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Family History and Other Characteristics That Increase

Risk for Stroke


Family members share genes, behaviors, lifestyles, and environments that can influence their
health and their risk for disease. Stroke risk can be higher in some families than in others, and
your chances of having a stroke can go up or down depending on your age, sex, and race or
ethnicity.

The good news is you can take steps to prevent stroke. Work with your health care team to
lower your risk for stroke.

Genetics and Family History


When members of a family pass traits from one generation to another through genes, that
process is called heredity.

Genetic factors likely play some role in high blood pressure, stroke, and other related
conditions. Several genetic disorders can cause a stroke, including sickle cell disease. People
with a family history of stroke are also likely to share common environments and other
potential factors that increase their risk.

The chances for stroke can increase even more when heredity combines with unhealthy
lifestyle choices, such as smoking cigarettes and eating an unhealthy diet.

Find out more about genetics and disease on CDC’s Office of Public Health Genomics website.

Family health history is a record of the diseases and health conditions that happen in your
family. Family health history is a useful tool for understanding health risks and preventing
health problems. To help people collect and organize their family history information, CDC’s
Office of Public Health Genomics worked with the U.S. Surgeon General and other federal
agencies to develop a web-based tool called My Family Health Portrait

Age
The older you are, the more likely you are to have a stroke. The chance of having a stroke
about doubles every 10 years after age 55. Although stroke is common among older adults,
many people younger than 65 years also have strokes.1

In fact, about one in seven strokes occur in adolescents and young adults ages 15 to
49.2 Experts think younger people are having more strokes because more young people are
obese and have high blood pressure and diabetes. Read more about the younger face of
stroke.
Sex
Stroke is more common in women than men, and women of all ages are more likely than men
to die from stroke. Pregnancy and use of birth control pills pose special stroke risks for
women.1 Learn more about stroke in men Cdc-pdf[PDF-248K] and stroke in women Cdc-
pdf[PDF-222K].

Race or Ethnicity
Blacks, Hispanics, American Indians, and Alaska Natives may be more likely to have a stroke
than non-Hispanic whites or Asians. The risk of having a first stroke is nearly twice as high for
blacks as for whites. Blacks are also more likely to die from stroke than whites are.3 Learn more
about stroke among blacks and Hispanics.

A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the
brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive
oxygen and nutrients from the blood or there is sudden bleeding into or around the brain. The symptoms of a
stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble
speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking,
dizziness, or loss of balance or coordination; or sudden severe headache with no known cause. There are two
forms of stroke: ischemic - blockage of a blood vessel supplying the brain, and hemorrhagic - bleeding into or
around the brain.

Generally there are three treatment stages for stroke: prevention, therapy immediately after the stroke, and
post-stroke rehabilitation. Therapies to prevent a first or recurrent stroke are based on treating an individual's
underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes. Acute stroke therapies
try to stop a stroke while it is happening by quickly dissolving or removing the blood clot causing an ischemic
stroke or by stopping the bleeding of a hemorrhagic stroke. Post-stroke rehabilitation helps individuals
overcome disabilities that result from stroke damage. Medication or drug therapy is the most common
treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics
(antiplatelet agents and anticoagulants) and drugs that break up or dissolve blood clots, called thrombolytics.

Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from
stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as
debilitating as paralysis is one-sided weakness or hemiparesis. Stroke may cause problems with thinking,
awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or
forming speech. A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their
emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke
survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is
made worse by movement and temperature changes, especially cold temperatures. Recurrent stroke is
frequent; about 25 percent of people who recover ...
Behaviors That Increase Risk for Stroke

Diets high in saturated fats, trans fat, sodium, and cholesterol have been linked to stroke. Find
healthy recipes and meal plans at the Million Hearts® Heart-Healthy Recipes page.External
Your lifestyle choices can affect your chances of having a stroke. To lower your risk, your
doctor may suggest changes to your lifestyle.

The good news is that healthy behaviors can lower your risk for stroke.

