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5 FAQs on stroke prevention

The risk of suffering a stroke is widespread in the United States. Every 40 seconds, someone in the U.S. has a stroke - and every 40 minutes someone dies of one.

Not all of the risk factors for stroke are within a person's control. But it's still important to know the potential consequences and what can be done to prevent them.

What is the difference between a heart attack and a stroke?

Though they share certain similarities, stroke and heart attack are different medical issues.

A stroke occurs when blood supply is cut off to the brain, either partially or entirely. Like a heart attack, it involves blood vessels, but it affects the brain, not the heart itself. Deprived of oxygen from the blood flow, brain cells begin to die within only a few minutes.

Are there different types of strokes?

Often, what blocks the flow of blood to the brain is a clot in the blood vessels. Medically, this is called a "transient ischemic attack" (TIA). More colloquially, it could be called a mini-stroke.

Most strokes -- about 87 percent, are mini-strokes that don't cause lasting damage. But having had such an attack increases the risk of having a more serious stroke or heart attack later. It raises the risk by nearly 10 times as much.

A hemorrhagic stroke occurs when a blood vessel bursts within the brain and results in bleeding. The classification and consequences depend on the blood vessel that burst. When an artery or ordinary blood vessel is involved, it is called an "aneurism."

Do drugs that try to prevent strokes by thinning the blood have dangerous side effects?

Thousands of patients have sued drugmakers, contending that a widely used blood thinner called Xarelto led to massive bleeding resulting in fatalities and serious injuries.

In March 2019, two of these drugmakers, Johnson & Johnson and Bayer, agreed to pay $775 million to settle lawsuits by 25,000 patients. The patients contended the drug companies failed to warn of the risk of rampant bleeding that would not respond to treatment.

The drug companies did not admit wrongdoing. But the litigation with thousands of plaintiffs shows that concern about harmful effects from Xarelto is widely shared.

What are the most common risk factors for stroke?

Some factors relate to lifestyle choices. It reduces risk to avoid or quit smoking, to get enough exercise, and to maintain a healthy diet.

The percentage of Americans with conditions associated with stroke risk, however, is high. About 1 in 3 U.S. adults have obesity, diabetes or some other condition or habit that can make a stroke more likely.

Are older people especially at risk for strokes?

The risk of suffering a stroke does generally increase with age. But a stroke can occur at any age.

That is why the American Heart Association recommends that screening for heart and vascular disease should start at age 20. And data from the Centers for Disease Control and Prevention suggests that about one third of people who must be hospitalized for stroke are younger than 65 years old.

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