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Stroke

How much each habit raises, or lowers, the odds of a stroke. Tap a pill, answer yours. Green pills lower the risk, red raise it; a star marks an estimate, not a published number. All causes ›

What raises — or cuts — stroke death risk

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What raises — or cuts — stroke death risk

50%25%0%25%50%75%100%← more risk · % change in risk · less risk →Factors, ranked by biggest effect≈5×#1179%#2127%#3≈100%#497%#564%#610%51%#758%#845%#945%#1032%#11≈12%≈19%#1227%#1326%#1422%#1520%#16#17#18#19Everythingelseno single number

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Tap a pill to answer yours.

Where you sit

0 of 19 answered

Answer the 19 factors above to see which ones raise your own risk, which sit at the reference, and which the studies have no number for.

Relative risk versus each factor’s reference group; above the line is lower risk, below it higher.

Sources (23)Lewington et al., Lancet 2002 · Ettehad et al., Lancet 2016 · Mons et al., BMJ 2015 and 20 moreShow all
  1. [1]R. G. Hart, L. A. Pearce, and M. I. Aguilar. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med, 146(12):857-67, 2007. doi:10.7326/0003-4819-146-12-200706190-00007 Evidence: High
  2. [2]P. A. Wolf, R. D. Abbott, and W. B. Kannel. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke, 22(8):983-8, 1991. doi:10.1161/01.str.22.8.983 Evidence: Low
  3. [3]S. Seshadri et al. Parental occurrence of stroke and risk of stroke in their children: the Framingham study. Circulation, 121(11):1304-12, 2010. doi:10.1161/CIRCULATIONAHA.109.854240 Evidence: Low
  4. [4]Emerging Risk Factors Collaboration et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies. Lancet, 375(9733):2215-22, 2010. doi:10.1016/S0140-6736(10)60484-9 Evidence: High
  5. [5]D. Ettehad et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet, 387(10022):957-967, 2016. doi:10.1016/S0140-6736(15)01225-8 Evidence: High
  6. [6]S. Lewington et al. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet, 360(9349):1903-13, 2002. doi:10.1016/s0140-6736(02)11911-8 Evidence: High
  7. [7]J. M. Marin et al. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: an observational study. Lancet, 365(9464):1046-53, 2005. doi:10.1016/S0140-6736(05)71141-7 Evidence: Low
  8. [8]H. K. Yaggi et al. Obstructive sleep apnea as a risk factor for stroke and death. N Engl J Med, 353(19):2034-41, 2005. doi:10.1056/NEJMoa043104 Evidence: Low
  9. [9]P. Strazzullo et al. Excess body weight and incidence of stroke: meta-analysis of prospective studies with 2 million participants. Stroke, 41(5):e418-26, 2010. doi:10.1161/STROKEAHA.109.576967 Evidence: High
  10. [10]T. Chikritzhs et al. Has the leaning tower of presumed health benefits from 'moderate' alcohol use finally collapsed?. Addiction, 110(5):726-7, 2015. doi:10.1111/add.12828 Evidence: Not graded (review)
  11. [11]T. Stockwell et al. Do "Moderate" Drinkers Have Reduced Mortality Risk? A Systematic Review and Meta-Analysis of Alcohol Consumption and All-Cause Mortality. J Stud Alcohol Drugs, 77(2):185-98, 2016. doi:10.15288/jsad.2016.77.185 Evidence: High
  12. [12]S. C. Larsson et al. Differing association of alcohol consumption with different stroke types: a systematic review and meta-analysis. BMC Med, 14(1):178, 2016. doi:10.1186/s12916-016-0721-4 Evidence: High
  13. [13]M. J. O'Donnell et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet, 376(9735):112-23, 2010. doi:10.1016/S0140-6736(10)60834-3 Evidence: Moderate
  14. [14]U. Mons et al. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium. BMJ, 350:h1551, 2015. doi:10.1136/bmj.h1551 Evidence: High
  15. [15]A. Pan et al. Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review. JAMA, 306(11):1241-9, 2011. doi:10.1001/jama.2011.1282 Evidence: High
  16. [16]Y. Leng et al. Sleep duration and risk of fatal and nonfatal stroke: a prospective study and meta-analysis. Neurology, 84(11):1072-9, 2015. doi:10.1212/WNL.0000000000001371 Evidence: High
  17. [17]N. K. Valtorta et al. Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart, 102(13):1009-16, 2016. doi:10.1136/heartjnl-2015-308790 Evidence: High
  18. [18]A. Descatha et al. The effect of exposure to long working hours on stroke: A systematic review and meta-analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury. Environ Int, 142:105746, 2020. doi:10.1016/j.envint.2020.105746 Evidence: High
  19. [19]C. D. Lee, A. R. Folsom, and S. N. Blair. Physical activity and stroke risk: a meta-analysis. Stroke, 34(10):2475-81, 2003. doi:10.1161/01.STR.0000091843.02517.9D Evidence: High
  20. [20]F. J. He, C. A. Nowson, and G. A. MacGregor. Fruit and vegetable consumption and stroke: meta-analysis of cohort studies. Lancet, 367(9507):320-6, 2006. doi:10.1016/S0140-6736(06)68069-0 Evidence: High
  21. [21]A. Reynolds et al. Carbohydrate quality and human health: a series of systematic reviews and meta-analyses. Lancet, 393(10170):434-445, 2019. doi:10.1016/S0140-6736(18)31809-9 Evidence: Moderate
  22. [22]W. Liu et al. Secondhand smoking and neurological disease: a meta-analysis of cohort studies. Rev Environ Health, 36(2):271-277, 2020. doi:10.1515/reveh-2020-0053 Evidence: High
  23. [23]Prospective Studies Collaboration et al. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 55,000 vascular deaths. Lancet, 370(9602):1829-39, 2007. doi:10.1016/S0140-6736(07)61778-4 Evidence: High

