About 800,000 Americans will have a stroke this year and even if you’re younger than 55 there’s a one-in-five chance it could be you.

Understanding the risk factors can help us prevent a stroke. Knowing the signs prepares us to act fast when one happens.

In this article, we discuss the signs of stroke, risk factors, and ways to reduce those risks.

Stroke – How to Be Prepared for the Worst

Most strokes are ischemic, which is when blood flow to the brain is either blocked by a blood clot or reduced by atherosclerosis, a narrowing and hardening of the arteries.

Because crucial nutrients and oxygen can’t reach the brain tissue, brain cells begin to die within minutes. That’s why a person’s sight, speech, and movement are often impaired during a stroke.

Signs of a stroke can be subtle and sudden. Yet, it’s imperative that we act fast for the greatest chances of recovery. No matter how subtle the signs, please call 911 immediately if you suspect a stroke. National organizations use the acronyms FAST or BEFAST to remind us the signs.

Signs of stroke (BEFAST):

Balance – Loss of balance or dizziness.
Eyes – Vision changes; blurred or blackened vision, double vision.
Face – Facial drooping or a sudden, severe headache possibly accompanied by dizziness, vomiting, or altered consciousness.
Arms – Weakness, numbness, or paralysis in the face, arm, or leg, especially on only one side of the body. Test: Try to raise both arms overhead. If one arm falls, you may be having a stroke. Similarly, if you smile in the mirror and once side of your mouth droops, it may be a stroke.
Speech – Trouble speaking, confusion, or difficulty understanding speech.
Time – Call 911 as soon as you notice any of these signs. Don’t waste time trying to drive someone to the hospital. Tell the paramedics if the person is taking blood thinners.

Although most strokes are ischemic, 10-15% are hemorrhagic, which is when an artery bursts and blood leaks into the brain, causing swelling, pressure, and brain damage. Hemorrhagic strokes are more deadly.

In addition to the signs above, you may experience a sudden, severe headache in the back of your head with a hemorrhagic stroke. Like, the worst headache you’ve ever had in your life. You may also have severe muscle pain in the neck and shoulders.

Genetics and Lifestyle Influence Stroke Risk

We can reduce many stroke risks with a healthy lifestyle, but not all. For example, women are more likely to have a stroke. Every year, more women die from stroke than breast cancer. Additionally, if you are Hispanic, African American, or an Asian/Pacific Islander, your risk is inherently higher.

If a family member has had a stroke, you’re at higher risk because genetics play a role in stroke and genetic disorders that can cause stroke.

Similarly, genetics play a role in risk factors that we can mitigate like high blood pressure, diabetes, high cholesterol, and Atrial fibrillation (A-fib), in which blood clots form in the heart and then detach and travel to the brain. It’s suspected that around 700,000 Americans have undiagnosed A-fib, which causes 23% of strokes.

Atherosclerosis causes about half of strokes is also the leading cause of coronary artery disease (CAD). This buildup of fats, cholesterol, and other substances on artery walls is both hereditary and influenced by your lifestyle.

Risk factors for atherosclerosis:

• High cholesterol and triglyceride levels
• Lack of physical activity
• High blood pressure
• Poor circulation
• Alcohol abuse
• Heart disease
• Drug abuse
• Poor sleep
• Poor diet
• Diabetes
• Covid19
• Smoking
• Obesity

Reducing Our Risks of Stroke

Getting treatment for high cholesterol, high blood pressure, high blood sugar, A-fib, and all conditions related to stroke is critical for stroke prevention – the first and a recurrent stroke. A third of stroke victims will have a second stroke within two years. Likewise, your risk of stroke is extremely high after a heart attack, especially the first year.

If you’re already at an elevated risk of stroke, it’s also important see your doctor if you get Covid-19. Your risk of stroke or heart attack is three to eight times higher the first week of Covid-19 infection.

The American Heart Association president explains in this video that’s because the Covid-19 virus attaches to a protein receptor in the lining of your blood vessels throughout the body.

In addition to managing conditions linked to stroke, a healthy lifestyle is great prevention. We significantly reduce our risk of atherosclerosis, high blood pressure, diabetes, obesity, depression, and other conditions tied to stroke with regular exercise, a healthy diet, and limited alcohol consumption.

Healthy Lifestyle Recommendations

• A vegetarian or Mediterranean diet, high in fiber and micronutrients while low in saturated fats, trans fats, and sodium.
• At least 40 minutes of moderate to vigorous exercise three to four times a week.
• Limiting alcohol (any type) to one drink a day.
• Maintaining a healthy weight.
• Smoking cessation.
• Reduce stress.

For more guidance on mitigating your stroke risk, check out our articles:

I Have High Cholesterol! Now What?
Preventing Heart Disease with Genetics and Advanced Testing
How to (Really) Eat 5 Servings of Veggies a Day