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Risk factors of Stroke
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Stroke is a disease influenced by multiple risk factors, some of which can be modifiable while others, such as age and gender, are not. Knowing these factors and addressing the ones we can control is key to reducing the incidence of this life-threatening disease.
Age. It is the main risk factor. Although stroke can happen at any age, its incidence increases as people get older. After the age of 55, the risk of stroke doubles with each decade.
Gender. Men have a higher risk of stroke than women. However, at advanced ages (80 years and older), its incidence is higher in women due to their longer life expectancy.
Family history. Genetic predisposition plays an important role. Having a first-degree relative who has had a stroke increases the risk of experiencing one.
Ethnic and socioeconomic factors. Certain populations, such as African-Americans and Hispanics, have a higher risk of stroke. This is likely related to a higher prevalence of risk factors like high blood pressure and diabetes, as well as other social determinants of health.
Arterial hypertension. This is the most significant risk factor and plays a major role in both ischaemic and haemorrhagic strokes. Proper blood pressure management significantly reduces stroke risk.
Mellitus diabetes. It increases the likelihood of stroke by 1.8 to 6 times, especially when associated with high blood pressure or hypercholesterolemia.
High cholesterol. Excess cholesterol in the blood promotes the formation of atherosclerotic plaques in the arteries, increasing the risk of ischaemic stroke.
A sedentary lifestyle. The lack of physical activity is directly related to the risk of having a stroke, as it contributes to developing obesity, high blood pressure, and insulin resistance.
Smoking. Smoking increases the risk of both, ischaemic and haemorrhagic strokes. The risk decreases significantly within five years of quitting.
Drug and alcohol consumption. Alcohol abuse can lead to high blood pressure and arrhythmias such as atrial fibrillation, which increase the risk of having a stroke. The use of drugs such as cocaine or amphetamines is strongly associated with haemorrhagic strokes in young people.
Some population groups. Such as African Americans and Hispanics, can present a greater risk of stroke. There are clear indications of an increased risk of stroke in groups living in adverse socio-economic conditions.
Heart disease. Atrial fibrillation is a major cause of cardioembolic stroke. Other heart conditions, such as myocardial infarction or valvular heart disease, also increase stroke risk.
Stress and psychosocial factors. Chronic stress and depression are associated with an increased risk of vascular diseases, including stroke.
Since many of these factors are modifiable, adopting healthy lifestyle habits, like maintaining a balanced diet, exercising regularly, avoiding smoking and managing diseases such as hypertension and diabetes, can significantly reduce stroke risk.
Pollution and Stroke Risk
There is growing evidence that air pollution can increase the risk of having a stroke. Prolonged exposure to pollutants, such as emissions from vehicles, factories and other sources of pollution, can affect brain and arterial health. Fine particles, in particular, can enter our bodies through the lungs, triggering inflammation and damaging blood vessels. This contributes to the development of diseases such as hypertension and atherosclerosis (hardening of the arteries), increasing stroke risk. It is therefore advisable to reduce exposure to pollution wherever possible, avoiding highly polluted areas, choosing sustainable transportation, and supporting efforts to improve air quality in urban areas and spaces.
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Substantiated information by:
Antonia Fernández
Nurse
Neurology Department
Arturo Renú Jornet
Neurologist
Neurology Department
Xabier Urra Nuin
Neurologist
Neurology Department
Ángel Chamorro Sanchez
Head of the Cerebral Vascular Pathology Unit
Published: 20 February 2018
Updated: 24 July 2025
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