In the United States, stroke ranks among the leading causes of death and long-term disability, according to the American Stroke Association. What makes it especially alarming is that many of its risk factors—like high blood pressure and high cholesterol—often go unnoticed until serious damage is already done.
Still, just because these risks can be “silent” doesn’t mean they’re uncontrollable. In fact, the Centers for Disease Control and Prevention estimates that up to 80% of strokes are preventable through lifestyle changes, including improved diet, regular physical activity, and more.
Few people understand this better than the doctors who treat strokes every day. These experts are deeply aware of the daily choices that influence stroke risk—for both themselves and their patients.
“I like to think about stroke prevention as something proactive,” says Dr. Anthony Kim, a vascular neurologist and medical director of the UCSF Stroke Center. “What can I do now to prevent a stroke later?”
Here are the key habits stroke specialists say they personally avoid—and why you should, too:
1. Leading a Sedentary Lifestyle
Dr. Arthur Wang, director of endovascular neurosurgery at Tulane University School of Medicine, warns that inactivity is a major, yet modifiable, risk factor for stroke.
There’s no single definition of a sedentary lifestyle, but it generally involves spending too much time sitting or lying down, and not enough time moving.
“Regular physical activity helps keep arteries clear by preventing plaque buildup,” Wang explains. He recommends aiming for about 30 minutes of moderate exercise at least five days per week.
That can include walking, biking, gardening, or attending a fitness class—whatever gets you moving.
2. Ignoring High Blood Pressure
“Blood pressure, blood pressure, blood pressure—that’s the number one issue,” emphasizes Dr. Kim.
High blood pressure is the most significant modifiable risk factor for stroke. Left unmanaged, it can quietly damage your blood vessels over time, drastically increasing stroke risk.
“If we could magically eliminate high blood pressure across the U.S., we’d see 60% fewer strokes,” Kim says. “It’s the leading cause, and it’s often symptomless, which is why we call it the ‘silent killer.’ You need to have it measured, monitored, and managed.”
3. Skipping Routine Health Check-Ups
“Most stroke risk factors don’t produce obvious symptoms,” says Dr. Wang. “You wouldn’t know your blood pressure or cholesterol is high unless you get screened.”
That’s why it’s critical to schedule regular check-ups with your primary care provider. Routine screenings can catch high blood pressure, elevated cholesterol, abnormal blood sugar, and other risk factors early—before they lead to serious health issues.
“It’s essential for patients to stay on top of these screenings, especially because so many stroke risk factors don’t show up in noticeable ways,” Wang adds.
Doctors can also evaluate your non-modifiable risk factors, such as gender, race, or family history. “Women are at greater risk of stroke, and rates are higher among Black individuals,” Wang notes. “Also, a personal or family history of stroke significantly raises your own risk.”
4. Smoking
Both Dr. Kim and Dr. Wang list smoking as one of the most harmful habits when it comes to stroke prevention.
“Smoking significantly raises your risk of stroke and heart disease,” Kim says. “It damages blood vessels, causing them to narrow over time, which can eventually block blood flow to the brain. That’s exactly how a stroke happens.”
Avoiding these common habits—and replacing them with healthier ones—can go a long way toward reducing your risk. As stroke doctors emphasize, prevention isn’t about perfection. It’s about staying informed, being proactive, and taking small steps each day to protect your brain and heart.
Drink Excessively
You probably already know that alcohol isn’t great for your health—it’s tied to various cancers, liver disease, and yes, an increased risk of stroke. Dr. Anthony Kim confirms this, noting a clear connection between heavy alcohol use and higher chances of heart disease and stroke.
According to the CDC, excessive drinking is defined as consuming more than four drinks in a single sitting for women or five for men. Weekly, drinking more than eight drinks for women or 15 for men also counts as excessive.
The general guideline? Women should stick to no more than one drink a day, and men no more than two, says Kim—standards supported by the Dietary Guidelines for Americans.
Neglect a Healthy Diet
Diet plays a critical role in managing stroke risk. That means cutting back on foods high in saturated fat, added sugar, and salt, says Dr. Arthur Wang. Dr. Kim adds that too much salt, in particular, is directly tied to high blood pressure—one of the most important risk factors for stroke.
So what should you eat? Dr. Kim points to Michael Pollan’s well-known advice: “Eat food. Not too much. Mostly plants.” A balanced diet focused on fruits, vegetables, whole grains, and lean proteins can go a long way toward protecting your heart and brain.
Ignore Medical Treatment or Warning Signs
With strokes being as common as they are, it’s vital to recognize the signs and seek treatment immediately. According to Dr. Kim, stroke treatments are most effective when administered as early as possible.
“Because strokes aren’t always painful and symptoms can vary a lot, awareness is key,” he explains.
To help people remember the warning signs, Kim recommends the acronym FAST, as promoted by the American Stroke Association:
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Face drooping
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Arm weakness
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Speech difficulty
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Time to call 911
“These aren’t all the possible symptoms of a stroke, but if any of them happen suddenly, it’s a strong signal something could be wrong,” Kim says.
Once again, speed is everything. The sooner someone receives medical attention, the better their chances of recovery.
