A multitude of risk factors can precipitate a stroke, yet the impact of certain conditions or behaviors may exert a more potent influence on the likelihood of experiencing a severe stroke rather than a mild one, as suggested by recent research. Stroke is recognized as the third leading cause of mortality globally, resulting in an estimated 5.5 million deaths each year, according to a study conducted in November 2018.

"A stroke is an event where the central nervous system sustains damage due to vascular causes, which can be either a blockage, responsible for approximately 80% of strokes in the United States, or a hemorrhage due to a ruptured blood vessel, accounting for the remaining 20%," explained Dr. Steve Messe, a professor of neurology at the University of Pennsylvania, who was not affiliated with the study. The US Centers for Disease Control and Prevention identify hypertension (elevated blood pressure), atrial fibrillation (irregular heartbeat), and smoking as some of the risks associated with stroke.

The study, published in the journal Neurology, reanalyzed data gathered between 2007 and 2015 from the INTERSTROKE study. Participants were enrolled from 142 centers across 32 countries and were administered standardized questionnaires to assess risk factors. The researchers examined 13,460 stroke patients and classified the cases into severe and non-severe stroke categories using a six-point scale that quantifies a patient's level of disability. "Our research investigated the correlation between modifiable risk factors and the severity of stroke.

We found that three risk factors—elevated blood pressure, smoking, and atrial fibrillation—were associated with a higher risk of severe stroke compared to mild-moderate stroke," stated Dr. Catriona Reddin, the principal investigator of the study, in an email. "This underscores the significance of managing these risk factors, in conjunction with other stroke risks."

Previous studies have already established a link between obesity, high blood pressure, and high cholesterol levels and the incidence of stroke, which aligns with the findings of this new research. "Our study underscores the particular importance of certain risk factors in severe stroke cases. We hope that the dissemination of our study's outcomes will highlight the critical nature of managing stroke risk factors," said Reddin, a geriatric medicine specialist registrar at University Hospital Galway and a research fellow at the University of Galway in Ireland.

High blood pressure, often underestimated by the general population, is a significant risk factor, especially considering that half of Americans suffer from it, according to Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, who was not involved in the study. (Dr. Freeman also serves as a medical advisor for WeWard, an activity-tracking application that motivates users to be more active by allowing them to earn points exchangeable for prizes or charitable donations.

He has not received any financial compensation for this role.) Hypertension can stem from an unhealthy lifestyle or certain health conditions, such as diabetes or obesity, and can also occur during pregnancy. This condition can lead to damage in the heart's tissue and conduction system, potentially resulting in atrial fibrillation, according to the Cleveland Clinic.

Smoking is strongly correlated with cardiovascular disease and can cause blood clots, obstructing blood flow to the heart and brain. "It's not just tobacco smoke; marijuana smoke or even severe air pollution can significantly contribute to increased vascular events and risks," Freeman noted. Adopting a plant-based diet, increasing physical activity, reducing stress, fostering relationships, and ensuring adequate sleep can all contribute to lowering the risk of stroke, according to Freeman. Reducing salt intake, avoiding high-cholesterol foods, and consuming fresh fruits and vegetables can help lower blood pressure. Regular physical activity not only helps control blood pressure but also aids in maintaining a healthy weight.

Individuals who are more physically active have been found to have a 25% to 30% lower risk of stroke compared to those who are the least active, as reported by the American Heart Association. Exercise has also been shown to mitigate the adverse effects of stress, including blood pressure spikes, by increasing the production of endorphins.

In the event that you suspect a stroke in yourself or someone nearby, it is crucial to immediately call emergency services and seek emergency room care, as advised by Dr. Messe. Stroke treatment is time-sensitive, and prompt action is essential. The American Heart Association recommends using the acronym FAST to recognize the warning signs of a stroke:

• Face: Attempt to smile. Is one side of the face drooping?
• Arms: When raising both arms, does one arm drift downward?
• Speech: Is there difficulty speaking? Is speech slurred?
• Time: If any of these signs are observed, call emergency services immediately.