Controllable Risk Factors

Here are a few examples of known risk factors for stroke that, in most cases, can be mitigated through lifestyle changes and/or medical treatment to counteract the increased stroke risk.

Patent foramen ovale (PFO)

Patent foramen ovale (PFO) is a hole between the heart’s left and right atria (upper chambers). We all had a hole like this before birth, but it is supposed to close shortly after birth. In approximately 20-25% av the population, the hole doesn’t close and this increases their risk for a stroke.

Most people with PFO doesn’t know about their condition since it is very common to have no noticeable symptoms. If you are diagnosed with PFO, there are certain medical treatments available that wont close the hole but can decrease the risk of a stroke. Discuss the situation with your physician, because preventative medical treatment is only recommended in certain cases and must be determined on an individual basis.


Atherosclerosis is caused by plaque building up inside the arteries. The plaque consists of fat, cholesterol, calcium and certain other substances. Over time, the plaque will harden and make the arteries more narrow. Atherosclerosis increases the risk of stroke, TIA and heart disease.

Sometimes, lifestyle changes (diet and physical activity) is sufficient to manage the atherosclerosis. In other cases, medication and/or surgery will be recommended.

Carotid artery stenosis

The carotid arteries are the two main blood vessels in the neck that bring blood up to the brain. Carotid artery stenosis is a condition where one or both become abnormally narrow, which in turn increases the risk of a stroke.

Known risk factors for carotid artery stenosis are age and high cholesterol. While we can’t do anything to reduce our age, there are both lifestyle changes and medical treatments available that can impact our cholesterol levels.

Carotid artery stenosis will often exist without any symptoms that are noticeable to the patient, but your physician can test you for the condition. Treatment options are available for diagnosed carotid artery stenosis.

High blood pressure

blood pressureA high blood pressure increases the risk of several health problems and stroke is one of them. In the United States, high blood pressure is the prime cause of strokes. On average, a person with a high blood pressure is 1.5 times more likely to experience a stroke compared to a person with a healthy blood pressure. A high blood pressure can make the blood vessels weaker and cause damage to major organs, including the brain.

A high blood pressure is typically treated with a combination of improved diet, improved physical activity and medication.

Atrial fibrillation (AFib)

Atrial fibrillation (AFib) is a quivering or irregular heartbeat (arrhythmia). AFib is linked to an increased risk of blood clots, stroke, heart failure and certain other heart-related health issues.

The main reason why AFib increases the risk of experiencing a stroke is that AFib allows blood to pool in the heart, increasing the risk of clot formation.

Known risk factors for AFib include high blood pressure, heart disease and diabetes. AFib occurs at all ages, but is much more common in people aged 65 and above.

AFib can be treated with medications or electrical stimulation, with the aim of restoring the regular rhythm of the heart. Underlying risk factors should also be addressed, such as high blood pressure.

High cholesterol

Cholesterol is found in certain foods but is also produced by the human body.

Cholesterol in the arteries can reduce or block blood flow to the brain, causing a stroke.

The current recommendation is to keep total cholesterol levels below 200. If you are above this, consider lifestyle changes and possibly also medication to reduce your risk of a stroke.


On average, a person with diabetes is several times more likely to experience a stroke than a person who doesn’t have diabetes. In part, this is because many people with diabetes – especially Type II diabetes – also have other risk factors for stroke, such as high blood pressure, high cholesterol levels and atrial fibrillation.

The ideal treatment will depend on which type of diabetes you have and also other individual factors. For many, a combination of lifestyles changes and medication is recommended. For Type I diabetes, providing the body with insulin is always the recommendation. For Type II diabetes, the situation is different and some patients can control the diabetes with changes in diet and physical exercise.

Fibromuscular dysplasia (FMD)

A person with fibromuscular dysplasia (FMD) has an increased stroke risk. That is because in a person with FMD, some of the arteries that carry blood have fibrous tissue growing in the walls. This tissue makes the blood vessels narrower than they should be, reducing blood flow and increasing the risk of a stroke. If you have been diagnosed with FMD, discuss possible mitigation of stroke risk with your physician.


A transient ischemic attack (TIA) should be taken seriously since it is a known warning sign for a future full-scale stroke. In itself, the TIA will typically not cause any permanent damage, only stroke-like symptoms that lasts for anything from a few minutes to 24 hours.

After a TIA, the risk of experiencing a stroke within the following three months is highly elevated. The week right after the TIA is especially dangerous.

In some cases, surgery is recommended after a TIA to reduce the risk of a future stroke.

A previous stroke

If you have experienced a stroke in the past, your risk of experiencing another stroke is elevated.

In the United States, approximately 800,000 strokes occur each year. Out of these strokes, approximately 25% happen to people who have already experienced at least one stroke in the past. After a stroke, it is therefore important to not just focus on rehabilitation and adaptation – taking measures to reduce the risk of a future stroke is also very important.