Each year, nearly 800,000 people in the United States experience a stroke, according to the National Institutes of Health. Strokes are responsible for about 130,000 deaths annually, making them the fifth leading cause of death in the country (https://www.nichd.nih.gov/health/topics/stroke/conditioninfo/risk).
“While we’re getting better at preventing death from strokes, stroke still has tremendous consequences even for survivors,” said Jose G. Romano, M.D., a neurologist with the University of Miami Health System. “Stroke is the leading cause of permanent adult disability.”
There are two main types of strokes. Ischemic strokes account for approximately 87% of cases and occur when a clot blocks blood flow to the brain (https://www.stroke.org/en/about-stroke/types-of-stroke). Hemorrhagic strokes happen when a weakened blood vessel ruptures, often due to aneurysms or arteriovenous malformations.
Medical organizations such as the American Heart Association and American Stroke Association prioritize stroke prevention. Dr. Romano noted, “After a heart attack, there’s a strong chance the person can resume their normal life afterward. After a stroke, however, about 70% of survivors can’t return to their usual activities. That’s why prevention is so critical with stroke.”
In October 2024, these organizations updated their guidelines for primary stroke prevention for the first time in ten years (https://www.ahajournals.org/doi/10.1161/STR.0000000000000475). The new recommendations emphasize healthy lifestyle choices known as “Life’s Essential 8.” These include eating better, being more active, quitting tobacco use, getting healthy sleep, managing weight, controlling cholesterol levels, managing blood sugar levels, and managing blood pressure.
Dr. Romano highlighted that high blood pressure is often overlooked but remains one of the most significant risk factors for stroke: “One of the main offenders is high blood pressure, and about one-third of adults have it,” he said. “If we could treat hypertension, it would make a big difference in the stroke numbers. Unfortunately, many people aren’t even aware that they have high blood pressure until it’s too late.”
He also pointed out that maintaining a healthy diet is particularly challenging: “A minority of Americans have an ideal score on ‘Life’s Essential 8,’ but diet is definitely the most challenging one for people, especially cutting down on our salt intake,” he said.
The latest guidelines also address sex-specific risks. For women, certain factors such as estrogen use—common in birth control and menopausal medications—combined with tobacco use can increase venous thrombosis risk and potentially lead to stroke. Endometriosis is also linked to higher risk.
Pregnant women face increased risk if they develop preeclampsia—a pregnancy complication characterized by high blood pressure and potential kidney damage.
Dr. Romano concluded by stressing awareness and management: “If you care about your future physical health and cognitive health, it’s important to do your best to reduce these risks as much as possible,” he said. “If you can prevent stroke, you can avoid the disability and the onset of cognitive decline that is frequently associated with it.”
More information on facts and statistics about strokes can be found at https://www.strokeinfo.org/stroke-facts-statistics/.
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