While a stroke may seem like an unpredictable event, there are tests available to help figure out whether you have a higher risk for stroke in the future. No one can forecast exactly when a stroke will happen, but getting an idea of your stroke risk level can help you modify some behaviors and other factors to improve your outlook. The following tests can help you determine which type of action you need to take to reduce your risk of having a stroke.
Heart Auscultation
Heart auscultation, which describes the process of having your healthcare provider listen to your heart through a stethoscope, can help identify problems with heart valves or heartbeat irregularities. Both heart valve problems and heart rhythm problems are known to lead to blood clots that can cause a stroke.
Fortunately, heart valve disease and heart rhythm irregularities are treatable once they are detected—and your practitioner should be able to detect issues early during routine physicals. In some instances, if you have abnormal heart sounds, you may need to be further evaluated with another heart test, such as an electrocardiogram (EKG) or an echocardiogram.
Electrocardiogram
An EKG monitors your heart rhythm by using small metal discs positioned on the skin of the chest. A painless test, an EKG does not involve needles or injections and it does not require you to take any medication.
When you have an EKG, a computer-generated pattern of waves is produced that corresponds to your heartbeat. This wave pattern, which can be printed on paper, tells your healthcare providers important information about how your heart is working. An abnormal heart rate or an irregular heart rhythm can put you at risk of stroke.
One of the most common heart rhythm abnormalities, atrial fibrillation, increases the formation of blood clots that may travel to the brain, causing a stroke. Atrial fibrillation is not uncommon and it is a treatable heart rhythm abnormality. Sometimes, people who are diagnosed with atrial fibrillation are required to take blood thinners to reduce the chances of having a stroke.
Echocardiogram
An echocardiogram is a type of heart ultrasound used to observe heart movements. It is a moving picture of your heart in action. It does not require needles or injections, and it typically takes longer to complete than an EKG. If you have an echocardiogram, your healthcare provider might recommend consulting with a cardiologist, who is a practitioner who diagnoses and manages heart disease.
An echocardiogram is not considered a screening test, so it is less common than other tests on this list when it comes to evaluating stroke risk. That being said, it is used for the evaluation of a number of specific heart problems that cannot be fully assessed with heart auscultation and EKG, and therefore can help paint a clearer picture of overall cardiovascular health.
Blood Pressure Measurement
Over two-thirds of individuals who experience a stroke have hypertension, which is defined as blood pressure at 130mmHg/80 mmHg or above. Guidelines for treating hypertension recommend a systolic blood pressure at or below the target of 120 mmHg to reduce your stroke risk.
Hypertension means that your blood pressure is chronically elevated. Over time, this leads to disease of the blood vessels in the heart, the carotid arteries, and the blood vessels in the brain, all of which can cause a stroke.
Hypertension is a manageable medical condition. Some people are more genetically predisposed to hypertension, and there are some lifestyle factors that contribute to and exacerbate hypertension. Management of high blood pressure combines diet control, salt restriction, weight management, stress control, and prescription medications.
Carotid Auscultation
You have a pair of sizeable arteries, called carotid arteries, in your neck. The carotid arteries deliver blood to your brain. Disease of these arteries leads to the formation of blood clots that can travel to the brain. These blood clots cause strokes by interrupting blood flow to the arteries of the brain. Often, your healthcare provider can tell if one or both of your carotid arteries are diseased by listening to the blood flow in your neck with a stethoscope.
If you have abnormal sounds suggestive of carotid disease, you likely will need further tests, such as carotid ultrasound or carotid angiogram, to further evaluate the health of your carotid arteries. Sometimes, if the carotid artery disease is extensive, you may need surgical repair to prevent a stroke.
Testing Your Lipid and Cholesterol Levels
Your blood cholesterol and lipid levels are easily measured with a simple blood test. Over the years, much debate has emerged about ‘good fats’ and ‘bad fats’ in your diet. That is because medical research has gradually been uncovering vital information about which dietary elements impact the cholesterol and triglycerides levels in the blood.
Some people are more predisposed to high fat and cholesterol levels due to genetics. Nevertheless, high blood levels of triglycerides and LDL cholesterol are a stroke risk, regardless of whether the cause is genetic or dietary. This is because excessive lipids and cholesterol can lead to vascular disease and can contribute to the formation of blood clots, which cause strokes and heart attacks.
Current guidelines for optimal blood lipids and cholesterol levels are:
- Below 150 mg/dL for triglyceridesBelow 100 mg/dL for LDLAbove 50 mg/dl for HDLBelow 200 mg/dL for total cholesterol
If you have elevated lipid and cholesterol levels, you should know that these are manageable results and that you can lower your levels through a combination of diet, exercise, and medication.
Testing Your Blood Sugar
Individuals who have diabetes are two to three times more likely to experience a stroke throughout their lifetime. Furthermore, people with diabetes are more likely to have a stroke at a younger age than people without the disease. There are several tests that are commonly used to measure blood sugar. These tests are used to determine whether you have undiagnosed diabetes or early diabetes.
A fasting blood glucose test measures your blood glucose level after eight to 12 hours of fasting from food and drink. Another blood test, the hemoglobin A1C test, evaluates your overall glucose levels over a time period of six to 12 weeks prior to the blood test. Fasting glucose and hemoglobin A1C test results can be used to determine whether you have borderline diabetes, early diabetes, or late-stage diabetes. Diabetes is a treatable disease that can be managed with diet, medication, or both.
A Word From Verywell
The tests outlined above can be helpful markers of your future stroke risk, especially when used together. If you’re concerned about your risk levels, take action by talking to your healthcare provider about ways to reduce your chances of having a stroke. Your practitioner can help you pinpoint specific areas to modify your risk through medication and lifestyle changes, such as making dietary shifts, increasing exercise, and quitting smoking.
Additionally, be sure you know the warning signs of a stroke or a mini-stroke, which may include numbness on one side of the face, difficulty walking, loss of coordination on one side of the body, trouble communicating, and changes in vision, among other signs.
If you or anyone around you experiences signs of stroke, call 911 immediately for medical attention. Time is of the essence: The window for preventing long-term damage from a stroke is just three to 4.5 hours.
