10 Tests That Measure Your Stroke Risk

While a stroke may seem like an unpredictable event, there are tests available to help figure out whether you have a high risk for stroke in the future - including some tests you can do on your own. No one can forecast exactly when a stroke will happen, but getting an idea of your stroke risk level can help guide some modifiable or partially-modifiable 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:

Doctor examining mature woman
Jonatan Fernstrom/Getty Images 

Heart Auscultation

Heart auscultation, which describes the process of having your doctor 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 stroke-producing blood clots. Fortunately, heart valve disease and heart rhythm irregularities are treatable once they are detected - and your doctor 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 medical heart test, such as an electrocardiogram (EKG) or an echocardiogram.


An EKG monitors your heart rhythm by using small metal discs positioned superficially 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 doctors 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 forming 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.


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. 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 doctor might recommend consulting with a cardiologist, who is a doctor who diagnoses and manages heart disease.

Blood Pressure

Over 2/3 of individuals who experience a stroke have hypertension, which has long been defined as blood pressure higher than 140mmHg /90 mmHg. Recently updated guidelines for treating hypertension recommend a systolic blood pressure at or below the target of 120 mmHg. This means that if you have previously been told that you have 'borderline' hypertension, your blood pressure might now fall into the category of hypertension. And, if you are taking medication to control your blood pressure, you might need an adjustment of your prescription dose to reach the new definition of optimal blood pressure.

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 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 strength 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 doctor can tell if one or both of your carotid arteries have the disease by listening to the blood flow in your neck with a stethoscope.

Often, if you have abnormal sounds suggestive of carotid disease, you 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.

Fat and Cholesterol Levels

Your blood cholesterol and fat 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 fats 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 fat 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 fat and cholesterol levels are:

  • Below 150 mg/dL for triglycerides
  • Below 100 mg/dL for LDL
  • Above 50 mg/dl for HDL
  • Below 200 mg/dL for total cholesterol

Find out more about your ideal fat and cholesterol levels and learn more about the current guidelines for fat and cholesterol in your diet. If you have elevated fat 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.

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 non-diabetics. 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 8-12 hours of fasting from food and drink. Another blood test, a hemoglobin A1C test, evaluates the impact of your overall glucose levels on your body over a time period of 6-12 weeks prior to your taking the blood test. Fasting glucose and hemoglobin A1C test results can be used to determine whether you have borderline diabetes, early diabetes, or untreated late-stage diabetes. Diabetes is a treatable disease that can be managed with diet, medication or both.

Independent Self-Care

This is not so much a ‘test’ as it is determining whether or not you are able to participate in caring for yourself regularly. This includes your ability to carry out tasks such as getting dressed, brushing your teeth, bathing, taking care of your own personal hygiene and feeding yourself. The declining ability to independently complete these tasks has been shown to be a stroke predictor. Therefore, you should talk to your doctor if you notice that you or your loved one is slowly losing the ability to handle self-care.

Walking Speed

One scientific research study from Albert Einstein College of Medicine that looked at the walking speed of 13,000 women found that those who had the slowest walking speed were at a 67% greater risk of stroke than those who had the fastest walking speed. Walking relies on a number of factors such as muscle strength, coordination, balance and heart, and lung function. Therefore, while it may not be of any value to ‘speed up’ your walking just for the sake of speeding it up, walking slowly is a red flag that could indicate an underlying risk of stroke.

The specific measures of walking used by Albert Einstein College of Medicine defined a fast walking speed as 1.24 meters per second, average walking speed as 1.06-1.24 meters per second and slow walking speed as slower than 1.06 meters per second.

Standing on One Leg

Researchers in Japan have published the results of a scientific study that concluded that being able to stand on one leg for longer than 20 seconds is another indicator that can determine a person’s chances of having a stroke. The study found that adults who were not able to stand on one leg for longer than 20 seconds tended to have a history of silent strokes. Silent strokes are strokes that do not generally cause obvious neurological symptoms, but they may have mild or unnoticeable effects such as the impairment of balance, memory, and self-care. Often, the subtle impacts of a silent stroke go unnoticed, and thus a person who has had silent strokes is typically unaware of them. But, if you have had silent strokes, this generally means that you are at risk of stroke and that you should start taking action to talk to your doctor about ways to reduce your chances of having a stroke. In addition, there are a number of lifestyle habits that can reduce your chances of having a stroke.

Was this page helpful?
Article Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Yaghi S, Kamel H. Stratifying stroke risk in atrial fibrillation: beyond clinical risk scoresStroke. 2017;48(10):2665–2670. doi:10.1161/STROKEAHA.117.017084

  2. Wajngarten M, Silva GS. Hypertension and stroke: update on treatmentEur Cardiol. 2019;14(2):111–115. Published 2019 Jul 11. doi:10.15420/ecr.2019.11.1

  3. Samai AA, Martin-Schild S. Sex differences in predictors of ischemic stroke: current perspectivesVasc Health Risk Manag. 2015;11:427–436. doi:10.2147/VHRM.S65886

  4. Cleveland Clinic. Understanding cholesterol numbers: what do they mean? Reviewed June 2018

  5. Mcginn AP, Kaplan RC, Verghese J, et al. Walking speed and risk of incident ischemic stroke among postmenopausal women. Stroke. 2008;39(4):1233-9. doi:10.1161/STROKEAHA.107.500850

  6. Tabara Y, Okada Y, Ohara M, et al. Association of postural instability with asymptomatic cerebrovascular damage and cognitive decline: the Japan Shimanami health promoting program study. Stroke. 2015;46(1):16-22. doi:10.1161/STROKEAHA.114.006704