Uncommon Stroke Risk Factors

A RUSH expert identifies stroke risk factors that you may not be aware of
Young woman opening artificial sweetener packet to add to coffee

From diet drinks to sugar replacements used in cooking and baking, artificial sweeteners are everywhere. For people looking to lose weight without giving up flavor, they’re a tempting alternative.

But recent research reveals some artificial sweeteners may increase the risk of heart attack and stroke.

What does the research say?

A study published in Nature found that the sugar substitute erythritol caused blood clots to form easily when added to whole blood.

It also found that higher levels of erythritol in the blood increased the risk for heart attack and stroke.

Is erythritol safe?

This research is part of a growing body of evidence that suggests artificial sweeteners may not be totally harmless.

“I generally recommend that patients avoid or limit artificial sweeteners,” says Laurel Cherian, MD, a neurologist at RUSH. “If people are bored of water and need something with flavor, flavored seltzer water is a great option. You can also use fruit such as strawberries or cucumbers to infuse water with flavor.”

What other stroke risk factors should I know about?

Stroke is caused by a blood clot in the brain. The clot blocks the flow of blood, leading to damaged brain tissue and even death.

The most common stroke risk factors have no symptoms at all, including:

She also identified other risk factors that you may not be aware of.

Recreational drug use

“In recent years, marijuana has been legalized in several states, including Illinois,” Cherian says. “There’s a perception that just because it’s legal, it’s perfectly safe. However, marijuana may cause irritability and constriction of blood vessels in the brain. This can lead to stroke, particularly when combined with common medications like antidepressants and over-the-counter decongestants.”

Cocaine use is also linked to stroke.

Hormonal birth control

While oral contraceptives have lower doses of hormones than when they first came on the market, there remains an increased risk for stroke with estrogen-only oral contraceptives. The risk for stroke is lower with the progesterone-only pill (sometimes called the minipill).

Your risk rises if you use oral contraceptive and have additional stroke risk factors (such as high blood pressure, advanced age or tobacco use).

If smoke or have other vascular risk factors like uncontrolled blood pressure, Cherian recommends using other forms of birth control because of increased stroke risk. Talk to your doctor about your stroke risk factors before starting hormonal birth control.

Blood vessel injury in the neck

Arterial dissection is when an artery tears along the inside wall. This tear can cause a stroke.

“Although relatively rare, it’s one of the leading causes of stroke in patients younger than 45,” Cherian says.

Sometimes, arterial dissection occurs at random, with no clear cause. However, minor trauma to the neck may cause a tear to form. Car accidents, coughing and chiropractic manipulation have all been linked to arterial dissection.

How can I control my stroke risk?

Although the more unusual causes of stroke may be scary, it’s the silent killers (such as high blood pressure) that are more likely to cause a stroke.

“Know your numbers,” Cherian says. “Work with your doctor to make sure your blood pressure and other risk factors are well controlled. Eating a healthy, low-sodium diet can also help your heart and vascular health.”

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