Stroke is a leading cause of death in men, killing almost the same number of men each year as prostate cancer and Alzheimer’s disease combined. Stroke is also a leading cause of long-term disability, and men under age 44 are hospitalized for ischemic stroke at a higher rate than women in the same age group.

These facts are alarming, but there is good news: About 4 in 5 strokes are preventable. That’s why it’s important to know your risk for stroke and take action to reduce the risk.

A stroke, sometimes called a brain attack, happens when blood flow to an area of the brain is blocked or when a blood vessel in the brain bursts. When brain cells are starved of oxygen, they die. Stroke is a medical emergency.

It’s important to get treatment as soon as possible (see sidebar). A delay in treatment increases the risk of permanent brain damage or death.

High blood pressure, also called hypertension, is a major risk factor for stroke.

Nearly half of men (47%) have high blood pressure (greater than or equal to 130/80 mm Hg) or are taking medicine for their blood pressure. Four out of 5 men with high blood pressure do not have their blood pressure controlled.

Half of U.S. men, or 17.3 million people, who are recommended to take medicine for high blood pressure aren’t treated or aren’t taking medicine. Two out of 3 of these men have a blood pressure greater than or equal to 140/90 mm Hg.

Half of men who are taking medicine for high blood pressure but whose blood pressure is uncontrolled have a blood pressure greater than or equal to 140/90 mm Hg.

Other risk factors for stroke include the following:

• Smoking damages blood vessels, which can cause a stroke. About 1 in 6 men smoke. Men are also more likely to be smokers than women are.
• Overweight and obesity. Having overweight or obesity increases stroke risk. About 3 in 4 men in the United States have overweight or obesity.
• Diabetes increases stroke risk because it can harm blood vessels in the brain. About 1 in 9 men have diabetes.
• Too much alcohol. Drinking too much alcohol can raise blood pressure levels and increase the risk for stroke. It also increases levels of triglycerides, a form of fat in your blood that can harden your arteries. Men are more likely than women to drink too much alcohol.
• Not enough physical activity. Not getting enough physical activity can lead to other health conditions that can raise the risk for stroke. In 2017, fewer than 1 out of 3 men met the guidelines for aerobics and muscle strengthening.

Active and healthy, Adrian thought he was the last person who needed to think about stroke. But Adrian did not realize that he had an increased risk of stroke due to family history.

Almost half of African Americans have a risk factor that can lead to a stroke.

• More than 2 in 5 African American men have a blood pressure greater than or equal to 140/90 mm Hg or are taking medicine to control their blood pressure. High blood pressure is more severe in African American men than in white men. More than 3 in 5 African American men with a blood pressure greater than or equal to 140/90 mm Hg or who are taking medicine to control their blood pressure do not have it under control.
• About 1 in 9 African American men have been diagnosed with diabetes, and many more have the disease but do not know it.
• Sickle cell disease, a common genetic disorder in African Americans, can lead to a stroke. About 1 in 365 black or African American babies are born with sickle cell disease.
• About 1 in 5 African American men smoke.
• About 7 in 10 African American men have overweight or obesity.
• Eating too much salt, or sodium, can raise your blood pressure, putting you at higher risk of stroke. Researchers think there may be a gene that makes African Americans more sensitive to the effects of salt, which in turn increases the risk of developing high blood pressure.

• One in 4 Hispanic men has a blood pressure greater than or equal to 140/90 mm Hg or is taking medicine to lower blood pressure—a major risk factor for stroke. More than half of Hispanic men with blood pressure greater than or equal to 140/90 mm Hg or who are taking medicine to control their blood pressure do not have it under control.
• About 1 in 7 Hispanic men have been diagnosed with diabetes, and many more have the disease but do not know it. Diabetes is also more common in people of Mexican and Puerto Rican ancestry than in people of Cuban or Central/South American ancestry.
• About 1 in 7 Hispanic men smoke.
• About 4 in 5 Hispanic men have overweight or obesity.

