According to the American Stroke Association, on average, someone in the United States has a stroke every 40 seconds. Although incidence of stroke has increased, more people are surviving stroke, and the death rate is declining. While age is the major risk factor, people with stroke are likely to have more than one risk factor.

Age:    

• People most at risk for stroke are older adults, particularly those with high blood pressure, who are sedentary, overweight, smoke, or have diabetes. Older age is also linked with higher rates of post-stroke dementia. Younger people are not immune, however. About 28 percent of stroke victims are under the age of 65.

Heart disease:

• Patients with one condition often have risk factors for the other, such as high blood pressure, atherosclerosis, hardening of the arteries, and diabetes.
• The risk of stroke increases during surgical procedures involving the coronary arteries, including coronary bypass operations and angioplasty. Coronary bypass poses the greater risk -- about 2-5 percent.
• Anti-clotting drugs used for treatment of heart disease and heart attacks slightly increase the risk for hemorrhagic stroke.
• A heart attack itself poses a high risk for stroke, which is about 2.5 percent in the first six months and 5 percent per year thereafter.

Obesity:

• Obesity may increase the risk for both ischemic and hemorrhagic stroke, independent of other risk factors that often co-exist with excess weight, including insulin resistance and diabetes, high blood pressure, and unhealthy cholesterol level. Weight that is centered around the abdomen--the so-called apple shape--has a particularly high association with stroke, as it does for heart disease, in comparison to weight distributed around hips--the so-called pear-shape.

Genetics:

• Genetics may also be responsible for many of the causes of stroke. Studies indicate that a family history of stroke, particularly in one's father, is a strong risk factor for stroke.

Stress:

• Stress also plays a role in patient's who suffer a stroke. One survey revealed that men who had a more intense response to stressful situations, such as waiting in line or problems at work, were more likely to have strokes than those who did not report such distress. In some people, prolonged or frequent mental stress causes an exaggerated increase in blood pressure, which in turn can increase the risk for stroke.

Depression:

• Depression has also been linked to higher risk for stroke and lower stroke survival rates. In one study, patients with severe depression had a 73% higher risk for stroke, and those with moderate depression had a 25% higher risk than average. The risk for stroke in African-Americans with depression was 160% higher than average.

Timing:

• Like heart attack and sudden cardiac death, stroke appears to be more common in the morning hours, perhaps due to a temporary rise in blood pressure at that time. Various studies point to a higher risk for stroke on weekends, Mondays, and holidays. The risk for hemorrhagic stroke may also be higher in the winter, particularly in older people with high blood pressure.