Stroke sometimes can be the result of genetics, passed from one generation to the next, but family habits also can be carried on and affect stroke risks.

Story by: David Steen Martin; Reviewed by Tamika M. Burrus, M.D. on December 28, 2023

If someone in your family has had a stroke, your risk of a stroke is higher. Stroke sometimes can be the result of genetics, passed from one generation to the next, but family habits also can be carried on. 

You can improve your odds significantly by knowing the risk factors and making healthy lifestyle choices.

Strokes can happen at any age but are more common the older you get, doubling each decade after age 55.

Stroke risk is greater among people who smoke or who are inactive, and among people with high blood pressure, diabetes, hyperlipidemia (high cholesterol), atrial fibrillation and sleep apnea.

“It’s important everyone takes the risk of stroke seriously,” said Tamika M. Burrus, M.D., a neurologist and stroke specialist with Norton Neuroscience Institute. “Stroke is the fifth-leading killer in the United States, and the leading cause of serious long-term disability.”

Your lifestyle makes a big difference in your chance of having a stroke, regardless of whether there is stroke in your family. 

High blood pressure is the biggest risk factor for stroke, after age.

Medications can lower your blood pressure. Your diet can, too. Eating fruits and vegetables is good, as is lowering the amount of salt in the food you eat.

Diabetes is another risk factor for stroke. Diabetes combined with high blood pressure gives you an even greater chance for a stroke. If you have diabetes, lowering your high blood pressure will reduce the risk of stroke by more than half.

Physical inactivity puts you at higher risk for stroke. Exercise will lower the risk. The American Heart Association recommends 150 minutes a week of moderate to vigorous exercise — 300 minutes is better still.

A poor diet also raises your chance of having a stroke. Hyperlipidemia, one of the primary risk factors for stroke, simply means an abnormally high concentration of fats in the blood.

Instead of fried foods, try to choose foods like fish with so-called healthy fats. Simply reducing the amount of soda or other sugar-sweetened beverages  also will lessen the odds you will have a stroke.

Almost 1 in 5 people who are active smokers will have a stroke, and the more you smoke, the higher the risk. Smoking 20 cigarettes a day more than doubles your chance of a stroke. If you quit, your risk goes back to normal in two to five years.

Atrial fibrillation, or A-fib, is a type of abnormal heart rhythm that poses a risk for stroke. It’s important to talk to your health care provider to make sure it is controlled.

Obstructive sleep apnea is another risk factor. Ways to lower the risk include getting off sedative medications, avoiding alcohol and buying a wedge that will put you in a more supportive position to breathe better when you’re sleeping.

Some people experience stroke symptoms that come and go. When you experience temporary stroke symptoms, it’s called a transient ischemic attack or TIA.

It’s very important to get TIA checked out by a health care provider. Of people who have TIA, 1 in 10 will have a stroke within 90 days.

If someone in your family has had a stroke, they should work on reducing their odds of having another one. Having one stroke also puts you at higher risk for another one. Norton Neuroscience Institute offers a stroke prevention class that can help. 

It’s important family and friends are familiar with the symptoms of a stroke: balance difficulties, eyesight changes, facial weakness, arm weakness and speech difficulties, or sudden severe headache.

Strokes result from blood clots and bleeds in the brain. When that happens, part of the brain does not get enough oxygen and brain cells can die. 

“We know time is of the essence. When someone has a stroke, part of their brain is not getting enough oxygen, and they will lose 2 million brain cells a minute,” Dr. Burrus said. “The more time that passes, the more damage is being done in the brain.”