Unhealthy Diet
Diets high in saturated fats, trans fat, and cholesterol have been linked to stroke and related
conditions, such as heart disease. Also, getting too much salt (sodium) in the diet can raise
blood pressure levels.

Physical Inactivity
Not getting enough physical activity can lead to other health conditions that can raise the risk
for stroke. These health conditions include obesity, high blood pressure, high cholesterol, and
diabetes. Regular physical activity can lower your chances for stroke.

Obesity
Obesity is excess body fat. Obesity is linked to higher “bad” cholesterol and triglyceride levels
and to lower “good” cholesterol levels. Obesity can also lead to high blood pressure and
diabetes.

Too Much Alcohol


Drinking too much alcohol can raise blood pressure levels and the risk for stroke. It also
increases levels of triglycerides, a form of fat in your blood that can harden your arteries.

 Women should have no more than one drink a day.


 Men should have no more than two drinks a day.

Tobacco Use
Tobacco use increases the risk for stroke. Cigarette smoking can damage the heart and blood
vessels, increasing your risk for stroke. The nicotine in cigarettes raises blood pressure, and
the carbon monoxide from cigarette smoke reduces the amount of oxygen that your blood
can carry. Even if you don’t smoke, breathing in other people’s secondhand smoke can make
you more likely to have a stroke.
Adrian Cushenberry’s Story
A “Prime Example” of How Stroke Can Happen to Anyone
“Stroke can happen to anybody. I’m a prime example of that, because I knew I was a fit
individual. I knew what I could push my body to do, and I knew I was living life right, health-
wise. What I didn’t know was that I was at a higher risk of stroke because of my family
history.”

—Adrian Cushenberry, 50, stroke survivor

The day was like any ordinary day for metro-Atlanta resident Adrian Cushenberry. On a
February morning in 2017, the 49-year-old was headed to work after his usual workout and
stopped to buy an orange juice. The drive-through attendant suspected something might be
wrong; she told Adrian he’d fallen asleep. Adrian didn’t believe it. But just seconds later, he
drove his car into two parked vehicles. He couldn’t move the left side of his body. A police
officer arrived and immediately knew that Adrian was having a stroke. The officer called for an
ambulance right away, and Adrian was successfully treated at Atlanta’s Emory University
Hospital—just 8 minutes from the scene of the stroke.

Before his stroke, Adrian worked out 5 days a week and ran in nearly 30 road races each year.
He didn’t smoke, rarely drank, was careful with his diet, and considered himself to be in great
health. What he didn’t know was that as an African American man, he was at a higher risk of
stroke. A scan at the hospital revealed that the clot had formed in an abnormal web of blood
vessels in his neck—a condition found in some African American men.

A Family History of Stroke Risk


African-American men are at greater risk of having a stroke than any other group of men in
the United States. Compared to white men, they are twice as likely to have a stroke, have
strokes at younger ages, die from stroke, or have stroke-related disability that affects their
daily activities. Two in 5 African-American men have high blood pressure, just like Adrian, his
twin brother, and their father. Adrian’s grandfather also had a stroke. This family history of
stroke and high blood pressure meant Adrian’s stroke risk was higher than average, too—
despite his healthy lifestyle.

Luckily, Adrian was in such good health that he was a prime candidate for a special surgery to
remove the blood clot that caused his stroke. He credits his physical fitness before the stroke,
along with fast treatment from emergency responders and at the hospital, with how well he
has been able to recover. Plus, Adrian says, he has an “entourage” of supporters, including
friends, family members, and his “fit family,” who work out with him regularly.

Running Toward Health


Today, Adrian continues to work hard to recover his high level of physical fitness. He takes
medicine to prevent blood clots and control his blood pressure, and he is determined not to
let stroke stop him from doing what he loves. An avid runner, on the anniversary of his stroke,
Adrian ran Atlanta’s Hot Chocolate 15K Race, a 9.4-mile race, finishing just a few minutes
behind his previous time.

After his stroke, Adrian says he re-evaluated his life. “I started to slow down and recognize
that nothing really matters other than friends and family,” he said. “Now I call friends and
family more often to say, ‘I love you.’” Adrian adds that it’s important for stroke survivors to
know they are not alone and that they can live a productive life after having a stroke. “You
have the opportunity to write the next chapter of your life,” he says.

