of all stroke deaths in the United States each year.

The good news is that once you quit smoking, the benefits start right away and continue over time. Within 2 to 4 years of quitting, your smoke-related risk of stroke will have nearly reached zero.

Support for quitting smoking is available with behavioral therapy, counseling, and even some medications or drug-replacement therapies.

While people who drink light to moderate amounts of some types of alcohol may have a lower risk of heart disease than those who don’t, the American Heart Association (AHA) notes that there may be other factors aside from alcohol consumption that provide the benefit. The AHA also notes that other behaviors, like exercising more and eating antioxidant-rich fruits, may lower your stroke risk better.

You may want to reevaluate your drinking habits if you engage in heavy alcohol use or misuse, which can significantly increase your risk of stroke. In part, that’s because drinking a lot of alcohol can increase your blood pressure.

If you drink, it’s best to stick to light to moderate alcohol consumption, which the AHA defines as up to one drink per day for women and up to two drinks per day for men. If you don’t already drink, they say, don’t start.

If you have difficulty limiting or stopping drinking, there are ways to get help. Behavioral therapy is a good place to start. Community support groups can help, too.

Overweight and obesity are leading risk factors for stroke. They’re also closely linked to other conditions or diseases that increase your risk for stroke, including high blood pressure and diabetes.

The risk of stroke in someone who has overweight is 22% higher than a person at a moderate weight. For people with obesity, the risk is 64% higher.

Weight management techniques can include getting regular exercise and taking in fewer calories.

But for some people, those changes may not be enough to lower the risk. A doctor may prescribe medications or procedures that can help you lose weight.

It’s best to talk with your doctor about the right target weight for you.

Exercise can have a positive impact on some of the leading risk factors for stroke. It can help you:

  • lower blood pressure
  • lower blood sugar levels
  • lose weight or maintain a moderate weight

Exercise can support your heart health and reduce your risk of stroke. People who exercise regularly have a lower risk of stroke, and those who do have a stroke are less likely to die than people who aren’t active.

Aim for moderate-intensity exercise most days of the week, even if you’re not looking to lose weight. This exercise doesn’t have to come from endless walking on a treadmill. Consider alternative ideas, like:

Research increasingly makes it clear that poor sleep quality may increase your risk of stroke.

Poor sleep is known to cause issues like fatigue, poor memory, and even anxiety and depression.

Sleep issues linked to stroke include:

  • insomnia
  • excessive daytime sleepiness
  • sleep apnea
  • hypersomnia, or sleeping more than 9 hours a night

Doctors recommend finding a healthy balance of 7 to 8 hours of sleep. But if you can’t do that alone, you can talk with your doctor about medications, techniques, and sleep aids that may help.

Having a stroke can also worsen existing sleep issues, which can increase your risk for a recurrent stroke.

Atrial fibrillation (AF or Afib) is a type of heart arrhythmia or irregular heartbeat. If you have Afib, you have a higher risk of stroke and blood clots.

Afib is linked to 1.9% of strokes per year. And while that may not seem like a lot, if Afib is coupled with other risk factors, the likelihood of a stroke increases.

Afib must be properly diagnosed and treated by a doctor. For many people, treatment will include medications that prevent blood clotting.

Eating a nutritious and balanced diet can help you lose weight and positively impact other issues that can contribute to stroke risk. For instance:

  • Reducing sodium consumption may help lower your blood pressure.
  • Eating more healthy fats, like fish and heart-healthy oils, may improve your cholesterol levels.
  • Limiting added sugar and refined carbs can make managing your blood sugar levels easier.

You don’t have to focus on counting calories. Instead, focus on eating more nutritious foods, like:

  • fresh fruits
  • vegetables
  • legumes
  • whole grains
  • fish
  • poultry

You can also help reduce your risk by skipping or limiting certain foods, such as:

  • refined sugars
  • red meat
  • ultra-processed foods

Making subtle changes to what you put on your plate can have a significant impact on your health.

Learn more about how diet can influence stroke risk.

If you have an increased risk of a stroke, you can work closely with your doctor to understand how to reduce your risk factors as much as you can.

Many of the strategies for stroke prevention can also support your overall health and may even reduce your risk of other health conditions.

But preventing stroke is not a one-size-fits-all plan. Combining these strategies to meet your individual risk factors can ultimately have a positive long-term impact on your health.