Every factor, one by one

One quick question each. The charts above follow your answers, and so does every other What Matters page that asks the same question.

  1. #1Atrial fibrillation[1, 2]≈5×

    An irregular heartbeat lets clots form in the heart and travel to the brain.

    Have you been diagnosed with atrial fibrillation (an irregular, often fast heartbeat)?

    reference
    ≈5×
    no number

    Not answered yet. Tap an option to save your answer. This answer does not change your life estimate.

  2. #2Early stroke in the family[3]+179%

    In 3,443 Framingham offspring with verified parental stroke status, having a parent with a documented stroke by age 65 nearly tripled a child’s risk of the same kind of stroke, after adjusting for age, sex and the usual risk factors.

    Has a parent, brother, or sister had a stroke before about age 65?

    reference
    +179%
    +179%
    no number

    Same number, 2 answers: The Framingham analysis compared offspring with at least one parent with a verified stroke by 65 against those with none; it did not count how many relatives.

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  3. #3Diabetes[4]+127%

    Across 102 studies, diabetes more than doubled ischaemic stroke (the clot kind, about four in five strokes) and raised bleeding strokes by half.

    What’s your blood sugar like?

    reference
    ≈+38%
    +127%
    +127%
    no number

    Same number, 2 answers: The collaboration compared diabetes with no diabetes; it did not split by how well it was controlled.

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  4. #4High blood pressure[5, 6]≈+100%

    The biggest modifiable stroke factor.

    What’s your blood pressure like?

    reference
    ≈+41%
    ≈+7%
    ≈+100%
    no number

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  5. #5Sleep apnea[7, 8]+97%

    In 1,022 patients referred for a sleep study, obstructive sleep apnea (five or more breathing pauses an hour) carried nearly twice the risk of a composite of stroke or death from any cause, independent of blood pressure, smoking, weight, diabetes, cholesterol and atrial fibrillation.

    Do you snore loudly or wake up gasping?

    reference
    ≈+25%
    ≈+10%
    +97%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  6. #6Body weight[9]+64%

    Across 25 cohorts and 2.3 million people, overweight went with 22% more ischaemic strokes and obesity with 64% more; bleeding strokes rose only with obesity, and not significantly.

    How would you describe your weight?

