Individuals who suffer from conditions or engage in activities like high blood pressure, atrial fibrillation (an irregular heartbeat), or smoking face not only a greater chance of having a stroke but may also experience more severe strokes compared to those who do not have these risk factors. This is according to research published in the online edition of Neurology® on November 13, 2024, which is a journal by the American Academy of Neurology.
Dr. Catriona Reddin from the University of Galway in Ireland, a member of the American Academy of Neurology and the study’s author, stated, “A stroke can result in disability or death, but many risk factors can be altered through lifestyle changes or medication. Our findings highlight the need to manage stroke risk factors, specifically high blood pressure, atrial fibrillation, and smoking, to prevent serious and life-altering strokes.”
The research included a diverse group of 26,948 participants from 32 different countries, with an average age of 62. Half of the individuals experienced a stroke, while the other half did not have any stroke history.
Among those who had strokes, 4,848 experienced severe strokes, while 8,612 had mild to moderate strokes. Severe strokes were characterized by outcomes such as being unable to walk independently, needing significant assistance with daily activities, or even resulting in death. On the other hand, mild to moderate strokes included outcomes ranging from no symptoms to needing some help with personal care but being able to walk unaided.
The researchers assessed various stroke risk factors for each participant, including blood pressure over 140/90 millimeters of mercury (mmHg), atrial fibrillation, diabetes, high cholesterol, smoking, alcohol use, diet quality, physical inactivity, psychological and social stress, and excess abdominal fat, often measured as waist-to-hip ratio.
The study compared the significance of these risk factors for severe strokes against mild to moderate strokes, as well as between individuals who had strokes of different severities.
Among those who experienced a severe stroke, 74% had high blood pressure, in contrast to 72% of individuals with mild to moderate strokes. Additionally, 11% of the severe stroke group had atrial fibrillation compared to 9% in the mild to moderate category. Furthermore, 30% of participants in both groups were current smokers.
After accounting for factors such as age, gender, nationality, and stroke type, the researchers discovered that individuals with high blood pressure were 3.2 times more likely to suffer a severe stroke and 2.9 times more likely to experience a mild to moderate stroke than those without high blood pressure.
They also found that people with atrial fibrillation had a 4.7 times higher likelihood of experiencing a severe stroke and a 3.6 times greater chance of having a mild to moderate stroke compared to those without the condition.
Furthermore, current smokers faced a 1.9 times higher risk of severe strokes and a 1.7 times higher risk of mild to moderate strokes than non-smokers.
Dr. Reddin concluded, “These results underline the critical importance of managing high blood pressure, which is globally the most significant modifiable risk factor for strokes. This is especially crucial for lower- and middle-income nations where there are rising rates of high blood pressure and younger individuals suffering strokes.”
One limitation of the study acknowledged by the authors is the lack of measurement for additional factors that could influence stroke severity. For instance, Dr. Reddin pointed out that smoking is linked to diseases like cancer and chronic obstructive pulmonary disease, which might also heighten stroke severity.
