In clinical work, we found that many patients and their families often have some common problems and misunderstandings, which are briefly summarized and organized for reference.
High-risk group: over 40 years old, hypertension, hyperlipidemia, diabetes, addiction to tobacco and alcohol, heart disease, and family history of stroke.
Younger patients: If there is an aura of cerebral infarction or cerebral hemorrhage, be sure to check for smoky disease or other cerebrovascular diseases.
Cerebral infarction aura: occasional or frequent transient limb numbness or weakness, transient blurred vision, dizziness, lightheadedness, unexplained fainting, slurred speech, etc. Some patients with cerebral ischemia present with chronic headache and significant memory loss.
How to prevent cerebral infarction?
I. Quit smoking, including passive smoking (staying in a room where others smoke).
Second, limit alcohol, it is best to stop drinking.
Third, control the “three highs”
1, control high blood pressure
Control at about 120/80mmHg. (Already obvious ischemia, blood pressure can not be too low, otherwise it will induce cerebral infarction, specific blood pressure control goals need to consult a physician) choose long-acting drugs, once a day antihypertensive drugs, such as amlodipine. Short-acting drugs can cause blood pressure fluctuations between doses and are not ideal for control.
High blood pressure generally requires lifelong medication, do not measure the blood pressure is normal and stop using, high again to eat. It is easy to induce brain hemorrhage or heart disease.
Blood pressure needs to be measured frequently, you can’t just take the medication without measuring it, it’s not good to have a blood pressure that is too high or too low. There is no blood pressure that cannot be lowered, ask your doctor to help you choose your own medication. Not the more expensive the drug the better, others taking good results may not be the best for you, must be under the guidance of a doctor to select and take drugs.
Low-salt diet.
Weight control. Men’s weight (kg) should be controlled at height (cm) – 100, women’s weight (kg) should be controlled at height (cm) – 105.
2. Control of blood sugar
It is important to understand the following elements on how to use medication for diabetic patients.
(1) Blood glucose refers to the concentration level of glucose in the blood. After a normal person eats, food is digested and absorbed into the blood in the digestive tract, blood glucose will rise briefly, and insulin in the body will be released accordingly to increase and maintain blood glucose at a normal level. Diabetic patients cannot release enough insulin according to the rise of blood glucose after eating, which leads to a prolonged rise in blood glucose level, thus causing harm.
(2) Glucose is a direct energy substance for human cells, just like gasoline for a car, which is necessary for the body. A reasonable blood glucose level is good for the cells to function, too high or too low is not good.
(3) The nutrients of food include sugar, fat, protein, inorganic salt, trace elements, fiber, and vitamins.
Only sugars, fats and proteins can be directly or indirectly converted into glucose in the body, which can lead to an increase in blood sugar. Foods containing sugar are mainly: rice, pasta, sugary drinks, sweet fruits (watermelon, pears, etc.) Foods containing protein are mainly: meat, eggs, milk; foods containing fat are mainly: vegetable oil (rapeseed oil, sesame oil, etc.), lard, cream, butter, etc.
How to use medication for diabetic patients.
Step 1: Set the total food calories. Determine the total daily calorie requirement (provided by sugar, fat and protein in food) according to each person’s weight and daily activity. In order to maintain a normal life, the total daily dietary calories are relatively fixed, neither more nor less. The proportion of sugar, fat and protein in each meal can be reasonably allocated according to the different dietary habits of individuals.
Step 2: Set the dosage of medication, reasonably allocate and adjust the dosage of medication according to dietary habits, and at the same time measure the blood sugar level before and after three meals so that it is at a reasonable level, neither high nor low. The dosage of medication is determined according to the three meals of the diet. It is not that we do not eat or eat less when the blood sugar is high or eat more when the blood sugar is low. Rather, after three meals are reasonably determined, the dosage of medication is increased when blood sugar is high and reduced when blood sugar is low.
Since sugary drinks and sweet fruits (watermelon, pears, etc.) will lead to high blood sugar immediately after consumption, diabetics should not eat them or eat them as little as possible. While all other foods can be consumed normally, it is only a matter of the total amount eaten. The consumption of any food containing sugar, fat or protein, as long as there is too much of it, will lead to a rise in blood sugar, not eating steamed buns is better than eating rice or meat. Sugar, fat and protein are all essential nutrients for the human body and should be consumed in reasonable amounts every day to ensure that they are necessary for good health.
