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Stroke Risk Factors

Assessment of Stoke Risk Factors: Age – Cardiovascular Disease – Migraine – Gender Race – Obesity – Diet

Stroke Risk Factors

The article below is a form created for stroke risk assessment. Statistical data were translated into simple numbers. I made it initially for office use a few years ago. A healthy female younger than 55 years was taken as a reference (lowest chance of stroke). Numbers assigned to each risk factor reflect how many times the chance of stroke rises in relation to her chances of stroke.

For example, 70 years old (3) male (0.3) with history of hypertension (2) and Atrial Fibrillation (4) has the chance of stoke 1+3+0.3+2+4=10.3 times more than a person with no risk factors (1). In order to assess your own risk of stroke, add up all the numbers in the purple boxes that apply to you and then add “1”.
These numbers have no absolute values, but they help to assess an overall weight of each particular risk factor. This form also helps to understand relative importance of each particular risk factor in order to choose the appropriate preventive measures.
Please, understand that the translation of statistical data into these numbers is approximate and it does have a significant margin of error. Treatment of conditions with stroke risk obviously lowers the assigned values.

Age: After age 55 stroke risk doubles approximately every 10 years.

1.0    Female younger than 55 y.o. – Reference point
2.0    >55 y.o.
3.0    >65 y.o.
4.0    >75 y.o.

Sex: Males have slightly higher chance of stroke
0.3    Male

Race: Blacks and Hispanics have higher chance of stroke
1.4    Black
1.0    Hispanic

Diabetes: Diabetes causes small vessel disease. It is a common reason for lacunar strokes
1.3    Diabetes

Hypertension: Hypertension causes small vessel disease (lacunar and hemorrhagic strokes) and increases severity of atherosclerosis
2.0    Hypertension

Heart Disease: Multiple heart conditions are associated with strokes. Most commonly they are embolic strokes
1.0   Coronary artery disease (CAD)
6.0   History of heart attack (myocardial infarction)
3.0   Congestive Heart Failure (CHF)
4.0   Atrial Fibrillation without heart valve disease
19.0   Atrial Fibrillation with heart valve disease
4.0   Pacemaker

Carotid artery disease accounts for 7% of ischemic strokes. The chance of stroke strongly depends on severity of carotid stenosis.
4.6    Less than 75% carotid stenosis
13.0   More than 75% carotid stenosis

Migraine is associated with increased chance of lacunar stroke. Headache itself has nothing to do with the stroke. The cause of this association is not known. Migraine with aura together with birth control pills significantly increases the chance of stroke.
4.0   Migraine

Heredity: Having close family members with stroke is a risk factor
0.9   Close family members with stroke

0.8   Elevated homocystein level

Smoking is a risk factor predominantly for lacunar strokes and hemorrhagic strokes. Besides, smoking worsens atherosclerosis and secondary increases the chance of other risk factors.
0.5   Smoking
4.0   Combination of smoking, birth control pills and age over 35

1.5   Diet (high in animal fat) is a risk factor for ischemic stroke. On the other hand, lack of dietary animal fact increases chance of hemorrhagic strike about threefold!

Lack of current physical activity is a risk factor for lacunar stroke.
1.0   Lack of current exercise

Obesity, especially abdominal obesity, is a stroke risk. High correlation is found between stroke risk and ratio of waist v.s. hip circumferences.
2.8  Waist/hip circumference ratio in males above 0.93
1.5  Waist/hip circumference ratio in females above 0.86

Some of stroke risk factors are intentionally omitted. Blood vessel anomalies (aneurysms and AVMs) are obviously risk factors for hemorrhagic strokes. They are described elsewhere.
High cholesterol level demonstrates a clear correlation with coronary artery disease, but reports on correlation with stroke are controversial.
Metallic prosthetic heart valves carry a tremendous risk for embolic stroke. Since these patients are always on anticoagulant therapy, the actual risk is very hard to study.

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