| 🧠 Stroke Risk Factor |
💡 Why it matters |
| 🩺 Hypertension (systolic or diastolic) |
The single most important modifiable risk factor for stroke. It increases the risk of both
ischaemic stroke and, even more strongly, intracerebral haemorrhage. The key problem is
chronic sustained hypertension, not brief transient rises. Long-term high blood pressure damages
small penetrating arteries, accelerates atherosclerosis, and promotes cardiac disease including
atrial fibrillation.
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| 🎂 Age |
Stroke can occur at any age, including in children and young adults, but incidence rises markedly with age,
especially after 55 years. Older age also increases the prevalence of AF, hypertension, diabetes, and atherosclerosis.
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| 🚹 Male sex |
Stroke is slightly more common in men during much of adult life, although the difference narrows in older age.
In practice, modifiable vascular risks matter far more than sex alone.
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| 🍬 Diabetes mellitus |
Diabetes substantially increases stroke risk by accelerating atherosclerosis, causing endothelial dysfunction,
and clustering with other risks such as hypertension, obesity, and dyslipidaemia. It is especially important for
ischaemic stroke and cerebral small-vessel disease.
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| 🌍 Ethnicity / ancestry |
Stroke risk varies by ethnicity. Some populations, including Black and East Asian groups, have higher rates of
certain stroke subtypes, including intracerebral haemorrhage and intracranial atherosclerotic disease.
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| ❤️ Atrial fibrillation / atrial flutter |
A major cause of cardioembolic stroke. AF should be formally assessed with CHA₂DS₂-VASc and managed according
to anticoagulation guidance. Paroxysmal AF can still carry important embolic risk.
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| 🫀 Valvular heart disease |
Certain valve lesions, especially rheumatic mitral stenosis with AF, markedly increase the risk of
cardioembolism. Prosthetic valves and infective endocarditis are other important embolic settings.
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| 🔁 Previous stroke or TIA |
One of the strongest predictors of future stroke. A prior TIA or stroke suggests established vascular or embolic
disease and demands urgent secondary prevention.
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| 🧱 Carotid stenosis |
Indicates significant atherosclerotic disease and may directly cause stroke through
artery-to-artery embolism or reduced ipsilateral cerebral perfusion.
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| 🧈 Dyslipidaemia |
Raised LDL cholesterol and an adverse lipid profile increase the risk of atherothrombotic ischaemic stroke.
Lipid lowering is a key part of vascular prevention.
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| 🚬 Current cigarette smoking |
Smoking increases stroke risk through endothelial injury, accelerated atherosclerosis, platelet activation,
and increased coagulability. It is more strongly linked with ischaemic stroke, and cessation reduces risk over time.
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| 💊 Oral contraception and HRT |
Oestrogen-containing therapy can increase the risk of thromboembolic stroke, especially when combined with
smoking, migraine with aura, hypertension, or thrombophilia. The absolute risk remains low for most
younger women, but risk assessment matters.
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| 👨👩👧 Family history |
A family history of stroke, early vascular disease, or inherited disorders such as thrombophilia, CADASIL,
or some lipid disorders may increase risk. It is mainly a clue to underlying susceptibility.
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| 😰 Psychosocial stress |
Chronic stress is associated with a modest increase in stroke risk, probably via hypertension, smoking, alcohol use,
poor sleep, and autonomic activation.
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| 🏃 Physical inactivity |
Physical inactivity is an important and modifiable risk factor. Regular exercise appears protective against both
ischaemic and haemorrhagic stroke by improving BP, weight, insulin sensitivity, and lipid profile.
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| 🍷 Excess alcohol |
Heavy alcohol use and binge drinking increase stroke risk, particularly for haemorrhagic stroke,
hypertension, and AF.
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| ⚖️ Obesity |
Obesity, especially central obesity, increases stroke risk directly and indirectly through
hypertension, diabetes, dyslipidaemia, sleep apnoea, and inactivity.
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| 🤰 Pregnancy and puerperium |
Stroke in pregnancy and the postpartum period is uncommon but important, especially around delivery and in the first
6 weeks postpartum. Mechanisms include hypertensive disorders, hypercoagulability, cardiomyopathy, arterial dissection,
and cerebral venous sinus thrombosis.
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| 🌈 Migraine |
Migraine with aura is associated with increased ischaemic stroke risk, particularly in younger women and especially
when combined with smoking or oestrogen-containing contraception.
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| 🩸 Polycythaemia / raised haematocrit |
A raised haematocrit increases blood viscosity and may contribute to thrombosis. If present, think about causes such as
polycythaemia vera, hypoxia, smoking, testosterone use, or dehydration.
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| 🧬 Antiphospholipid antibodies / APS |
Important especially in younger patients with stroke, recurrent thrombosis, miscarriage history, or autoimmune disease.
APS is a key cause of both arterial and venous thrombosis.
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| 💥 Illicit drugs |
Sympathomimetic drugs such as cocaine, amphetamine, and methamphetamine increase the risk of both
ischaemic and haemorrhagic stroke through severe hypertension, vasospasm, arrhythmia, vasculopathy,
platelet activation, and occasionally vasculitis-like syndromes.
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