Cerebrovascular disease (stroke, strokes) is a common and frequent disease that endangers human health. According to incomplete statistics, there are >1.5 million new cases and >6 million existing survivors every year, of which 75% lose their labor force and 40% are moderately disabled, and it is the main cause of disability and cognitive impairment in the elderly, which not only causes suffering to the patients themselves, but also brings misfortune to their families. The direct or indirect economic loss is up to tens of billions of dollars per year.
The risk factors that have been identified are: hypertension, heart disease (atrial fibrillation, infective endocarditis, mitral stenosis, recent large myocardial infarction), smoking, transient ischemic attack, disease-free carotid stenosis, diabetes, parental history of stroke, risk factors that have not been fully identified are: hyperlipidemia, obesity or overweight, oral Most strokes can be prevented by taking the necessary preventive and control measures against the risk factors and by long-term effective adherence. 1. Relationship between hypertension and stroke
Most stroke patients have a history of hypertension. There is a lot of evidence that long-term mental anxiety, stress, excessive salt intake, certain genetic factors and poor lifestyle are all triggers for elevated blood pressure. With the accelerated pace of modern urban life, people are under more and more pressure in psychology, work and life.
In China, the incidence of hypertension has increased significantly in the last 20 years, and its main cause is due to the damage to blood vessels caused by hypertension and the changes caused by the characteristics of the cerebrovascular structure itself. Hypertension can cause spasm of small blood vessels throughout the body, and prolonged vasospasm can cause deformation of the vessel wall due to lack of oxygen, thickening of the vessel wall, narrowing of the lumen and loss of elasticity. If coupled with other factors, such as high blood lipids, high blood sugar, high blood viscosity and other factors to accelerate the formation of thrombosis, but also easy to form tiny aneurysms. Some parts of the cerebral vessels are steeper and straighter, which can easily rupture and lead to cerebral hemorrhage.
2. The relationship between hyperlipidemia and stroke
Hyperlipidemia, also called hyperlipidemia, is an abnormality in the body’s fat metabolism that causes an increase in blood lipids or a change in blood lipid levels beyond the normal range. Commonly, hyperlipidemia is characterized by abnormalities in 1 or more of the following indicators.
(1) Elevated serum total cholesterol level.
(2) Elevated serum triglyceride levels.
(3) Abnormally low serum HDL cholesterol level.
In recent years, as people’s living standards continue to improve and their diets and lives change, the overall blood lipid levels of the population are increasing year by year. In the early 1990s, about 60% of people in the United States exceeded the criteria for borderline hyperlipidemia. In the early 1990s, about 60% of the population in the United States exceeded the standard for borderline hyperlipidemia, and in the early 1990s there was a significant increase in lipid levels compared to the 1980s, especially in large cities in the north, where it is estimated that 30% to 40% of the population has varying degrees of hyperlipidemia, or abnormal lipid metabolism. Recent studies have shown that even when total cholesterol levels are not high, high triglycerides are a new independent risk factor for stroke. When there is more lipid in the body than the body needs, it accumulates in the walls of blood vessels, causing them to harden and narrow.
3. The relationship between diabetes and stroke
Experts estimate that there are more than 30 million cases of diabetes mellitus in China. Diabetes mellitus damages the walls of cerebral blood vessels in many ways, manifesting itself in both macroangiopathy and microangiopathy, promoting thrombosis. .
Patients with chronic diabetes have impaired cerebral blood flow autoregulation and decreased local cerebral blood flow. Long-term chronic hyperglycemia can increase blood viscosity, and diabetes can disrupt lipid metabolism, so that HDL cholesterol (also better cholesterol), which has a protective effect on blood vessels, is reduced, and triglycerides in the blood cannot be fully utilized, thus leading to hyperlipidemia. Accelerate the atherosclerosis of small and medium-sized vessels; LDL cholesterol (bad cholesterol) bad effect accelerates the atherosclerosis of large and medium-sized arteries; hyperinsulinemia promotes the formation of atherosclerotic plaques; brain cell metabolism disorders, blood vessel wall damage, blood hypercoagulation state in diabetic patients are all causes of atherosclerosis, cerebral ischemia and hypoxia and cerebral infarction.
