Cerebrovascular disease, commonly known as stroke, is a common disease that endangers the health of middle-aged and elderly people. According to national disease monitoring data, the incidence of cerebrovascular disease is increasing year by year and has a trend of rejuvenation, and its mortality rate has jumped to the top of the causes of death in China, half of the stroke survivors are left with varying degrees of disability, such as hemiplegia, speech impairment, dementia, and inability to take care of themselves, and 1/4 of the stroke patients will Stroke occurs again within 1-5 years, and the risk of stroke is even greater. Because of the limitations of the current treatments for cerebrovascular diseases, prevention is very important. Prevention can effectively reduce or even avoid the onset of stroke and achieve a healthy and long life outcome at a small cost. The significant decline in stroke incidence in some developed countries after decades-long or even longer prevention efforts has given us a good lesson. Why do strokes occur? The occurrence of cerebrovascular disease, which appears to be an accidental event from the surface phenomenon, is actually the inevitable result of long-term damage to the cerebral blood vessels. With age, the combined effect of stroke prone factors such as hypertension, diabetes, heart disease, hyperlipidemia, obesity, carotid artery stenosis, smoking and family genetics, the elderly inevitably develop different degrees of atherosclerosis. Those with milder lesions and slower progression will not experience significant cerebral blood supply deficiency and are less likely to have a stroke; those with more severe lesions will experience significant narrowing of the cerebral vessels or the formation of small aneurysms. When stimulated by external environmental factors, a thrombus can form in the cerebral artery, causing cerebral infarction (ischemic stroke); or the cerebral artery can rupture, causing cerebral hemorrhage or subarachnoid hemorrhage (hemorrhagic stroke). Emboli of cardiac origin or emboli shed from other atherosclerotic plaques outside the brain can cause cerebral embolism if they block the cerebral arteries. How can cerebrovascular disease be prevented? Whether it is hemorrhagic cerebrovascular disease or ischemic cerebrovascular disease, the pathological basis is mostly atherosclerosis. The prevention of stroke is the comprehensive control of various atherogenic risk factors, including pharmacological therapy, non-pharmacological therapy and therapeutic lifestyle improvement, and the prevention of cerebrovascular disease can be divided into three levels according to the different conditions of the population. I. Primary prevention Primary prevention is mainly to prevent the onset of disease. Individuals with only one or several of the above risk factors and no aura or manifestation of cerebrovascular disease are classified as primary prevention targets, i.e., they are actively treated for the presence of risk factors, while the occurrence of other risk factors is regularly monitored and targeted measures are taken. In addition to risk factors such as age, gender, genetics and race that cannot be intervened, treatable risk factors such as hypertension, hyperlipidemia, diabetes, coronary artery disease, asymptomatic carotid stenosis and blood hypercoagulability are intervened and treated. In primary prevention, the following aspects should be focused on: (a) Control of hypertension. Both ischemic stroke and hemorrhagic stroke are linearly related to systolic and diastolic blood pressure. Therefore, active control of hypertension is the most important aspect of prevention of cerebrovascular disease. Once hypertension is detected, it should be treated promptly and requires lifelong adherence. There are many kinds of anti-hypertensive drugs, and as much as possible, choose drugs that have a protective effect on the cardiovascular and cerebrovascular system, while the dosage of drugs must be adjusted as necessary with changes in blood pressure. For people with hypertension combined with hyperviscosity, hyperlipidemia or diabetes and other stroke risks, special attention should be paid to monitoring and control, and targeted treatment. (2) Adjust blood lipids to prevent atherosclerosis. Hyperlipidemia can have no obvious symptoms in the early stage, but its damage to cardiovascular and cerebrovascular is serious. Therefore, once a patient clearly has hyperlipidemia, timely treatment and long-term regulation should be carried out. At present, there are many drugs used to lower lipid, among which Shuduzhi, Lipitor and Lipin Lipid have good lipid-lowering effect. (C) Active treatment of diabetes. Diabetes mellitus in adults is mostly type II diabetes. As with hypertension, the control of diabetes also requires lifelong treatment. The choice of medication and the dosage of medication varies with individual differences, and the medication must be guided by a clinician. In addition to drug therapy, non-drug therapies such as diet control, weight control, and exercise should be combined. (iv) Pay attention to physical examination. As the elderly age, many risk factors for cerebrovascular disease increase, and many elderly people think they are in good health and are usually reluctant to go to the hospital for checkups, but they may have already buried the hidden danger of cerebrovascular disease, and once the disease develops, the consequences will be more serious than those of the general elderly. Regularly check blood pressure, blood sugar, blood lipids, blood rheology and electrocardiogram in a targeted manner, and correct any abnormalities in a timely