Strokes come on suddenly and can be deadly or debilitating, placing them among the scarier health concerns. Yet many people ignore stroke risk, mistakenly believing there's nothing to be done. While some strokes do come out of the blue, in many cases there are signs of the impending danger -- if you know what to look for.
Some risk factors are well known, such as being a longtime smoker or having high blood pressure or atrial fibrillation, but many come as big surprises. These ten surprising clues can alert you to a higher-than-normal risk of stroke. If one or more of these applies to you, you'll want to up your awareness, because acting fast can mean the difference between life and death.
1. You get migraines
Migraines, particularly those accompanied by aura -- visual disturbances such as flashing lights -- boost the risk of stroke by 21 percent. This comes from long-term studies in Iceland that followed men and women for 26 years. Researchers are looking for an underlying genetic risk factor that could contribute to migraine, heart attack, and stroke.
Scary fact: Migraine sufferers are also more likely to have a heart attack or peripheral artery disease, which causes narrowing blood vessels in the legs.
Best bet: The precise connection between migraines and stroke isn't understood, but both conditions involve blood vessels in the brain. Migraines occur when the blood vessels in the brain constrict, then swell, while ischemic strokes -- the most common kind -- are caused by a blood clot blocking an artery in the brain. With that in mind, some experts recommend taking steps to prevent and treat migraines, either with natural remedies or medication to minimize effects on blood vessels.
2. You're Hispanic
According to the American Stroke Association, Hispanics of both genders are much more likely to have a stroke than any other race. What's more, the strokes are more deadly: 33 percent of all deaths of Hispanic women are due to stroke, while in men it's a still startling 25 percent. Diet and other factors seem to paly a role, but researchers also predict that an underlying genetic predisposition will be discovered.
Scary fact: People of Hispanic descent also tend to have strokes earlier in life; the average age of stroke in Hispanics is 67, compared with 80 in whites.
Best bet: The higher risk of stroke in Hispanics is partially linked to higher rates of diabetes, high blood pressure, obesity, and metabolic syndrome, all of which up stroke risk, so controlling these underlying conditions can provide some protection.
3. You love bacon
If your diet includes regular consumption of processed meats such as sausage, bacon, lunch meats, ham, and hot dogs, your stroke risk is 23 percent higher. The scientific explanation isn't clear-cut, but researchers suggested that sodium in meat may increase risk both by boosting blood pressure and by causing vascular stiffness. Nitrate and nitrite preservatives may also contribute to stroke risk by a mechanism that isn't known yet. Of course, there are other foods that can trigger a stroke, but processed meat is among the worst culprits.
Scary fact: It's not just processed red meat that's the culprit; lower-fat deli meats such as turkey, chicken, and bologna were found to carry just as high a stroke risk.
Best bet: Make processed meats a special-occasion treat. Unfortunately, you can't just offset a bacon or salami habit by eating healthier overall; studies show that people who eat plenty of fruits, vegetables, and whole grains but who also eat large amounts of processed meats are still at higher risk.
4. You hate the gym
Sorry, couch potatoes, but that attachment to the remote really could kill you. Would you get off the couch if you knew that even moderate exercise could lower your risk of a nonfatal stroke by 20 percent and your risk of a fatal stroke by 30 percent? Overall stroke risk drops substantially with even moderate levels of cardiovascular fitness. Even a little helps. According to researchers, all you need is 30 minutes or more of aerobic activity -- brisk walking, for instance -- five times a week.
Scary fact: Lack of activity also makes strokes worse when they do happen. People who were less active before having a stroke had more severe strokes and didn't recover as fully afterwards, research shows.
Best bet: Build regular, moderate activity into your schedule. According to the Nurses Health Study, which followed 72,000 women between the ages of 40 and 65, regular exercise cut the risk of ischemic stroke by half.
5. You have diabetes
People with type 2 diabetes are two to three times more likely to have a stroke. And the risk can be even greater if you continue to smoke or develop hyperglycemia or atrial fibrillation. Strokes are also more severe and cause higher mortality in diabetics, particularly if their glucose levels were higher when they were admitted.
Scary fact: The increased stroke risk that comes with diabetes doesn't change, no matter how proactively you control the disease. According to recent research, being proactive about glucose control lowers the risk of vascular complications such as loss of vision but doesn't lower stroke risk.
