Harvard Heart Letter

Stroke after a heart attack: What’s the risk?

Here's what heart attack survivors need to know to lower their chance of a future stroke.


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First, the good news: The rate of first-time heart attacks has dropped by nearly half in the past 25 years. And heart attack survival rates have surged, thanks to improved treatments. The bad news? Compared to people without such a history, heart attack survivors not only face a higher risk of a second heart attack, they're also more likely to have a stroke.

The risk of stroke is higher in the first year following a heart attack, especially during the first month. After a year, however, only the risk of ischemic stroke remains elevated, according to study in the July 2016 Stroke that tracked more than a quarter-million heart attack survivors over a 30-year period. (See "Types of stroke: Blockage vs. bleeding" for a primer on the different types.)

The heightened stroke risk isn't surprising, given that heart attacks and ischemic strokes have nearly identical risk factors—namely, high blood pressure, diabetes, unhealthy cholesterol levels, lack of exercise, obesity, and cigarette smoking. But other factors can also come into play.

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