manner. (E) Adhere to a healthy lifestyle – pay attention to non-pharmacological therapies to prevent problems before they occur. Healthy people should be advised to stop smoking and avoid excessive alcohol consumption; reasonably improve dietary structure, reduce the proportion of animal fat, increase fish, fruits, vegetables, soybean products and milk, etc.; live a regular life, do physical exercise appropriately, balance psychology, maintain optimism, and ensure better sleep; keep bowel movements smooth to avoid acute cerebrovascular disease caused by a sharp rise in blood pressure due to forceful defecation. Some data show that a healthy lifestyle can reduce the incidence of hypertension by 55% and stroke by 75%, and improve the overall quality of life and significantly increase the per capita life expectancy at less than one-tenth of the cost of medical treatment. Secondary prevention Secondary prevention is the prevention of development. For patients with risk factors and precursors of stroke, such as transient ischemic attack, mini-stroke, complete stroke, and retinal ischemia. Early diagnosis and treatment should be provided to prevent serious cerebrovascular disease. Although the onset of cerebrovascular disease is sudden, it can be traced. Most of the patients have signs beforehand, such as sudden dizziness, numbness or weakness of limbs, slurred speech, headache different from usual, sudden fall for unknown reasons, drowsiness all day long, involuntary twitching of limbs, sudden loss of vision, etc. Most mini-stroke attacks are only within 1-5 minutes. Most mini-stroke attacks are within 1-5 minutes. Patients with these symptoms are called “high risk” and 50%-70% of them will have a stroke within 3-5 years, or even sooner. Therefore, people should pay enough attention when they are aware of such symptoms. It is important to actively treat transient ischemic attacks and reversible neurological deficits to stop the progression of mini-strokes and prevent the occurrence of cerebral infarction. Antiplatelet agents such as aspirin, pansentin, force antithrombotic, and poliovirus may reduce the risk of stroke. For those with severe stenosis of cerebral vessels, intra-arterial stent angioplasty, carotid endarterectomy, and intracranial and extracranial vascular bypass surgery can be used. Regardless of the treatment method, drug therapy is the basis, that is, drug therapy should be used routinely for any degree of cerebrovascular stenosis, regardless of whether surgical treatment is available. Among the drugs for the treatment of cerebrovascular stenosis, antiplatelet drugs are the first choice and the basic drugs. Tertiary prevention The purpose of tertiary prevention is to reduce disability and prevent recurrence. For patients who have already suffered from stroke, early or ultra-early treatment is required to reduce the degree of disability and to remove or treat risk factors to prevent recurrence. For example, for ischemic stroke, thrombolytic therapy should be started within 6 hours after the onset of stroke. The earlier the intervention of targeted therapeutic measures, the better the treatment effect and the lower the degree of disability. If aura symptoms such as sudden dizziness, headache different from usual, numbness or weakness of limbs, or slurred speech occur, and no relief for more than 30 minutes, the patient should be sent to the hospital immediately for treatment. The most effective treatments for ischemic cerebrovascular disease currently include stroke units, thrombolytic therapy, antiplatelet drugs and anticoagulation therapy. Hemorrhagic cerebrovascular disease can be treated with conservative internal medicine or surgery depending on the condition and the amount of bleeding. In recent years, minimally invasive hematoma removal for cerebral hemorrhage has been widely accepted and used for its minimal trauma and wide indications. For subarachnoid hemorrhage, both surgical and interventional treatments are available. Risk factors should be identified and managed accordingly along with the acute treatment. It should be noted that there are still some misconceptions in the understanding of cerebrovascular disease. For one, some people believe that cerebrovascular disease attacks can be prevented by intravenous drips of vascular unblocking drugs every autumn and winter, which has no scientific basis. Preventive infusions are mainly drugs that activate blood circulation, reduce blood viscosity, anti-free radicals and anti-platelet aggregation, which may theoretically have a role in preventing cerebrovascular disease, but the current “conventional” infusion prevention methods have not yet been validated by evidence-based medicine. In addition, infusion will increase the chance of infection and infusion reaction, cerebrovascular disease should be based on the etiology of comprehensive prevention and treatment, relying on one or two drugs infusion alone can not play a preventive role. Myth No. 2, some people believe that cerebrovascular disease is closely related to the elderly, and young and middle-aged people do not need to worry about this, the fact that this view is biased, pathological research found that: in about 20 years old, about 1/3 of people may occur mild atherosclerosis. Recent surveys have shown that stroke patients under 45 years of age have accounted for more than 9% of the total number of patients. In view of the early age of cerebrovascular disease onset, people over 40 years old should have an annual whole-body physical examination to enhance stroke prevention. And people with high-risk factors for stroke should have regular medical checkups at age 35 or older.