Blanche Teal-Cruise’s Story


A smoker for 40 years, Blanche knew the habit was unhealthy. But she had no idea how it
would eventually affect her health.

When Blanche almost fell down one morning after getting out of bed, she blamed her
dizziness on vertigo, a condition that makes you feel dizzy or lightheaded. But when she tried
to turn on the light, her arm felt like dead weight. So she rested a short while until she felt
better. Then she took a shower and drove to work. She had no idea she had suffered a mild
stroke.

When she arrived at work, a co-worker noticed that Blanche was not walking straight. When
Blanche spoke, she felt as if she had to push the words out of her mouth.

Blanche was lucky: When she got to the hospital, she was diagnosed with a transient ischemic
attack, often called a “mini-stroke.” Unlike major strokes, mini-strokes don’t cause permanent
injury to the brain. But mini-strokes can lead to a major stroke.

Blanche is a CDC employee who smoked cigarettes for more than 25 years and quit after
suffering a stroke.

Blanche’s mini-stroke was a wake-up call. Two weeks after her mini-stroke, Blanche quit
smoking for good. Like many African-American women, Blanche also had high blood pressure.
She now takes medicine to control her blood pressure and walks her dog every day to stay
active. She sees her doctor regularly and works to keep her weight down.

Blanche always talks to her friends and family about how to reduce their chances of having a
stroke and how to recognize when someone is having a stroke. She has learned so much
about how to prevent stroke, and she likes to spread the word to others about the importance
of going to the doctor and quitting smoking.

Brooke Bergfeld’s Story


A Stroke Survivor Shares Her Advice: “Timing Is Everything”

In April 2016, Brooke Bergfeld, of Bismarck, North Dakota, was celebrating being a new mom.
The 29-year-old had given birth to her first child, a boy named Hudson, after a problem-free
pregnancy. About a week after the birth, Brooke felt pain in her left arm, but she thought it
was muscle soreness from carrying around a new baby. Similarly, she chalked up her sudden,
terrible headache to migraines, like the ones she’d had before her pregnancy. Luckily,
Brooke’s mom, who was visiting at the time, noticed Brooke’s slurred speech and drooping
face—two classic signs of stroke—and immediately called 9-1-1.

At the hospital, doctors performed a procedure called a “thrombectomy” to remove a blood


clot that was thought to have caused the stroke. Brooke’s doctor diagnosed her
with fibromuscular dysplasiaExternal, a condition that can cause some blood vessels to narrow
or be deformed. This condition led to problems in the arteries in Brooke’s neck, where her
health care team thinks the clot formed.

“Timing is everything. Getting help as fast as possible was my saving grace…. If my mom
hadn’t been there, I would likely either not be here or have disabilities now. But because she
was so fast at calling 9-1-1 and getting me help, I have no disabilities, and I can function and
live my everyday, normal life.”

—Brooke Bergfeld, 31, stroke survivor

After undergoing several medical procedures and spending a few days in the hospital, Brooke
returned home with no serious disabilities or major limitations. She credits her mom’s quick
thinking, combined with the medical care she received in the ambulance and at the hospital,
for the fact that she is alive and healthy. Today, Brooke says she is “blessed to be alive and
knows there is life after a stroke.” She continues to see her doctors on a regular basis and
takes medicine to control her blood pressure as well as blood thinners to prevent clots. She
also tries to eat healthfully and fit more physical activity into her day. Her son’s birthday has
now become her celebration of life, too. “I can continue to live on and be happy and healthy,”
she says.

Since her stroke, Brooke has become an advocate for stroke awareness. She has traveled to
New York City to help teach others, especially women, that stroke can happen to anyone,
even younger people like her. Brooke encourages people to learn the signs of stroke and to
act F.A.S.T. when stroke happens. “Don’t downplay your symptoms,” she says. “It’s better to
call 9-1-1 right away if you have any symptoms of stroke.”