Most strokes can be prevented by keeping medical conditions under control and making healthy lifestyle changes:

Know your ABCS of heart and brain health:

• Aspirin: Aspirin may help reduce your risk for stroke, but you should check with your doctor before taking aspirin, because it can make some types of stroke worse. Before taking aspirin, talk with your doctor about whether it is right for you.
• Blood pressure: Control your blood pressure with healthy lifestyle changes (see below). If a blood pressure medicine is prescribed, take it as directed. Learn more about blood pressure.
• Cholesterol: Manage your blood cholesterol with healthy lifestyle changes. If a cholesterol medicine is prescribed, take it as directed. Learn more about cholesterol.
• Smoking: Don’t start smoking. If you do smoke, learn how to quit.

Make lifestyle changes:

• Eat healthy: Choose healthy foods, including foods with less salt, or sodium, to lower your blood pressure and foods that are rich in fiber and whole grains to manage your cholesterol. Learn more about healthy eating basics from ChooseMyPlate.gov, as well as small steps you can take to boost your healthy eating habits from the “Live to the Beat” campaign.
• Get regular physical activity: Regular physical activity helps you reach and maintain a healthy weight and keeps your heart and blood vessels healthier. Adults age 18 and older should get at least 150 minutes (2 hours and 30 minutes) of physical activity each week and do muscle strengthening activities on 2 or more days each week.Find inspiration and tips for getting regular physical activity from the “Live to the Beat” campaign.

Work with your health care team:

• Talk to your doctor about your chances of having a stroke, including your age and whether anyone in your family has had a stroke. Learn how to find the right doctor for you from the “Live to the Beat” campaign.
• Get other health conditions under control, such as diabetes or heart disease.

During a stroke, every minute counts! Fast treatment can lessen the brain damage that stroke can cause.

By knowing the signs and symptoms of stroke, you can take quick action and perhaps save a life—maybe even your own.

What are the signs of stroke in men and women?

• Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
• Sudden confusion, trouble speaking, or difficulty understanding speech.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
• Sudden severe headache with no known cause.

Call 9-1-1 right away if you or someone else has any of these symptoms.

Act F.A.S.T. to identify stroke

Act F.A.S.T. to help stroke patients get the treatments they need.

The stroke treatments that work best are available only if the stroke is recognized and diagnosed within 3 hours of the first symptoms. Stroke patients may not be eligible for these if they don’t arrive at the hospital in time.

If you think someone may be having a stroke, act F.A.S.T. and do the following test:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?

T—Time: If you see any of these signs, call 9-1-1 right away.

Note the time when any symptoms first appear. This information helps health care providers determine the best treatment for each person.

Do not drive to the hospital or let someone else drive you. Call 9-1-1 for an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room.

What should I do to treat a transient ischemic attack (“mini-stroke”)?

If your stroke symptoms go away after a few minutes, you may have had a transient ischemic attack (TIA), also sometimes called a “mini-stroke.” Although brief, a TIA is a sign of a serious condition that will not go away without medical help.

Unfortunately, because TIAs clear up, many people ignore them. But paying attention to a TIA can save your life. If you think you or someone you know has had a TIA, tell a health care team about the symptoms right away.

On the way to the hospital

If someone you know shows signs of stroke, call 9-1-1 right away.

Do not drive to the hospital or let someone else drive you. The key to stroke treatment and recovery is getting to the hospital quickly. Yet 1 in 3 stroke patients never calls 9-1-1.

Calling an ambulance means that medical staff can begin life-saving treatment on the way to the emergency room.

Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly than people who do not arrive in an ambulance. This is because emergency treatment starts on the way to the hospital. The emergency workers may take you to a specialized stroke center to ensure that you receive the quickest possible diagnosis and treatment.

The emergency workers will also collect valuable information that guides treatment and alert hospital medical staff before you arrive at the emergency room, giving them time to prepare.

