Stroke Prevention: Who Should Get Screened and When

Stroke screening can help identify those at high risk and determine best treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

While stroke can happen to anyone, certain risk factors put some people in more peril than others. For those at high risk, new screening methods can help spot problems before stroke occurs.

Although some stroke risk factors are beyond a person’s control (such as age and family history), many factors can be managed to lower the odds of having a stroke. In fact, the National Stroke Association says that 80 percent of strokes can be prevented by adopting a healthy lifestyle and/or taking the right medication.

Risks: Those You Can Control and Those You Can’t

Certain circumstances in life that increase the likelihood of stroke are unavoidable, such as being 55 or older; being male; coming from an ethnic background that is African American, Hispanic or Asian/Pacific Islander; or having a family history of stroke or transient ischemic attack (TIA). TIAs are “mini-strokes,” caused by a temporary clot, that last only a few minutes and do not cause any harm, but they are often warning signs — about one third of those who've had a TIA will have a stroke.

Other factors can be adjusted. If you take action through regular exercise, eating a healthy diet, and/or taking prescribed medication, you can lower stroke risk.

The following are controllable risk factors of stroke:

  • Blood Pressure. A blood pressure higher than 140/90 is a high risk level and from 120/80 to 139/90 is a cautionary level. Pressure at 120/80 or less is considered healthy.
  • Cholesterol. A person with a cholesterol level of 240 mg/dL or higher faces a greater risk for stroke. Cholesterol at this level more than doubles the risk of coronary heart disease, compared with cholesterol lower than 200 mg/dL, according to the American Heart Association. Cholesterol that is 200 to 239 mg/dL is considered borderline high.
  • Diabetes. Many people with diabetes have high blood pressure, high cholesterol and/or heart disease — all which put them at high risk of stroke. Those with elevated blood sugar levels but not diabetes may face an elevated risk as well. While people may not be able to get rid of diabetes, they can take measures to lower blood sugar levels and lower stroke risk.
  • Obesity. People with excessive weight are more likely to have high blood pressure, high cholesterol and diabetes.
  • Atherosclerosis. This progressive buildup of plaque in artery walls raises stroke risk because the buildup can block blood vessels that supply blood to the brain, but diet, exercise and medication can help reduce this buildup.
  • Atrial fibrillation. About 15 percent of all people who have strokes have this type of irregular heart rhythm as well. If left untreated, atrial fibrillation can lead to blood clots forming in the heart that can potentially travel to the brain, causing a stroke.
  • Tobacco and alcohol use. Stroke risk is twice as high for smokers as nonsmokers, and excessive consumption of alcohol has been linked with increased stroke risk.

An Advanced Screening Method

Healthcare providers can assess stroke risk factors through in-person checkups, interviews and blood tests. If enough risk factors are high, patients may consider getting an ultrasound of the carotid arteries, the two large blood vessels in the neck that supply blood to the brain. This screening can detect blockages, and if the blockage is severe enough, a doctor may perform a carotid endarterectomy (a surgery to remove the inner lining of the carotid artery) to remove the plaque to prevent a stroke.

The Society for Vascular Surgery says that individuals 55 years of age and older with cardiovascular risk factors such as a history of hypertension, diabetes, smoking, high cholesterol or known cardiovascular disease may benefit from such preventive screening.

While ultrasounds can pinpoint trouble in blocked arteries, they can also produce false-positive results, which has the potential to lead to unnecessary surgery. Other screening methods may be needed to confirm a blockage.

Sarah Samaan, MD, cardiologist and physician partner at the Baylor Heart Hospital in Plano, Texas, told dailyRx News, “A stroke is a devastating and life-changing condition. Very few people will completely recover from a stroke, and although many will be able to return to a productive and comfortable lifestyle, others will be left completely disabled and dependent. That's why it's so important to do everything possible to prevent the problem in the first place. Many of the risk factors are easily identified and easily treated.”

Review Date: 
April 23, 2014