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Risk factors
By Mayo Clinic staffSome 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.
- Having a family history. Your risk may be greater if one of your family members has had a TIA or a stroke.
- Being 55 years old or older. Your risk increases as you get older, especially after age 55.
- Being a man. Men have a slightly higher likelihood of TIA and stroke than women do, but more than half of deaths from stroke occur in women.
- Being black. Blacks are at greater risk of dying of a stroke than are people of other races, 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 risk factors, including:
- High blood pressure. A systolic blood pressure of 140 millimeters of mercury (mm Hg) or higher, or a diastolic pressure of 85 mm Hg or higher increases your risk.
- Cardiovascular disease. This includes heart failure, a heart defect, heart infection or 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.
- 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.
- Diabetes. Diabetes increases the severity of atherosclerosis — narrowing of the arteries due to accumulation of fatty deposits — and the speed with which it develops.
- Poor nutrition. Eating too much fat and salt, in particular, increases your risk of TIA and stroke.
- High cholesterol — a total cholesterol level of 200 milligrams per deciliter (mg/dL), or 5.2 millimoles per liter (mmol/L), or higher increases your risk of TIA and stroke.
- 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 clogs.
- Obesity. A body mass index of 30 or higher and a waist circumference greater than 35 inches in women or 40 inches in men increases risk.
- 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 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.
References
- Transient ischemic attack. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4781. Accessed Dec. 30, 2008.
- Wu CM, et al. Early risk of stroke after transient ischemic attack: A systematic review and meta-analysis. Archives of Internal Medicine. 2007;167:2417.
- Stroke risk factors. American Heart Association. http://www.americanheart.org/presenter.jhtml?identifier=4716. Accessed Dec. 30, 2008.
- Sacco RL, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack. Stroke. 2006;37:577.
- NINDS transient ischemic attack information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tia/tia.htm. Accessed Dec. 31, 2008.
- Lewandowski CA, et al. Transient ischemic attack: Definitions and clinical presentations. Annals of Emergency Medicine. 2008;52:S7.
- Ischemic stroke. http://www.merck.com/mmpe/sec16/ch211/ch211b.html?qt=transient%20ischemic%20attack&alt=sh#sec16-ch211-ch211b-446. Accessed Dec. 31, 2008.
- Sudlow C. Dipyridamole with aspirin is better than aspirin alone in preventing vascular events after ischaemic stroke or TIA. British Medical Journal. 2007;334:901.
