Cerebrovascular disease has become one of the most important diseases threatening human life and health because of its high morbidity, mortality, disability, and recurrence rate. The study of its causative factors has become an important issue. Studies have shown that the occurrence of cerebrovascular disease is related to various factors such as age, gender, and race. However, such factors are difficult to be controlled and changed by people. Therefore, many experts have devoted themselves to the research of controllable factors of cerebrovascular disease in recent years.
I. Environmental and life factors
The external environment such as geography and climate are related to the occurrence of cerebrovascular disease. In China, with the increase of latitude, the incidence, prevalence and mortality of cerebrovascular disease are increased. The winter and spring seasons, when the climate is colder, are also the high incidence of cerebrovascular disease. Life factors such as poor diet, emotional instability and mental tension are also associated with cerebrovascular disease. Especially in the northern and coastal areas of China, high sodium diet is an important cause of cerebrovascular disease. Such factors can reduce the risk of disease by keeping warm at the right time, controlling diet, strengthening exercise, and regulating emotions.
Certain bad habits such as smoking and alcohol consumption are also one of the triggering factors of cerebrovascular disease. Smoking can increase blood viscosity, which can cause a significant increase in red blood cell pressure and viscosity; it can also cause vasoconstriction and damage to the blood vessel wall, leading to cerebrovascular disease. Studies have confirmed that smoking can increase the risk of stroke by two times. Long-term heavy alcohol consumption can lead to low platelet function and increased fibrinolytic activity, which can also cause small artery spasm, intimal fibrinoid necrosis, vitreous lesions and microaneurysm formation in deep penetrating cerebral arteries, leading to cerebrovascular disease. Studies have confirmed that the discontinuation of the above-mentioned bad habits can reduce the risk of cerebrovascular disease.
Second, disease factors
1.High blood pressure
Hypertension is the most important risk factor of cerebrovascular disease. It is believed that hypertension can directly act on small arteries with diameters of 50-200 microns, causing hyaline changes, microinfarction or microaneurysm formation in these vessels; it can also damage larger vessels with diameters greater than 200 microns and their endothelial cells through mechanical stimulation, causing atherosclerosis to occur. Effective control of blood pressure is a key measure to prevent cerebrovascular disease.
2.Hyperlipidemia
Elevated blood lipids are closely related to atherosclerosis. In Europe and America, the occurrence of cerebrovascular disease is greatly related to the formation of atherosclerotic plaques in large blood vessels, especially in the internal carotid arteries, while in Asian people, the occurrence of cerebrovascular disease is dominated by small arterial lesions, therefore, in terms of the occurrence of cerebrovascular disease, the effect of hyperlipidemia on European and American people is greater than that on Asian people. The risk of increased total cholesterol and LDL concentration is the greatest. Lipid-lowering treatment can effectively reduce the risk of carotid atherosclerosis, thus reducing the risk of cerebrovascular disease.
3.Diabetes
The risk of stroke in diabetic patients is about one times higher than that of those with normal blood glucose. The mechanism of cerebrovascular disease caused by diabetes mellitus is diabetic microvascular and macroangiopathy, and atherosclerosis caused by diabetes mellitus often starts from the damage of arterial endothelium. Another study has confirmed that platelet aggregation is increased in diabetic patients. Effective control of diabetes mellitus will effectively reduce the occurrence of cerebrovascular disease.
4. Hyperhomocysteinemia
Most studies have confirmed that moderately elevated homocysteinemia (Hcy) is associated with the development of cardiovascular and cerebrovascular disease. The mechanism of action is not yet clear, but one of the mechanisms may be the generation of free radicals. Secondly, the effect of Hcy on vascular endothelium and smooth muscle also plays an important role. In addition, Hcy
is also related to fibrinolysis and coagulation system.
5.Heart disease
Various cardiac diseases can increase the risk of cerebrovascular disease, such as atrial fibrillation, infected endocarditis, heart valve disease, acute myocardial infarction, etc. About 75% of patients who die of ischemic cerebrovascular disease are accompanied by heart disease. Atrial fibrillation is the most risk factor for cerebral infarction due to cardiac disease, and studies have shown that about 50% of cardiogenic cerebral embolisms are caused by atrial fibrillation. Anticoagulation and other measures can effectively reduce the occurrence of ischemic cerebrovascular disease.
6.Hematological system diseases
Many diseases of the blood system, such as leukemia, reblocking, thrombocytopenic purpura, erythrocytosis, etc., are prone to cerebral hemorrhage and cerebral infarction due to changes in blood composition.
7.Some infections
Some local infections such as otitis media, facial infection, paranasal sinusitis, peri-tonsillar abscess, cranial osteomyelitis, etc. can cause intracranial venous system thrombosis, resulting in increased cranial pressure and corresponding focal brain symptoms when they affect the intracranial vessels, especially the venous sinuses. Even liver abscesses, urinary tract infections or pelvic inflammatory disease can enter the intravertebral veins via the periventricular plexus and pass through the vertebral veins to the intracranial veins. With the development of neuroimaging, thrombosis of the intracranial venous system is increasingly confirmed in clinical practice.
8.Cerebral vascular malformation
There are both congenital and acquired forms, which are prone to hemorrhagic stroke or recurrent stroke attacks. They are not easily diagnosed before the onset of the disease, but can be diagnosed and treated by surgical or interventional methods after the disease.
Medical factors
The use of certain drugs is also associated with the occurrence of cerebrovascular disease. The most common is oral contraceptives. In addition, steroid hormones contained in contraceptives can affect the metabolism of fat and sugar, causing hyperlipidemia, which may lead to the formation of blood clots. Discontinuation of such drugs may reduce the occurrence of cerebral thrombosis.
Excessive fluid loss, inadequate intake, excessive dehydration, and invasive tests and treatments during the treatment of certain diseases also contribute to cerebrovascular disease. These are just a few of the common and common controllable factors that predispose to cerebrovascular disease. The occurrence of cerebrovascular disease is often the result of multiple factors acting together, and is a complex process, some of which can be intervened and some of which are difficult to intervene. As research progresses, more factors that predispose to cerebrovascular disease will be discovered, and more means of intervention will be available so that the occurrence of cerebrovascular disease can be prevented more effectively and the harm caused by cerebrovascular disease can be reduced.