Some patients with cerebral infarction did not know they had diabetes before the onset of the disease, but only discovered it after they were hospitalized for examination. Although these patients are not seriously ill at the onset of the disease, most of the CT findings are small infarct foci, mostly in critical areas and more than one in number, so the hemiplegia is more severe. Diabetic cerebral infarction has a tendency to be both less severe in CT presentation and more severe in clinical paralysis, and it does not recover easily and is prone to recurrence. This is mainly because diabetes damages micro-arteries, makes it difficult to form collateral circulation, and hyperglycemia aggravates cell death and aggravates cerebral hematoma.
4., The relationship between age and stroke
The age-specific nature of stroke is striking. The incidence and mortality of both ischemic and hemorrhagic strokes increase with age. In particular, the incidence and mortality rates increase linearly with age. In two surveys in urban and rural areas of China, for example, the incidence rate in the age group of 75 years and above is 1.4 to 1.6 times that of 65-74 years, 3 to 4 times that of 55-64 years, 5 to 8 times that of 45-54 years, and more than 30 times that of 33-44 years. The above findings show that the incidence and mortality of stroke increases with age.
5. The relationship between smoking and stroke
Smoking is an independent risk factor for ischemic stroke, and smoking can increase the risk of stroke by 2 to 3 times. Passive smoking also increases the risk of atherosclerosis in the home, and smoking is a determinant of atherosclerotic plaque thickening. The greater the number of cigarettes smoked the greater the risk, and the earlier the age of smoking, the greater the chance of stroke.
Smoking increases blood clotting, blood viscosity, promotes platelet aggregation, increases blood pressure, and also accelerates atherosclerosis. Compared with hypertension, smokers have a smaller relative risk of stroke, but controlling smoking is still of greater value for stroke prevention. Smoking may also affect the effectiveness of antihypertensive drugs. The risk of stroke decreases only after 2 to 5 years of smoking cessation. China is known as the world’s “big smoker”, therefore, encourage and urge smoking cessation as one of the management measures to reduce the risk of stroke.
6. The relationship between alcohol consumption and stroke
People who drink heavily are one time more likely to have a stroke than the average person. Regular heavy drinking can lead to increased blood pressure, hypercoagulability, increased heart rate, arrhythmia and reduced cerebral blood flow. If a blood vessel in the brain ruptures, a “hemorrhagic stroke” may occur. It has long been recognized that excessive or chronic alcohol consumption (60 g/day) increases the risk of hemorrhagic stroke, especially the risk of subarachnoid hemorrhage (which is 2 to 4 times higher in non-drinkers). Studies have concluded that alcohol consumption can influence the occurrence of stroke by
a) inducing cerebral embolism due to arrhythmia or abnormal heartbeat movement.
b) Inducing hypertension.
c) Increasing platelet aggregation.
d) Activation of the coagulation system.
e) Stimulation of cerebral vascular smooth muscle contraction causing a decrease in cerebral blood flow. And a small or moderate amount of alcohol, preferably a small amount of red wine 50 to 100 ml per day, can help to raise HDL and activate blood clotting and prevent atherosclerosis.
7, the relationship between obesity and stroke
Obese people are prone to diabetes, usually accompanied by increased blood lipids, obese people’s bodies exist in large amounts of adipose tissue, fat itself also requires a lot of blood vessel input nutrients, the heart has to work hard, thus increasing the extra burden, which can lead to hypertension and heart failure, so also prone to stroke. If you are obese or overweight, you should make weight control a big thing and not be careless about it, otherwise it will be too late to regret.
8., Salt and stroke relationship
High salt intake and hypertension certainly have an important relationship. Epidemiological studies have shown that high salt intake is likely to induce hypertension, which leads to the risk of stroke. The difference in the distribution of stroke and hypertension between Japan and China has a parallel relationship with the amount of salt in the diet of the population.
In the last decade, it has been suggested that calcium and potassium have a protective effect on hypertension and stroke, and that high sodium salt alone does not necessarily lead to hypertension, but only increases the risk of hypertension and stroke with low calcium factors, which means that drinking a bag of milk containing 250 mg of calcium daily can effectively supplement the low dietary calcium intake in China. 500 grams of vegetables and fruits per day can effectively supplement the intake of potassium. If calcium and potassium diets are properly taken care of in the population, they can lower hypertension and reduce the risk of stroke.
In conclusion, a healthy lifestyle and control or avoidance of stroke risk factors can significantly reduce the chance of stroke, thus improving the quality of life and leading to a healthy and happy old age.