    +64%
    +64%
    +22%
    reference
    ≈+7%

    Same number, 2 answers: The meta-analysis pooled everyone with a BMI of 30 or over as one obese group.

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  7. #7Alcohol[10, 11, 12, 13]+51%

    Alcohol runs two ways on stroke, on paper.

    How much alcohol do you drink?

    reference
    −10%
    ≈+8%
    +51%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  8. #8Smoking[14]+58%

    Across 25 cohorts of adults over 60, current smokers had 58% more strokes than never smokers and former smokers 17% more.

    Do you smoke?

    reference
    +17%
    +58%
    +58%

    Same number, 2 answers: The CHANCES consortium compared current smokers with never smokers and did not split by cigarettes a day.

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  9. #9Depression[15]+45%

    Across 28 cohorts and 317,000 people, depression at the start went with 45% more strokes over the years that followed, and 55% more fatal ones.

    How often do you feel down or depressed?

    reference
    ≈+15%
    +45%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  10. #10Sleep length[16]+45%

    In an updated meta-analysis of prospective studies, sleeping more than nine hours went with 45% more strokes than seven to nine hours, and under six hours with 15% more.

    How much sleep do you usually get?

    +15%
    ≈+7%
    reference
    +45%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  11. #11Social isolation[17]+32%

    Across 8 longitudinal studies and over 3,000 stroke events, loneliness or social isolation went with 32% more strokes than strong social ties.

    How connected are you to friends and family?

    ≈−13%
    reference
    +32%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  12. #12Long working hours[18]≈+19%

    The WHO/ILO review of 22 studies found 55 or more hours a week went with 35% more strokes than 35 to 40 hours, and 49 to 54 hours with 13% more.

    How many hours a week do you work?

    ≈−12%
    reference
    ≈+19%
    no number

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  13. #13Physical inactivity[19]−27%

    Across 23 studies, highly active people had 27% fewer strokes than low-active people, and moderately active people 20% fewer.

    How many days a week do you get 30+ minutes of exercise?

    reference
    ≈−10%
    −20%
    −27%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  14. #14Few fruit and vegetables[20]−26%

    Pooling nine cohort studies, people eating 3 to 5 servings of fruit and vegetables a day had 11% less stroke than those eating under 3, and people eating more than 5 servings a day had 26% less.

    How many servings of vegetables and fruit do you eat a day?

    reference
    −11%
    −26%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  15. #15Little fibre[21]−22%

    In the largest review of fibre and health outcomes, 185 prospective studies and 58 trials, people eating 25 to 29 grams of fibre a day had 22% fewer strokes than the lowest intake band, alongside a 31% cut in coronary heart disease deaths and 15% fewer deaths overall.

    How much fiber do you eat daily (beans, whole grains, vegetables, fruit)?

    reference
    ≈−12%
    −22%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  16. #16Secondhand smoke[22]+20%

    Across 14 cohort studies and 697,000 people, non-smokers exposed to secondhand smoke had 20% more strokes than those who were not, holding whether or not the studies were restricted to lifelong non-smokers.

    How often are you around other people’s smoke?

    reference
    ≈+10%
    +20%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  17. #17Chronic stress[13]

    In the INTERSTROKE case-control study across 22 countries, high psychosocial stress went with 30% more strokes of any kind, one of ten factors the study found behind 90% of the worldwide risk of a first stroke.

    How stressed are you day to day?

    ≈−12%
    reference
    ≈+14%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  18. #18Waist-to-hip ratio[13]

    In the INTERSTROKE case-control study, people in the top third for waist-to-hip ratio had 65% more strokes than the bottom third, the third-biggest of the ten factors the study measured, ahead of diabetes and level with smoking.

    How’s your waistline?

    ≈−22%
    reference
    ≈+29%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

  19. #19Diet quality[13]

    INTERSTROKE scored diets across fried food, salty food, meat and fish, and fruit and vegetables; people in the worst third for that score had 35% more strokes than the best third.

    How would you describe your diet?

    ≈+11%
    reference
    ≈−10%
    ≈−18%

    Not answered yet. Tap an option to save your answer. Saved to your quiz answers, so the quiz shows it too.

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