Do strokes only affect older adults? While they’re more common among people aged 65 and older, 10 to 15 percent of people who have strokes are between the ages of 18 and 50. Strokes may be on the rise among certain younger adults. A recent study found that stroke incidence increased among men aged 20 through 44 between the years 1993 and 2015.

Some stroke risk factors are out of your control, including your age, gender, race and family history. But there are several risk factors which you may be able to change, either on your own or with the help of a doctor.  Taking steps to modify the following risk factors may help decrease your risk of stroke in your 40s or beyond:

• High blood pressure.
  Hypertension, or high blood pressure, is a problem that affects many adults, and it’s a common stroke risk factor. If you aren’t able to lower your blood-pressure levels on your own, your doctor may prescribe medication.
  Lifestyle changes may help, such as eating a healthy, low-salt diet; maintaining a healthy weight; exercising on a consistent basis; quitting smoking and limiting your alcohol intake.

• Diabetes.
  One of the common complications of diabetes is stroke. Keeping your blood-sugar levels under control will help  lower your stroke risk. Your doctor may prescribe medication to help you manage your diabetes, or you may be able to keep it under control with a healthy diet, regular exercise, and weight loss.

• High cholesterol levels.
  When your cholesterol levels are high, sticky plaque builds up on the inner walls of arteries, making it harder for blood to flow freely. When too much plaque builds up in arteries supplying blood to the brain or in large or small arteries within the brain, it may contribute to stroke. Managing your cholesterol levels with diet, exercise and medication should help you lower your stroke risk.

• Smoking.
  Cigarette smoking has been shown to encourage the blockage of arteries supplying blood to the brain and in the large or small arteries within the brain, which increases stroke risk. Quitting smoking won’t just lower your stroke risk, it will improve your overall health in countless ways. Seek advice from your primary-care physician if you’d like to quit but you’re having trouble attempting it on your own.

• “Heavy” drinking.
  Some research has shown that drinking more than two alcoholic beverages per day during middle age increases stroke risk more than other risk factors, such as diabetes or high blood pressure. Limiting the amount that you drink may help to lower your risk. The American Heart Association recommends no more than two drinks daily for men and no more than one drink daily for women.

• Obesity.
  Being very overweight is associated with unhealthy chronic conditions like diabetes, high blood pressure and high cholesterol levels, all of which raise your risk of stroke. Losing weight may help to lower your risk, even if you only lose 5 or 10 pounds.

• Diet.
  If you eat a salt-heavy diet, you may develop high blood pressure and increase your stroke risk. If your diet is high in saturated fat, you may have high cholesterol and an increased stroke risk. For better health, eat less salt and saturated fat, and increase your intake of fruits and vegetables. Five or more servings every day may significantly cut your risk of stroke.

• Physical inactivity.
  People who are sedentary are more likely to be overweight or obese and have high blood pressure, diabetes or high cholesterol levels, which all increase stroke risk. Getting 30 minutes of moderate exercise every day may help to lower your risk. Moderate exercise may be as simple as having a brisk walk.

• Too much stress.
  Chronic stress may increase your risk of high blood pressure or encourage you to smoke or drink too much, all of which are linked to stroke risk. Taking steps to lower your stress levels may lower your stroke risk, too. Try deep breathing, exercising regularly, listening to music you enjoy, talking to friends, and avoiding overly stressful situations.

“Working with your primary-care physician to adopt healthy lifestyle choices or begin taking medication now may decrease your risk of stroke in the future, whether in your 40s, 60s or 80s,” says neurologist Stephen Martino, M.D., of Hackensack Meridian Jersey Shore University Medical Center and Ocean University Medical Center.