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It's clear that strokes are a major cause of disability and death throughout the world. But many of the prime risk factors for stroke are within your power to change -- something we have long known.

A large international study published in The Lancet Medical Journal underscored how far prevention efforts could go. Collecting data from stroke patients and healthy individuals in 22 countries, it found that 10 largely modifiable risk factors account for 90 percent of the risk of stroke worldwide. That means there is much you can do to rein in your personal risk.
 

1. High blood pressure

This is the biggest contributor to strokes worldwide. The Lancet study estimated that blood pressure readings of 160/90 mm Hg or higher accounted for up to 52 percent of the "population-attributable risk" of stroke.
 

2. Sedentary lifestyle

In general, regular exercise is a good move for your cardiovascular health, as it helps lower blood pressure, regulate your weight, boost "good" high-density lipoprotein (HDL) cholesterol and prevent or manage type 2 diabetes. And there's evidence that even moderate levels of physical activity can curb your risk of stroke.
 

3. Apple-shaped

We often talk about excess pounds being a risk to your cardiovascular health, but it's that middle-aged spread around the waist that may be particularly worrisome.
 

4. Smoking

If you are still a smoker, you need to work on quitting. In the Lancet study, there was no evidence that former smokers were at greater risk of stroke than people who'd never smoked -- suggesting that the excess risk declines quickly after you quit.
 

5. Diet

Diet may be just as important as smoking habits. In particular, the Lancet study found, features of the traditional Mediterranean diet -- namely, a high intake of fish and fruit -- appeared protective against stroke.
 

6. Atrial fibrillation

This is the most common form of heart-rhythm disturbance, in which the upper chambers of the heart (atria) do not contract in a rhythmic pattern but instead quiver chaotically. If you have atrial fibrillation, it is critical that you take any anti-clotting medication or other drugs that your doctor has prescribed.
 

7. Cholesterol

Studies suggest that the relationship between cholesterol and stroke risk is complex. In the Lancet study, total cholesterol levels were not associated with strokes, confirming epidemiological evidence, but higher levels of high-density lipoprotein (HDL, or "good") cholesterol were linked to a lower risk of ischemic stroke.
 

8. Alcohol

Moderate drinking of alcohol was linked to a reduced risk of ischemic stroke, while any amount more than that was connected to an increased risk versus teetotaling.
 

9. Stress

Chronic stress (related to home or work life) was linked to an increased risk of stroke. It's not completely clear why.  It is unclear  whether stress-management classes can help lower your stroke risk.
 

10. Depression

Depression symptoms was linked to an increased risk of stroke. It's not completely clear why; it could be because mental-health woes make it more difficult to stick to your healthy diet, exercise and medication regimen. Also unclear is whether depression therapy classes can help lower your stroke risk.


Stroke Warning Signs

bullet Sudden numbness or weakness of the face, arm or leg, especially on one side of the body   
bullet Sudden confusion, trouble speaking or understanding   
bullet Sudden trouble seeing in one or both eyes   
bullet Sudden trouble walking, dizziness, loss of balance or coordination   
bullet Sudden, severe headache with no known cause



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Original date 3/1/96 Revised 9/24/14