Best bet: Taking hypertension medication and a statin to cut cholesterol lowers stroke risk considerably. And preventing diabetes by keeping active and losing weight lowers stroke risk as well.
6. You're African American
People of African-American descent are twice as likely to die from strokes as Caucasians. The risk comes with both a first stroke and with subsequent strokes. Also, in blacks strokes tend to occur earlier in life and to be more disabling if they aren't fatal. The genetic disorder sickle cell anemia also ups stroke risk because sickle-shaped cells can block blood vessels to the brain.
Scary fact: Between 6 and 8 percent of people with sickle cell anemia will have a stroke, and the danger is highest in children ages 2 to 10.
Best bet: You can't control genetics, but quitting smoking and making lifestyle changes to lose weight, lower blood pressure, and prevent diabetes can help reduce your stroke risk.
7. You like to kick back at the local bar
Would you cut back on the booze if you knew that three or more drinks a day can raise your stroke risk by 45 percent? That's the conclusion of a study published in the Annals of Internal Medicine, which followed 38,000 men between the ages of 40 and 75 for 15 years. There's also some alarming research -- albeit from a small study -- showing that the chance of stroke increases greatly in the first hour after consuming a drink.
Scary fact: Binge drinking, in particular, leads to a spike in stroke risk. And if you have high blood pressure and go on a bender, watch out; research found that drinking six drinks or more doubled the risk of stroke in men with hypertension.
Best bet: If you're a moderate drinker -- defined as having one or two drinks approximately every other day -- your risk of stroke is actually lower than it is for teetotalers. So limit your drinking to a few glasses (preferably of red wine, which is heart-protective) per week.
8. You're anemic
Anemia, caused by a lower-than-normal level of red blood cells, causes changes in the blood vessels of the brain, making it more vulnerable to a stroke and less able to counteract a stroke once it occurs. For some time, researchers have known that children and teenagers who were severely anemic had a high risk of stroke, but it's now known that even mild anemia ups stroke risk for adults, too.
Scary fact: New research published in February 2012 found that men who were only slightly anemic nonetheless had triple the chance of dying in the first year after a stroke.
Best bet: Treat anemia to increase red blood count with a diet high in iron or an iron supplement.
9. You buy your jeans in the husky or XL department
Being overweight is associated with higher stroke risk in three different ways: Above-average BMI, above-average waist circumference, and above-average waist-to-hip ratio all correlate with increased stroke risk. If you already have high blood pressure and high cholesterol, adding weight into the mix doesn't make as much of a difference because you're already at three times the average risk for stroke. But if your blood pressure and blood lipids are under control and you're still overweight, it's time to slim down.
Scary fact: An estimated 63 percent of men and 55 percent of women are considered overweight, and 30 percent are considered obese. If you're obese, your stroke risk skyrockets to as high as seven times that of the general population. Being overweight increases your risk of all types of heart disease, as well.
Best bet: Embark on a gradual, supervised weight-loss program with the goal of decreasing BMI to between 18.5 and 24.9. Guys, try to get down to a waist circumference of less than 40 inches. And gals, try for a waist measurement of less than 35 inches.
10. You don't like fruit or veggies
Study after study shows a direct relationship between the quantity and proportion of fruit and vegetables you eat and your stroke risk. Eat a diet low in fruits and veggies and high in saturated fat (such as meat) and carbs, and your stroke risk spikes. Eat a super-healthy diet in which half the food you eat comes from plants, and your stroke risk goes down in inverse proportion. Studies also show that specific antioxidants and phytochemicals present in carrots, citrus, white fruits (such as apples), greens, tomatoes, and other fruits and vegetables protect against stroke. One study found that an increase of one gram per day of white-fleshed fruits and vegetables is associated with a 9 percent lower risk of stroke. Another found that those who ate the most citrus fruits and juice had a 10 percent reduced risk of stroke compared with those eating none. That old-fashioned admonishment to eat an apple a day had science behind it after all.
Scary fact: Diet is one of the biggest contributors to stroke risk. Researchers at Harvard divided women into groups based on diet and found that those who ate the worst diet increased their total stroke risk by 47 percent, their ischemic stroke risk by 33 percent, and hemorrhagic stroke risk by 70 percent.
Best bet: Eat a fruit salad for breakfast. If your diet consists of close to 50 percent fruits and vegetables, you can slash your stroke risk by half.