High blood pressure is a big risk factor for stroke, but people with normal blood pressure can have a stroke. In a new study, researchers have identified other key determinants of this debilitating neurologic problem.

The good news is that some of the risk factors are modifiable, meaning patients themselves can change them and potentially reduce their risk of stroke. Important modifiable risk factors identified include smoking and being overweight.

Dr. Cairu Li and colleagues from Malmo University Hospital, in Sweden, followed more than 28,000 subjects for about 6 years to determine the risk factors for stroke. During that period, 466 subjects experienced a stroke, according to the report in the medical journal Stroke.

Most of the stroke patients had high blood pressure, but 12 percent had normal pressures, defined as less than 140/90, the report indicates.

Risk factors for stroke among patients with normal blood pressure included older age, smoking, being overweight, heart disease, and stomach ulcer. In addition, having a blood pressure on the high end of normal raised the stroke risk compared with lower pressures.

As to why stomach ulcers are linked to stroke, the authors said it may relate to a microbe called Helicobacter pylori that has been tied to ulcers as well as blood vessel plaques.

“Because (stomach) ulcer is a potentially treatable condition, this relationship could have important implications,” they add.

SOURCE: Stroke, February 2005.