Stroke is the third leading cause of death in the United States and it is the number one cause of serious, long-term disability. Most of us think about strokes as a condition affecting the elderly.  While it is true that the vast majority of strokes occur after age 65, recent statistics point to a troubling trend among young to middle aged people.  The incidence of stroke is increasing at the highest rate among the 40 to 60 year old segment of the population.  Currently, nearly 1 in 4 strokes occur before age 65.  Are you at risk?

Two high profile stroke victims highlight this trend among younger people.  Delaware attorney general Beau Biden suffered a stroke at age 41 last year.  His was classified as “mild” and he has made a good recovery.  Typically younger people recover better as they have retained more brain plasticity and have fewer co-morbidities to complicate their recovery.

 Less fortunate was rapper Nate Dogg who died this week from congested heart failure and complications from previous strokes.   He was only 41, but according to the LA Times and USA Today, he suffered from two previous strokes; the first at age 38 and the second the following year.  I certainly do not know all the details of his condition, but having a stroke puts you at significantly increased risk of having subsequent strokes.  It should be a wake-up call.

 How can you prevent a stroke?  Although there are several risk factors that you cannot change, such as family history, being African American or male[1], there are a number of risk factors that are modifiable.  A large case-control study evaluating the risk factors for stroke ahs identified 10 modifiable risk factors that are associated with 90% of stroke risk.  Of those modifiable risk factors, hypertension was the most important for all stroke types.[2]  In that study a history of hypertension was associated with a more than 2.5-fold increase in the risk for stroke.  The other risk factors included smoking, abdominal obesity, lack of regular physical exercise, diabetes, diet and alcohol intake, abnormal lipid profile, stress and depression.

 Not coincidentally, the risk factors for stroke and heart disease are the same; the relative importance of each risk factor varies for each disease.  And, the same lifestyle modifications that could reduce your risk of both heart disease and stroke also reduce your risk of diabetes and being obese, which further reduces your risk of having a vascular event.  It all boils down to modifying your lifestyle to avoid these debilitating chronic diseases, improve your quality of life and reduce your chance of dying prematurely.

[1] American Heart Association, Heart disease and Stroke Statistics, 2009

[2] O’Donnell MJ, Xavier D, Liu L, et al. Risk factors for ischemic and intracerebral haemorrhagic sroke in 22 countries (the INTERSTROKE study: A case-control study. Lancet 2010; DOI:10. 1016/S0140-6736(10)608343