Charles Stanley’s Story


“Take care of yourself. Get moving, lose weight, stop smoking—these steps will help people
avoid a stroke.”

—Charles Stanley, stroke survivor

Linda Stanley awoke to a loud noise in her home but was puzzled because she knew her
husband Charles should have been at work. She searched the house and called his name, but
she didn’t hear a response. When she entered the living room, she found Charles lying on the
floor. His work truck was still idling in the driveway. Linda wasted no time calling 9-1-1.

It turned out that Charles, who is African American, had a stroke, even though he was only 52
years old. African-American men are at a greater risk of stroke than any other group of men
and have strokes at younger ages.

“At first, I couldn’t do anything. People on TV sounded like they were speaking a strange
language,” Charles remembers. “I got so frustrated!”

Charles spent 3 days in the intensive care unit and 4 weeks in a rehabilitation center. He
worked with therapists to learn how to read, write, and walk again.

Charles realized that he had to make some changes in his lifestyle to avoid another stroke. He
lost nearly 100 pounds and worked with his health care team to get his blood pressure under
control. He also changed his eating habits and does an hour of cardio exercise every day.

Charles and Linda have advice for others at risk for stroke. “Take care of yourself. Get moving,
lose weight, stop smoking—these steps will help people avoid a stroke,” Charles recommends.
His wife adds, “Know the signs of stroke. Be ready to call 9-1-1 if you think someone’s having
a stroke.”

My story: The morning my dad suffered


a stroke and how home care saved our
family
This is my story on the morning my dad suffered a stroke and how home care saved
our family.

It was a Sunday morning in August 2016, when my sister dashed into my room and
jolted me awake. “Mei, come out now!” She exclaimed. Despite being in a half-
awoken state, I noticed her trembling voice and watery eyes, and I knew immediately
that something was terribly wrong.

I dashed out to the hall and saw my mother standing, and my father seated on the
sofa. In my head, i was wondering, what’s wrong? No one fainted. This thought
flashed through my mind in that split second as I rushed towards my parents and saw
my father having an unusual look in his eyes, with his mouth crooked and half of
his body shaking uncontrollably.

“He’s having a stroke! What do we do?” My mom and sister cried. I called the
ambulance right away. As as we left the house with the medics, I knew at that point,
that our lives is never going to be the same again. The darkest period in my entire
twenty-one years of life would begin from this moment.

The Diagnosis

After consulting our doctor, we found out that my dad had unfortunately suffered from
major Hemorrhagic Stroke which resulted in serious brain swelling. He had to
undergo Craniotomy surgery (removal of bone flap to allow brain to swell outwards
instead of compressing the other part of the brain). He remained in the Intensive
Care Unit for a month before getting transferred to the general ward for the next three
months.

Coping and Moving Forward

As a full-time student at that time, I had to rush down to the hospital every single day
after school to see my dad. I did my work in the ward and leeched onto free (but
unstable) Wi-Fi as much as I could. My sister at times went by days without being
able to visit my dad due to her long working hours. My mom, in her 50s, for four
entire months, travelled to the hospital every single day without fail and stayed there
from noon till night; even the hospital security guards chased her away. As much as
the freedom to go anywhere we want were robbed from us, my dad meant too much
to us to not be by his side when he needed us the most.

With his vital stats stabilising over the next 3 months, the hospital urged us to bring
him home as he did not require any more medical care. Most family members would
be delighted to hear this piece of news, but this statement from the hospital seemed
more like a bomb that dropped on us. With my father’s physical and mental
capacities taken away by the stroke, going home seemed impossible for
us. How are we going to take care of him at home? Who is going to monitor him
24/7? Are we skilled enough to do so? What if something happens at home? All
these questions flooded through our minds. We had no idea what home care was.
We were resistant to this idea because we believed that the hospital was the only
place that my dad could receive proper care at, that our minds could at least be at
ease with the doctors and nurses around.

The decision to engage in home care services

After exhausting every alternative, we decided to hire a home caregiver and brought
our dad home after 4 months of hospitalisation.
Today, after 6 months of home care for my dad, I say this is the best decision we could have made.

