Are Strokes Hereditary? 8 Genetic Risk Factors to Know

Stroke victims and families often ask, "Are strokes hereditary?" The answer is a complex one. While many factors that contribute to stroke are lifestyle-related, the undeniable truth is that genetics can play a significant role in determining an individual's risk.

Medically reviewed on 2/14/26 by Karen Murray, OTR, CHT, CSRS

DNA link to strokeDNA can play a role in stroke risk


Are Strokes Hereditary - The Short Answer

While a stroke itself is not inherited, the genetic conditions that cause them—like high blood pressure, sickle cell disease, and CADASIL—often are. If a first-degree relative has had a stroke, your personal risk may be 30% to 50% higher than average. Read on to find out about eight genetic conditions that have been linked to stroke.


Hereditary Conditions Linked to Stroke

A family history of stroke is a red flag. It suggests a potential genetic predisposition to conditions that can increase stroke risk. While not a guarantee that you will have a stroke, it certainly warrants attention and calls for proactive steps.

A variety of genetic disorders can elevate the risk of stroke. Understanding these conditions is crucial for early detection and prevention.

Vascular Disorders

  • Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL): This rare condition affects blood vessels in the brain, leading to recurrent strokes. CADASIL is a genetic mutation that leads to the buildup of abnormal proteins in the walls of small arteries in the brain. This buildup weakens and damages blood vessel walls. Over time, these vessels can narrow or become blocked, reducing blood flow to the brain which can lead to strokes, migraines, cognitive decline, and other neurological problems.
  • Fibromuscular Dysplasia (FMD): This disorder affects the arteries, causing abnormal growth and weakening, which can lead to aneurysms or blockages. While there is evidence suggesting a genetic component to FMD, it's not definitively considered a hereditary condition. The exact role of genetics in FMD is still being studied
  • Moyamoya Disease: A rare condition where arteries at the base of the brain become narrow, leading to reduced blood flow.  The abnormal blood vessels create a condition where the brain is deprived of adequate oxygen and nutrients, making it highly susceptible to stroke. Studies have shown that a specific gene, RNF213, is associated with Moyamoya disease.
  • Sickle Cell Disease: While primarily a blood disorder, it can lead to stroke, particularly in children. Blood cells in those with sickle cell disease are crescent-shaped and rigid. These abnormal cells can clump together and block blood vessels, particularly small ones in the brain. Additionally, sickle cell disease can cause inflammation in blood vessels, which can contribute to their narrowing and blockage. The higher risk of stroke in children with sickle cell disease is primarily due to the rapid growth and development occurring during childhood.

Blood Clotting Disorders

Blood Clot
  • Factor V Leiden: This genetic mutation increases the risk of blood clots, which can lead to stroke. The link is much stronger for venous strokes (strokes that occur in veins).
  • Protein S or C Deficiency: Protein S and Protein C are produced by the liver that work together as a natural anticoagulant. This means they help prevent blood clots from forming. A deficiency impairs the body's ability to break down blood clots, increasing stroke risk. 

If you have a family history of blood clots or have experienced one yourself, your doctor might recommend testing for Factor V Leiden or protein deficiency. Management of these disorders may involve medication to help prevent blood clots and maintaining a healthy lifestyle.

Connective Tissue Disorders

  • Marfan Syndrome: This genetic disorder affects connective tissue, including blood vessels, increasing the risk of aneurysms. To learn more about Marfan Syndrome, visit https://marfan.org. 


Preventing Hereditary Stroke

While you cannot alter your genetic makeup, you can take steps to reduce your risk of stroke. Even if you have a family history of stroke, adopting a healthy lifestyle is essential.  

  • Manage Blood Pressure: High blood pressure is a major risk factor for stroke. Regular monitoring and treatment are crucial. Make sure to adhere to medication recommendations as uncontrolled blood pressure is a leading cause of stroke.
  • Control Cholesterol: High cholesterol levels can contribute to stroke. A healthy diet and exercise can help manage cholesterol.   
  • Maintain a Healthy Weight: Obesity increases the risk of various health conditions, including stroke. 
  • Don't Smoke: Smoking significantly raises the risk of stroke. Quitting smoking is one of the best things you can do for your health.   
  • Regular Exercise: Physical activity helps maintain a healthy weight, reduces stress, and improves overall cardiovascular health.
  • Healthy Diet: A balanced diet rich in fruits, vegetables, and whole grains can help lower the risk of stroke.  
  • Limit Alcohol: Excessive alcohol consumption can increase blood pressure and other stroke risk factors.   
  • Regular Health Check-ups: Regular medical check-ups can help identify and manage risk factors early on.
  • Manage Underlying Conditions: If you have a diagnosed genetic condition, work closely with your healthcare provider to manage it effectively.
  • Know the Signs of Stroke: Familiarize yourself with the symptoms of stroke (FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 911) and act quickly if you suspect one.


Are Strokes Hereditary: Final Takeway

The answer to the question, "are strokes hereditary?" is complicated. Yes, there can be a hereditary link to stroke, but it's important to remember that while certain genetic factors can heighten the risk of stroke, not all strokes are hereditary, and many factors are within your control. To best understand your risk, consult with a physician regarding your family medical history. In addition, take stroke prevention measures by monitoring your health and making healthy lifestyle choices. By adopting a healthy lifestyle and working closely with your healthcare provider, you can significantly reduce your chances of experiencing a stroke. 


You can read the October 2025 article entitled The Role of Genetics in Stroke Risk and Outcome: A Review of Current Evidence from the journal Brain Behavior if you wish to learn more about the hereditary risks of stroke:

Brain Behav. 2025 Oct 20;15(10):e70820. doi: 10.1002/brb3.70820


Frequently Asked Questions

Strokes themselves are not inherited, but the genetic predisposition for conditions that cause strokes—such as high blood pressure or CADASIL—can be passed down through families. If a first-degree relative has had a stroke, your personal risk may be 30% to 50% higher than average.

CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy) is considered the most common inherited form of stroke. It is caused by a mutation in the Notch3 gene which affects the small blood vessels in the brain.

No. While family history is a significant risk factor, roughly 80% of strokes are preventable through lifestyle choices. Managing blood pressure, diet, and exercise can often offset genetic predispositions.



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About the Author

Karen Murray, OTR, CHT, CSRS, is a licensed occupational therapist,  Certified Stroke Rehabilitation Specialist, Certified Hand Therapist, and Certified Personal Trainer with over 29 years of experience working with stroke survivors in hospital, outpatient, and home settings. She founded Stroke-Rehab.com to help patients and caregivers better understand stroke recovery, find evidence-based resources, and regain independence at home.


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