Learn more about the important role emergency medical services (EMS) plays in improving stroke care.

At the hospital

At the hospital, health professionals will ask about your medical history and the time your symptoms started.

Brain scans will show what type of stroke you had. You may also work with a neurologist who treats brain disorders, a neurosurgeon who performs surgery on the brain, or a specialist in another area of medicine.

Treating ischemic stroke

If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, you may get a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic.

tPA improves the chances of recovering from a stroke. Studies show that patients with ischemic strokes who receive tPA are more likely to recover fully or have less disability than patients who do not receive the drug. Patients treated with tPA are also less likely to need long-term care in a nursing home.

Unfortunately, many stroke victims don’t get to the hospital in time for tPA treatment. This is why it’s so important to recognize the signs and symptoms of stroke right away and call 9-1-1.

Doctors may also treat ischemic stroke with other medicines, such as blood thinners, as well as surgery to remove the clot.

Treating Hemorrhagic Stroke

Other medicines, surgery, or procedures may be needed to stop the bleeding from hemorrhagic stroke and save brain tissue. For example,

Medicine, surgery, or other procedures may be needed to stop the bleeding and save brain tissue. For example:

• Endovascular procedures. Endovascular procedures, which can help repair a weak spot or break in a blood vessel, may be used to treat certain hemorrhagic strokes. Learn more about the procedure.
• Surgical treatment. Hemorrhagic strokes may be treated with surgery. If the bleeding is caused by a ruptured aneurysm, a metal clip may be put in place to stop the blood loss.

What happens next?

If you have had a stroke, you are at high risk for another stroke.

• 1 in 4 stroke survivors has another stroke within 5 years.
• The risk of stroke within 90 days of a transient ischemic attack (TIA) may be as high as 17%, with the greatest risk during the first week.

That’s why it’s important to treat the underlying causes of stroke, including heart disease, high blood pressure, atrial fibrillation (fast, irregular heartbeat), high cholesterol, and diabetes. Your doctor may give you medications or tell you to change your diet, exercise, or adopt other healthy lifestyle habits. Surgery may also be helpful in some cases.

Rehabilitation after a stroke begins in the hospital, often within a day or 2 after the stroke. Rehab helps ease the transition from hospital to home and can help prevent another stroke.

Recovery time after a stroke is different for everyone—it can take weeks, months, or even years. Some people recover fully, but others have long-term or lifelong disabilities.

What to expect after a stroke

If you have had a stroke, you can make great progress in regaining your independence. However, some problems may continue:

• Paralysis (inability to move some parts of the body), weakness, or both on one side of the body.
• Trouble with thinking, awareness, attention, learning, judgment, and memory.
• Problems understanding or forming speech.
• Trouble controlling or expressing emotions.
• Numbness or strange sensations.
• Pain in the hands and feet that worsens with movement and temperature changes.
• Trouble with chewing and swallowing.
• Problems with bladder and bowel control.
• Depression.

What is stroke rehabilitation?

Rehab can include working with speech, physical, and occupational therapists.

• Speech therapy helps people who have problems producing or understanding speech.
• Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke.
• Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing.

Therapy and medicine may help with depression or other mental health conditions following a stroke. Joining a patient support group may help you adjust to life after a stroke. Talk with your health care team about local support groups, or check with an area medical center.

Support from family and friends can also help relieve fear and anxiety following a stroke. Let your loved ones know how you feel and what they can do to help you.

How can I prevent another stroke?

If you have had a stroke, you are at high risk for another stroke. That’s why it’s important to treat the causes of stroke, including

• Heart disease.
• High blood pressure.
• Atrial fibrillation (fast, irregular heartbeat).
• High cholesterol.
• Diabetes.

Your doctor may prescribe you medicine or tell you to change your diet, exercise, or adopt other healthy lifestyle habits. Surgery may also be helpful in some cases.