With medical supplies readily available in Singapore (we fortunately receive medical
subsidies from the government and claims from insurance), my dad is now
comfortably at home getting cared for by our caregiver. The care and attention given
to him by our caregiver is undivided and my family can now carry on with our daily
activities with an ease of mind. We do not have to worry when our home caregiver
takes leave as we are thankful that respite care services are readily available for my
family.

Growing Old Without Breaking the Bank


The thing about home care, is that we are able to get professional home
carenurses to care for my dad in the comforts of our own homes. It is a tremendous
relief to be able to get professionals to help us when we were clueless about being
first time caregivers to stroke patients. Getting help also provided us the luxury of
time and and ease of mind that our dad was properly taken care of by experienced
caregivers.

Furthermore, being in a hospital makes him susceptible to bacteria and viruses


especially when his immune system had weakened drastically due to his immobility,
therefore we understood from many doctors that the community is the best place for
my dad to receive his care in.

On top of that, I am thankful for nurses within the community whom we can reach out
to for care advices and clinical procedures that my dad may require from time to time,
which greatly save us the hassle of transporting my dad to the hospital solely for
something which could be easily done within the comfort of our home.

Home is wherever the family is, and I can’t be thankful enough that with the advent
of home care services, my dad is home with us without compromising on the care
that he is receiving.
Lastly, before I end this post, I would like to mention that stroke can happen to
anyone, regardless of age and gender. As the top 10 principle cause of death in
Singapore, according to Ministry of Health, it is crucial to educate ourselves
and recognise warning signs and symptoms of stroke. We need to know and seek
medical treatment promptly and learn how to mitigate the after-effects of stroke. Be
alert, and save a life today.

Note: I chose to be anonymous in this story, but here’s hoping that my experiences
would be able to to help you in your caregiving journey, and help you understand
more about home care services.

Award winning Home Care trusted by health professionals – Jaga-Me

At Jaga-Me, we believe that healthcare should be a social good – it is a basic human


need, and should be available to as many people as possible. We aim to del iver the
highest quality care through innovation and a commitment to building meaningful
relationships.

My name is Emma this is my stroke story


Published: September 27, 2016

My name is Emma, and I had just turned twenty nine, two weeks before my stroke.
I had just got home from work and served my children their dinner. I sat down to watch TV and
noticed there were spots in my vision, just like the spots you get from staring at the sun or light.

I thought to myself that it was slightly strange, but I was convinced it would go away at any second.
When I realised it wasn’t going away I said to myself “this is definitely strange”. I hadn’t been looking
at any light and it seemed to be getting worse, and it began to annoy me that I couldn’t see all of the
TV – I was even annoyed that I was missing a good part.

It suddenly dawned on me that it wasn’t normal, I got worried and called ’13 HEALTH’. To ask what it
could be. I was still torn between ‘it’s nothing and something is seriously wrong.

As I was speaking to the nurse I noticed my hand feeling strange and told her, I was still holding
onto the belief that I thought it was just mind over matter and said “I’m fine”.

The nurse said straight away “I’m connecting to an ambulance - just stay on the line”. I was still
telling her “I’m fine, I don’t need an ambulance” and still wondering about my vision. I was told
sternly “no those symptoms aren’t good”.

The ambulance team spoke to me asking me to give my details. I gave them, but I couldn’t
remember my phone number. I knew this was strange, but thought maybe I’m a bit panicky with
everything going on.

My only focus after that was remaining calm, to not alarm my children, or for them to see the
ambulance. I didn’t want them to be anxious, especially as my eldest son, as he is familiar with
tragedy - I didn’t want him ‘freaking out’.

I went out to the garage to wait for the ambulance to arrive. When we heard sirens in the distance I
quickly said goodbye to their dad, and said “I will be back shortly” I was still thinking and believing I
was fine.

Ryan closed the garage door.

I stood on the drive-way and as the ambulance approached, I began to walk the short distance to
the end of the drive-way. I took a few steps and as I looked down, I noticed I was walking
diagonally. As I looked up I saw one ambulance officer coming out of the slide door of the
ambulance, and another one jumping out of the front. Then I collapsed.