Due to diabetic diet control, the amount of diet will generally be less than before, will feel hungry, can be appropriate to increase the consumption of fiber-containing foods, such as vegetables and fruits that do not contain sugar, like cucumbers, cabbage, but can not eat these at the same time eat more fried vegetables of oil.
Do not measure only fasting blood glucose level without measuring postprandial blood glucose level, there are many patients with normal fasting blood glucose level after medication, while postprandial blood glucose is very unsatisfactory and has been unaware that blood glucose control is actually unsatisfactory.
Blood sugar can be controlled by insulin or oral medication, please follow the advice of endocrinologist.
There is no single drug, food, secret recipe or recipe etc. that can cure diabetes, so do not listen to any such advertisement.
3. Monitor and control blood lipids
Eat less greasy food, such as fried food, high soup, etc. You can eat chicken, duck, fish, lean meat, beef, etc., but don’t drink bone broth, chicken soup, etc.
Blood vessels are like water pipes, and more oil flowing in them is bound to increase the speed of their clogging. However, oil is an essential nutrient for the body, so it must be consumed reasonably. It is recommended to use vegetable oils as much as possible and reduce the intake of animal oils. Since there is little or no activity after dinner, dinner should be as light as possible, and it is best not to eat chicken soup, bone broth and other soup foods for dinner.
Check blood lipids regularly. Pay particular attention to the low-density lipoprotein level (LDL) in the blood lipid examination. For people with cerebral infarction or at high risk, their LDL level should be below the level of 2.07 mmol/L, and you cannot just see the lipid examination results suggesting normal. Lipid-lowering drugs are preferred to statins, such as atorvastatin, etc.
IV. Anti-platelet drug therapy
Platelets are an important component of blood to prevent bleeding, but they can also cause cerebral vascular stenosis and blockage in people with “three highs”, so you can take drugs to control its function properly.
0.1 once a day to reduce the chance of cerebral infarction and myocardial infarction.
Patients at high risk for frequent transient ischemic attacks may be given concomitantly with clopidogrel (trade name Tagatha or Bolivar, another antiplatelet drug) 75 mg once daily.
Use this drug with caution if you have had a brain hemorrhage and follow your doctor’s advice.
Caution: Clopidogrel 75mg (usually for 3-6 months or longer) + BAY ASPIRIN 100mg daily (for life) taken at the same time, most people have no bleeding tendency, but a few patients may have abnormal gum bleeding, excessive menstrual flow, or black stool dizziness and other bleeding manifestations, need to discontinue the drug and seek medical attention immediately!!!
Five, usually pay attention to the appropriate amount of water, especially the right amount of water before bed to reduce blood viscosity and reduce the chance of cerebral infarction. In summer, pay special attention to not sweating too much, pay attention to timely hydration!
Relevant examination significance
1.Cranial CT – mainly used to understand whether there is brain hemorrhage, and cannot detect acute cerebral infarction.
2.Cranial MRI scan – to understand whether there is an infarct focus is best
3.Diffusion examination of cranial MRI can detect acute cerebral infarction.
4.Cranial CT angiography (CTA)–can find out whether there is stenosis, occlusion, aneurysm, etc. of large blood vessels in the neck and intracranial vessels
5.Cranial magnetic resonance angiography (MRA) – can also find out whether there are stenosis, occlusion, aneurysm, etc. in large blood vessels in the neck and intracranial blood vessels
6.Carotid ultrasound – non-invasive to know whether there is stenosis, occlusion, plaque and other information of the large blood vessels in the neck, the disadvantage is that the clinician cannot see the exact image of the vascular condition.
7.Heart ultrasound – to understand whether there is blood clot in the heart, etc.
8.Electrocardiogram – to understand whether there are arrhythmias, myocardial infarction, etc.
If the carotid artery stenosis is greater than 50%, it is important to consult a professional doctor to assess whether carotid endarterectomy or stenting is needed.
For carotid artery stenosis less than 50%, carotid endarterectomy or stenting is generally not required, only medication is needed.