The risks of cerebrovascular disease and how to prevent them

By NHS Choices Last updated Apr 23, 2021 7

There are nine risk factors for cerebrovascular disease.

They are:

high blood pressure (hypertension)
smoking
poor diet
high blood cholesterol
lack of exercise
being overweight or obese
diabetes
excessive alcohol consumption
stress

Many of the risk factors for cerebrovascular disease are linked, which means that if you have one it is likely you will also have others.

For example, people who drink excessive amounts of alcohol often have poor diets and are more likely to smoke. Also, someone who is overweight or obese is more likely to have high blood pressure, diabetes and high cholesterol.

Addressing one risk factor, such as giving up smoking, will bring important health benefits. However, to significantly reduce the risk posed by cerebrovascular disease you need to look at your lifestyle as a whole. In particular, you need to consider:

your weight
your diet
how active you are and the amount of regular exercise you do
whether you need to stop smoking
how much alcohol you drink
your stress levels

As well as reducing your risk of developing cerebrovascular disease, making changes to your lifestyle will also lower your risk of having other serious health conditions, such as coronary heart disease, heart attack and cancer.

High blood pressure

High blood pressure is one of the most significant risk factors for cerebrovascular disease. This is because the increase in blood pressure damages the walls of the brain’s blood vessels, increasing the risk of a blood clot forming or an artery rupturing (splitting). Both of these can trigger a stroke.

If you have high blood pressure, you are four times more likely to have a stroke than someone with healthy blood pressure.

Not taking enough regular exercise increases your chances of developing high blood pressure and high cholesterol (see below for advice about how much exercise you should be doing each week).

You can also prevent high blood pressure by eating healthily, maintaining a healthy weight, not smoking and drinking alcohol in moderation.

Read more about preventing high blood pressure.

Smoking

Smoking is also a major risk factor for cerebrovascular disease because the toxins in tobacco can damage and narrow the blood vessels that supply the brain. Smoking also causes high blood pressure.

It is estimated that a person who smokes 20 cigarettes a day is six times more likely to have a stroke than someone who does not smoke.

Therefore, if you smoke it is strongly recommended that you give up as soon as possible. Your GP will be able to provide you with helpful advice, and they can prescribe medication to help you stop smoking.

The NHS Smokefree service also provides useful information, advice and support. You can speak to an adviser by calling their free helpline on 0800 022 4 332 (Monday to Friday, 9am-8pm and Saturday and Sunday, 11am-4pm).

Diet

A diet that contains a high amount of saturated fat and salt can lead to high blood pressure, high cholesterol and narrowing of the arteries, which are all risk factors for cerebrovascular disease.

A low-fat, high-fibre diet that includes whole grains and at least five portions of fresh fruit and vegetables a day is recommended for a healthy heart.

You should limit the amount of salt in your diet to no more than 6g (0.2oz or 1 teaspoon) a day. Too much salt will increase your blood pressure.

Also, avoid eating foods that are high in saturated fat as these foods will increase your cholesterol level. Foods that contain high levels of saturated fat include:

meat pies
sausages and fatty cuts of meat
butter
ghee – a type of butter that is often used in Indian cooking
lard
cream
hard cheese
cakes and biscuits
foods that contain coconut or palm oil

Foods high in unsaturated fat can help decrease your cholesterol level. These foods include:

oily fish
avocados
nuts and seeds
sunflower oil
rapeseed
olive oil

High blood cholesterol

High blood cholesterol can cause your arteries to narrow, increasing your risk of developing a blood clot.

Not exercising regularly puts you at risk of getting high blood pressure and high cholesterol. Being physically inactive also increases your chances of becoming overweight (see below).

Exercise

To maintain a good level of health, the Department of Health recommends that you do at least:

150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or fast walking, every week, and
muscle-strengthening activities on two or more days a week that work all major muscle groups (the legs, hips, back, abdomen, chest, shoulders and arms)

Alternatively, you could do:

75 minutes (1 hour and 15 minutes) of vigorous-intensity aerobic activity, such as running or a game of singles tennis every week, and
muscle-strengthening activities on two or more days a week that work all major muscle groups (the legs, hips, back, abdomen, chest, shoulders and arms)

Another alternative would be to do:

a equivalent mix of moderate- and vigorous-intensity aerobic activity every week, for example two 30-minute runs plus 30 minutes of fast walking, and
muscle-strengthening activities on two or more days a week that work all major muscle groups (the legs, hips, back, abdomen, chest, shoulders and arms)

Read more about the physical activity guidelines for adults.

Weight

Being overweight or obese increases your risk of developing a number of serious health conditions, such as diabetes and high blood pressure.

To lose weight, you need to combine regular exercise with a calorie-controlled diet. After you have reached your ideal weight, you should aim to maintain it by eating healthily and exercising regularly.

You can use the healthy weight calculator to calculate your body mass index (BMI) and get tips about how to lose weight. You can also read more about losing weight.

Diabetes

The high blood sugar levels associated with diabetes can damage the body’s organs and arteries.

If you have type 1 diabetes, you will need regular insulin treatment to keep your blood sugar levels normal. You will also need to look after your health very carefully and, if necessary, make changes to your lifestyle.

If you have type 2 diabetes, it may be possible to control your symptoms by making some simple lifestyle changes, such as exercising regularly and eating healthily. However, you may eventually need medication (tablets or injections) to keep your blood glucose normal.

Alcohol

Drinking excessive amounts of alcohol can increase your cholesterol and blood pressure levels.

If you drink, you should not exceed the recommended daily alcohol limits. These are:

3-4 units a day for men
2-3 units a day for women

One pint of ordinary strength beer, lager or cider contains two units of alcohol, and a small glass of wine (125ml) or a single pub measure (25ml) of spirits contains one unit.

You should visit your GP if you are finding it difficult to moderate your drinking. Treatments such as counselling and medication are available to help you reduce your alcohol intake.

Read more about alcohol units and alcohol misuse.

Stress

Reducing the amount of stress in your life may help you control your blood pressure more effectively, as well as keeping your blood sugar levels under control. Both of these will help reduce your risk of getting cerebrovascular disease.

Regular exercise has been shown to reduce stress levels, as have relaxation techniques such as deep breathing and yoga.