Stroke risk factors, genetics, and prevention
Open accessAbstract
Stroke is a heterogeneous syndrome, and determining risk factors and treatment depends on the specific pathogenesis of stroke. Risk factors for stroke can be categorized as modifiable and nonmodifiable. Age, sex, and race/ethnicity are nonmodifiable risk factors for both ischemic and hemorrhagic stroke, while hypertension, smoking, diet, and physical inactivity are among some of the more commonly reported modifiable risk factors. More recently described risk factors and triggers of stroke include inflammatory disorders, infection, pollution, and cardiac atrial disorders independent of atrial fibrillation. Single-gene disorders may cause rare, hereditary disorders for which stroke is a primary manifestation. Recent research also suggests that common and rare genetic polymorphisms can influence risk of more common causes of stroke, due to both other risk factors and specific stroke mechanisms, such as atrial fibrillation. Genetic factors, particularly those with environmental interactions, may be more modifiable than previously recognized. Stroke prevention has generally focused on modifiable risk factors. Lifestyle and behavioral modification, such as dietary changes or smoking cessation, not only reduces stroke risk, but also reduces the risk of other cardiovascular diseases. Other prevention strategies include identifying and treating medical conditions, such as hypertension and diabetes, that increase stroke risk. Recent research into risk factors and genetics of stroke has not only identified those at risk for stroke but also identified ways to target at-risk populations for stroke prevention.
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Physical inactivity or sedentary behavior is a significant global risk factor for mortality associated with numerous adverse health outcomes including stroke.
“Physical inactivity, or sedentary behavior, is a significant global risk factor for mortality associated with numerous adverse health outcomes including stroke [2].”
From Patient-Perceived Factors Influencing Physical Activity Sensor Use in Stroke Prevention and Rehabilitation: Systematic Review of Qualitative Studies Using Thematic Synthesis (2026) · cites this paper as [2]
The Modifiable Risk Factors section says physical inactivity is associated with many poor health effects, including stroke, and that active people have lower stroke and stroke-mortality risk. It does not establish physical inactivity as a significant global risk factor for mortality generally; its statement about global burden concerns stroke, not inactivity. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHypertension is the most significant modifiable risk factor for stroke and can be effectively managed through medical and lifestyle interventions including pharmacotherapy, physical activity, dietary changes, and weight management.
“Hypertension, for example, the most significant modifiable risk factor for stroke, can be effectively managed through both medical and lifestyle interventions, including pharmacotherapy, PA, dietary changes, and weight management.”
From Patient-Perceived Factors Influencing Physical Activity Sensor Use in Stroke Prevention and Rehabilitation: Systematic Review of Qualitative Studies Using Thematic Synthesis (2026) · cites this paper as [2]
The Modifiable Risk Factors section calls hypertension the most important modifiable stroke risk factor and says medication, dietary change, and increased physical activity help control it. Targeted Risk Factor Modification also recommends combining lifestyle modification with pharmacological therapy. The paper links excess weight to blood pressure, but the passages do not establish weight management specifically as an effective hypertension intervention. (LLM, conf=0.84)
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- Authors
- Boehme, A. K., Esenwa, C., & Elkind, M. S. V.
- Affiliations
- Columbia University (US)
- Venue
- Circulation Research
- Published
- 2017-02-03
- Volume
- 120
- Issue
- 3
- Pages
- 472-495
- ISSN
- 0009-7330 (ISSN-L)
- 1524-4571
- PMC
- PMC5321635
- OpenAlex
- W2585605401
- Cited by
- 1,952
- References
- 315
- Citations by year
- 2026: 182 · 2025: 323 · 2024: 322 · 2023: 287 · 2022: 292 · 2021: 245 · 2020: 155 · 2019: 89 · 2018: 35 · 2017: 19
- FWCI
- 10.70
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Circulation Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Neurological Disorders and Stroke (T32NS007153)
- Topics
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- stroke, stroke risk factors, ischemic stroke, hemorrhagic stroke, modifiable risk factors, non-modifiable risk factors, hypertension, smoking, physical inactivity, diet, genetic polymorphism, atrial fibrillation, genetic susceptibility, environmental interaction, stroke prevention, lifestyle modification, smoking cessation, antihypertensive therapy, diabetes mellitus, inflammation, infection, pollution, cardiac arrhythmias
- MeSH terms
- Brain Ischemia, Clinical Trials as Topic, Diabetes Mellitus, Diet, Humans, Hypertension, Life Style, Risk Factors, Smoking, Genetic Predisposition to Disease, Stroke
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