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Stroke Risk, Prevention, and the Atherosclerosis Connection

Jonathan Vellinga, MD -

Stroke Risk, Prevention, and the Atherosclerosis Connection

Thinking, moving our bodies, speaking, and experiencing emotions are all controlled by our amazing brains. Besides coordinating our actions, the brain also acts as a storage unit for our memories (1). Brains make us who we are, so they are essential to protect.

Our brains require a constant flow of blood-borne oxygen to function properly. Anything that compromises blood flow to the brain is a potentially life-threatening situation. A stroke is a medical condition where parts of the brain are severely deprived of oxygen because of low or no blood flow, resulting in brain cell death. There are many types of stroke, but the most common types are ischemic and hemorrhagic. Ischemic strokes occur when blood flow to some portion of the brain is blocked or even completely halted. Hemorrhagic strokes happen when there is bleeding into parts of the brain where it usually would not be, coupled with oxygen deprivation.

Strokes are one of the leading causes of death for adults in the United States and a major contributor to severe disability (1). You might ask, "If a risk factor is out of my control, such as a family history of stroke, is my fate determined?" Another frequent question is, "How do I avoid having a stroke as my relatives did?" Let's examine what conditions increase the risk for strokes and, better yet, how to reduce your risk.

Stroke Risk Factors

A family history of strokes can increase the risk of experiencing one yourself, especially if an immediate family member had one before age 65. Other factors that increase stroke risks and can not be controlled include (2-4):

  • Age (generally, the risk increases with age)

  • Race (risk is higher in African-American populations)

  • Sex (males have a lower risk than females)

  • Previous event - stroke, heart attack/cardiovascular events, or transient ischemic attack (TIA)

  • Factor V Leiden genetic mutation (or other mutations affecting blood clotting)

  • Structural abnormalities of the heart valves

The risk factors above may not seem to be within our control. However, plenty of things are within our control - including prevention, treatments, and the risk factors below. Acting on the prevention suggestions below can help reduce the risks associated with genetic factors.

Regarding heart issues that may contribute to stroke risk, the Temecula Center for Integrative Medicine (TCIM) has produced articles about cardiovascular events, coronary artery disease, and regenerative medicine for heart failure. Please explore those articles and the section on arterial disease (below) for additional information if you have been diagnosed with a cardiovascular condition.

Some of the risk factors within our control, things we can change, are (5, 6):

  • Smoking (greatly increases the risk of stroke)

  • Hypertension (high blood pressure is the leading cause of stroke)

  • Diabetes (damages blood vessels and is statistically associated with other conditions that increase the risk of stroke, such as heart disease, high blood pressure, and cholesterol)

  • Diet (can affect the risk of narrowed arteries, blood pressure, and obesity)

  • Lack of exercise

  • Certain medications

Unfortunately, some medications are associated with an increased risk of stroke (7). Note, it's crucial to never withdraw from medicines without consulting the prescribing doctor, as some medications are dangerous if quit suddenly. A dialogue with your doctor discussing a cost-benefit analysis of a risk-enhancing medication (versus life without the prescription) may be worthwhile. Doctors can help factor in family history, personal health history, diet, and lifestyle information into evaluating this medication.

Connection: Arterial Diseases Linked to Stroke Risks

Arterial diseases (or "artery diseases") are a group of health conditions that negatively affect the arteries. These blood vessels carry oxygenated blood away from the heart to the rest of the body. Unfortunately, having an arterial disease can increase the risk of stroke. A few studies show that one-third of stroke patients have some form of heart disease (8). Not only do arterial diseases have an overlap of similar causes, but arterial diseases can directly cause a stroke.

Here are three examples of the link between arterial diseases and stroke risks:

1) Atherosclerosis (also known as "hardening of the arteries)- Characterized by plaque buildup on the arteries' inner linings. Inflamed endothelial linings of arteries become a gathering place for cholesterol, blood cells, and fat, which stick together, forming a "plaque” (9). Plaques can gradually get tougher and stiffen over time, decreasing the flexibility of the blood vessel and "hardening" them. Hardened plaque pieces can break off and get lodged in a vessel leading to the brain, blocking blood flow and increasing the risk of stroke.