I was confused, I remembered the officer grabbing me and yelling to the others ‘I think this is our
patient’ - I remember feeling strange, like an out-of-body feeling.

I had some comprehension, and I knew what was going on, but at the same time was unable to
construct the words to communicate. It’s like I couldn’t control anything, I felt like my intelligence
and thoughts had been robbed. I remember thinking they must think I’m normally like this because
they don’t know me.

When I woke up I realised I couldn’t use my arm, and my speech sounded different. I was petrified.

The doctors weren’t telling me much, although they talked about stroke and used all sorts of words I
didn’t understand, they talked amongst themselves. The doctors told me they were waiting to speak
to the specialist neurologist, and asked me if I had my family coming? They would talk to me soon.

I still was thinking it would be nothing serious. I found the MRI scan, as it was next to my bed. I had
a look and found it said ‘confirmed: CVA’. I thought yay, it’s not a stroke. It is something else, and
probably nothing bad. Little did I know that CVA actually meant stroke!

The medical team came back with a specialist doctor and explained to me that I had a stroke, and
explained where in my brain I had had it. They gave me some resources, and explained the
medication they had given the night before. Medication that I’m on for life.

I was in total shock. I asked if I will see properly again and get movement in my arm back. The
doctors explained they were unsure, and can’t tell with a brain injury. You have to wait and time will
tell. If it starts to improve that means it is more likely to be able to make a full, or near full recovery.
They said I may never be back to 100%.

Words can’t describe that sinking and heart aching feeling. I felt so sad, and sorry, as the next day
was my Dad’s birthday - he would have to hear this news on his special day.

I was given further tests to find a cause, and they found that a blood clot had gone the wrong way
from a hole in my heart, into my brain.

I continued with rehab with the help and support of my stroke nurse and team, and at first I had
little hope. Then I began to learn to do things with my left hand, and it was my son and daughter
that were the biggest heroes. They would encourage me to colour and draw with them to ‘wake up
mummy’s hand’, as we’d explained to my 5 year old, that my hand was just sleeping. Over time,
dedication and hard work, it got better and better; improving strength - and I now pretty much have
it completely back.

I find the biggest struggle in my day-to-day life is the tiredness and my memory loss. It’s not the ‘it’s
been a tough week at work’ tiredness. Nor the have a glass of wine to ‘get on with it’ or the ‘have a
strong coffee and you’ve got this’. And you can’t fix it with an attitude of no-one will know I’m
stressed. Nope, this tiredness comes on suddenly, where ever you are, and literally, completely wipes
you out.

The feeling makes ordinary things difficult, if not impossible to do. Simple things like writing or
having a conversation; deep thinking and any intelligent thinking required at work is - impossible.

I feel like I’m trapped inside my own head, and it is entirely exhausting. It’s non-negotiable and
utterly unshakeable. I want to retreat away from society in fear of people not understanding. It must
be difficult for people to understand when looking at me, you can’t see the cause it is hidden. You
can’t see the damage to my brain, it is not self-evident when I’m doing something and literally forget
what I am doing, or why I am there or what is happening. Doctors call it cognitive fatigue and tell me
there is no treatment or cure.

Four weeks after my major stroke, I had a minor one caused by remnants of clotting from the
previous stroke, and a seizure, which can happen in around five per cent of stroke survivors.

So then came a lot more testing, an increase of medications, and heightened emotions. Doctors keep
telling me how lucky I am and how important it was that I got to the hospital so early. I received
thrombolysis treatment.
They described the procedure used to break-down the clot to prevent further damage. I educated
myself and found out more about the F.A.S.T mnemonic. Why speed and time is so important, as
well as constantly being reminded that ‘you’re so young to have a stroke’ by everyone.
I learned that stroke one of Australia’s biggest killers, it kills more women than breast cancer, and
more men than prostate cancer!

I am so grateful to the ambulance officers, paramedics, 13Health, hospital staff and the stroke
rehabilitation teams - I now realise I am truely “lucky in an unlucky way”.

Emma xo

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