Comprehensive Stroke Center

​​​​​Although few people realize it, everyone is at some risk for stroke. Stroke is the leading cause of long-term disability in the United States, and is the third leading cause of death in the United States.

The good news is that many strokes can be prevented. The UW Medicine Stroke Center at Harborview provides prevention services for patients at every stage, from those who simply want to know their risk, to stroke victims who require treatment to avoid future attacks and those needing rehabilitation following a stroke.

You can prevent a stroke by: 
  • Managing chronic conditions, such as: 
  • Making healthy lifestyle choices, such as: 
    • Following a heart healthy diet and exercising regularly. Visit Healthfinder.gov for more information.
    • Stopping smoking
  • Having medical interventions, including drug therapy for chronic conditions, surgery to treat severe narrowing of large blood vessels

High blood pressure and stroke

A blood pressure reading of 140/90 mm Hg or higher is considered hypertension, the medical term for high blood pressure. High blood pressure is the number one cause of stroke.  If present, high blood pressure considerably increases the risk of both ischemic stroke and hemorrhagic stroke. Some estimates suggest that if high blood pressure could be eliminated, the number of strokes that occur would be cut in half.

High blood pressure is under-recognized and under-treated. The only way to find out if you have high blood pressure is to have it checked! If you want to find out, go to your health-care professional's office, a local drug store, or, in many towns, a local fire department and ask to have your blood pressure measured.

More information about hypertension is available from the ​National Heart Lung and Blood Institute.

High Cholesterol and stroke

A high blood cholesterol level is associated with an increased risk of ischemic (nonhemorrhagic) stroke. The cholesterol causes plaques that can narrow and block blood vessels in the brain, increasing the chance of both large artery stroke and small artery stroke.

Numerous studies have shown that lowering high cholesterol levels, especially with medications known as statins, leads to a decreased risk of having a stroke or a heart attack. Cholesterol treatment guidelines to prevent heart attack apply equally well to stroke prevention.

For more information, visit the National Cholesterol Education Program.

Heart disease and stroke

Heart attack and stroke have many of the same causes. The disease of the blood vessels called atherosclerosis is the most common cause of heart attacks and also causes most strokes. Treating a person to reduce their risk of a heart attack will also decrease the risk of a stroke. Heart disease can cause a stroke when a blood clot forms in, or passes through the heart. The blood clot can travel to the brain, block an artery, and cause an embolic stroke.

A number of conditions increase a person’s chances of having a blood clot form in their heart. These include:
  • An irregular heart beat; the most common form is atrial fibrillation
  • A serious heart attack, or myocardial infarction
  • A Patent Foramen Ovale, or PFO, which is a hole connecting the right (venous) and left (arterial) sides of the heart that could allow blood clots that form in the veins of the legs to get into the arterial circulation and cause strokes. Researchers are working to determine the best treatment for this type of stroke.
  • An infection on a heart valve, or endocarditis

Treatments to prevent stroke will depend on the type of heart problem, but could include: 

  • Lifelong blood thinning for atrial fibrillation and heart attack
  • Closure of a PFO
  • Antibiotics and/or valve replacement surgery for endocarditis

Diabetes and stroke

People with diabetes have an increased risk of stroke. Complications of diabetes, such as stroke and kidney disease, can be reduced by improved control of blood sugar. There are two types of diabetes: Type I and Type II, which both result from a deficiency of insulin, a hormone produced by the pancreas gland. Good control of diabetes and reduction of other risk factors will lower a patient’s stroke risk.

Blood clots and stroke

Blood clots can cause block vessels that bring oxygen to the brain, causing an ischemic stroke. The greater than normal tendency to form blood clots is known as a hypercoaguable state.  Most conditions cause blood clots in the venous side of the blood circulation (on the way back to the heart) while only a few are known to cause arterial blood clots (leading away from the heart to the body’s parts).

If a person has a stroke where no other clear cause is found, health-care providers will do blood tests to determine whether venous hypercoaguable or aterial hypercoaguable conditions could be responsible. Blood clots can often be prevented with medication.

Talk to your health-care provider for more information.