Wellness Tips

Are Strokes Hereditary? How Genetics Affects Your Risk

Your genes can influence your risk of stroke in several ways. Some genetic disorders can cause or increase your risk of stroke. Knowing your risk and family history may help you prevent a stroke.

More than 795,000 people in the United States each year experience a stroke, according to the Centers for Disease Control and Prevention (CDC). The CDC also notes that the risk of stroke may be higher in some families than in others.

A stroke occurs when there’s a blockage in blood flow to your brain. Certain risk factors, like an unbalanced diet or smoking, can make this occurrence more likely. Because family members often have similar environments, habits, and experiences, it’s not unusual for them to have a similar risk for stroke.

But genetics may also play a role. The genes you inherit may increase your chances of certain stroke risk factors. You may also inherit a disorder that increases your risk of stroke.

Keep reading to learn more about how your genes influence your stroke risk and what you can do to lower it.

Research suggests that 15-52% of people with a stroke have a family member who has also had a stroke. And a large systematic review from 2019 found that your risk of stroke may be 36–44% higher if you have a parent or sibling who has had a stroke.

Shared environmental factors and habits likely account for much of the reason why strokes can seem to run in families. But genetics also plays a key role.

According to a 2017 research review, your genes influence your stroke risk in four ways:

  • genetic disorders that primarily cause stroke
  • genetic disorders, such as sickle cell anemia, that include stroke as a complication
  • genetic mutations that increase your risk of stroke
  • genetic mutations that cause stroke risk factors, like hypertension or diabetes

Having a family history of stroke may also increase your risk of having a stroke at a younger age.

Having siblings with strokes and a family history of early-onset stroke may also increase your risk for recurrent stroke.

Experts divide inherited disorders that affect stroke risk into two categories:

Inherited stroke disorders

Single gene mutations can lead to the following blood vessel disorders which primarily cause stroke:

  • CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy)
  • CARASIL (cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy)
  • familial amyloid angiopathy
  • collagen 4 (COL4A1) mutations

With the exception of CARASIL, the above disorders are autosomal dominant. That means you only need to inherit the gene mutation from one parent. For CARASIL, both parents need to carry the gene mutation.

CADASIL and CARASIL largely lead to ischemic stroke. Familial amyloid angiopathy and collagen 4 mutations could cause hemorrhagic stroke.

Genetic disorders that include stroke

Some inherited disorders primarily cause other symptoms. But these symptoms may lead to stroke. Examples include:

  • blood disorders such as:
  • blood vessel disorders such as:
  • metabolic disorders, such as:
  • connective tissue disorders, such as:

Anyone can have a stroke, but certain factors increase your risk. Key risk factors include:

  • Age: Your risk of stroke doubles every 10 years after you turn 55.
  • Sex: People assigned female at birth are more prone to stroke. This is partly due to increased blood pressure during pregnancy and estrogen from birth control medication.
  • Race or ethnicity: Non-Hispanic Black people are 50% more likely to have a stroke than white people in the United States.
  • Diet: Diets high in salt, cholesterol, and saturated and trans fats are at increased risk of stroke.
  • Lack of physical activity: Not getting enough physical activity can lead to health conditions that increase your stroke risk.
  • Smoking: Smoking can damage your blood vessels, and nicotine can raise your blood pressure. Even vaping can increase your risk.
  • Alcohol: Drinking too much alcohol could increase the risk of hemorrhagic stroke, especially in Black and Hispanic people.

The following health conditions also increase your risk of stroke:

There’s no way to guarantee you won’t have a stroke, especially if you have a family history. Still, you can work to reduce your risk.

If you have a medical condition that can lead to stroke — inherited or otherwise — work with a doctor to manage your condition. That could mean keeping your cholesterol, blood pressure, or diabetes under control.

Treatments for inherited disorders vary widely, ranging from vitamin supplements for MELAS to bone marrow transplantation for sickle cell anemia. Talk with a doctor to determine the best course of treatment for your condition.

In all cases, you can reduce your stroke risk by addressing modifiable risk factors like diet, exercise, and smoking. The CDC recommends the following:

Having a family member with a history of stroke doesn’t mean that you’ll necessarily have one. But it could mean that your risk is higher.

In addition to environmental factors, genetics can influence stroke risk. Inherited genetic mutations could lead to conditions that either cause stroke or increase your risk.

Knowing your family history can help you be more aware of your own risk. Managing modifiable risk factors for stroke, like diet and smoking, can help you reduce your risk.

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