Strokes seem to hit out of the blue, but they really aren’t a mystery. We have the power to lower our chance. Here’s how.

Published: April 11, 2016 | Updated: November 27, 2019

Knowing how to prevent a stroke and learning if you are at risk doesn’t have to be a mystery. Most risk factors can be changed, treated or medically managed. Here are 12 health issues you can avoid or control to lower your risk for stroke.

High blood pressure (hypertension) – The single most important risk factor for stroke. Even mild hypertension can increase your risk for stroke. Generally, blood pressure of 120/80 or lower is ideal. Controlling blood pressure by reducing salt in your diet, controlling your weight, exercising regularly, managing stress and/or taking medication will reduce your risk for stroke.

Heart disease – The second most important risk factor for stroke and a major cause of death among stroke survivors. Having regular medical checkups will give your your physician a chance to monitor your heart health. Heart disease, including irregular heart rhythms, heart attacks and heart valve disorders, can be treated with medical care.

Sleep apnea – A potentially serious sleep disorder that is linked to increased risk for stroke even in people with no other risk factors, such as obesity, high blood pressure, diabetes and smoking. Research suggests there is a link between people who suffer from silent strokes and sleep apnea. Silent strokes have no visible symptoms and can cause permanent damage to the brain, most often in the areas that affect mood, thought, cognition and memory.

High cholesterol and lipids – These increase the risk for stroke but can be controlled by proper medical treatment and a healthy diet and lifestyle.

Lack of exercise and physical inactivity – Increases stroke risk through excess fat storage and a higher risk for heart disease.

Obesity and being overweight – These strain the heart and blood vessels, and are associated with high blood pressure. Obesity also puts you at risk for diabetes and heart disease, which increase the chance of stroke.

Cigarette smoking – Greatly increases stroke risk, especially for those who use birth control pills. The good news is that stroke risk declines dramatically within a few years of stopping smoking.

Excessive alcohol use (more than two drinks per day) – Raises blood pressure, and binge drinking increases stroke risk even more. Healthy young adults who are heavy drinkers are just as susceptible to stroke as older persons.

Illegal drug abuse – Carries a high risk for stroke from cerebral embolisms (blood clots in the brain). Cocaine use has been closely linked to strokes, heart attacks and a variety of other cardiovascular complications that can be fatal, even among first-time cocaine users.

Use of birth control pills – Especially those with high levels of estrogen appear to increase the risk for blood clots, including clots that cause stroke. Women over age 30 are especially at risk. The risk is even higher in women who smoke.

Diabetes – Increases stroke risk due to circulatory problems caused by the disease, especially when diabetes is not well-controlled.

Stress – Tends to increase blood pressure, so it indirectly increases risk for stroke. Stress management, including relaxation techniques, exercise, biofeedback and/or counseling, can help lower blood pressure, thus lowering the risk for stroke.