Stroke is a leading cause of death and disability worldwide. However, many cases of severe stroke that lead to permanent disability, long-term brain damage, or death are preventable. Researchers have identified risk factors, including modifiable lifestyle choices and manageable medical conditions, linked to severe stroke.

"Stroke can lead to disability or even death, yet there are a number of risk factors that people can modify with a change in lifestyle or medication. Our results emphasize the importance of managing risk factors for stroke, especially high blood pressure, atrial fibrillation, and smoking in order to prevent severe, disabling stroke," said study author Dr. Catriona Reddin, at the University of Galway in Ireland.

To understand the factors affecting severe stroke, researchers conducted a large-scale study involving 26,948 participants with an average age of 62, from across 32 countries. Half of the participants had experienced a stroke, while the rest had not. Among the stroke survivors, 4,848 cases were classified as severe and 8,612 as mild to moderate.

Patients were classified as having experienced a severe stroke if they needed constant nursing care or could not walk or care for themselves independently. Those who could walk without assistance and required only some help with personal care were considered mild or moderate cases.

The researchers then assessed all the participants for stroke risk factors such as high blood pressure (more than 140/90 mmHg), atrial fibrillation, diabetes, high cholesterol, smoking, alcohol use, diet quality, sedentary lifestyle, stress, and excess abdominal fat. They also noted how these factors were for those participants who had severe stroke and mild to moderate stroke compared to those who did not have a stroke.

The analysis revealed that three factors: high blood pressure, atrial fibrillation, and smoking, not only increased the risk of stroke but were also linked to a higher risk of severe stroke.

Having high blood pressure was associated with a 3.2 times higher risk of severe stroke and a 2.9 times higher risk of mild to moderate stroke. People with atrial fibrillation faced a 4.7 times greater risk of severe stroke and a 3.6 times higher likelihood of mild to moderate stroke. Finally, smoking increased the risk of severe stroke by 1.9 times and mild to moderate stroke by 1.7 times, compared to non-smokers.

"Our findings emphasize the importance of controlling high blood pressure, which is the most important modifiable risk factor for stroke globally. This is particularly relevant for lower- and middle-income countries that have rapidly increasing rates of high blood pressure and strokes at younger ages," Reddin said.

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