How to Prevent Stroke

As our diet has become more Westernized in recent years, the number of patients with arteriosclerosis and the resulting angina, myocardial infarction, and cerebral infarction has increased significantly. Among strokes, the proportion of ischemic stroke (cerebral infarction) has also increased, and, as in the West, it accounts for 80% of strokes.

Once brain tissue undergoes necrosis due to a stroke, it cannot be restored to its previous state by any treatment (acupuncture, medication, physical therapy, etc.). Therefore, when a stroke occurs, many patients are left with aftereffects to varying degrees, and the pain suffered by the patient as well as the social and economic losses are very great. Even in other countries, it has been reported that 20% of long-term hospitalized patients require help from family members because of stroke. The only way to fundamentally solve the burden of such strokes is prevention, and physicians’ main concern is also the effective prevention of stroke.

For stroke prevention, it is important to identify the risk factors for stroke. Through many studies in the past, the risk factors that increase the occurrence of stroke have been well established. Research on risk factors that have not yet been identified is also ongoing. By controlling risk factors through lifestyle management, medication, and sometimes surgery, the occurrence of stroke can be reduced. By controlling only the already well-known risk factors, about 80% of strokes can be prevented.

The best treatment for stroke is thorough prevention. All factors that can trigger stroke should be understood, and these factors should be actively reduced.

1. Hypertension

This is the most important risk factor for stroke and is present in more than 50% of patients with cerebral infarction and in 70–88% of patients with cerebral hemorrhage. When you have high blood pressure, arteriosclerosis occurs, causing the walls of the blood vessels to thicken or harden. As a result, the blood vessels narrow and the inner lining of the vessels is damaged, making it easier for blood to clot and form a thrombus. This can block blood vessels and cause cerebral infarction. In addition, when blood pressure is high, the walls of small blood vessels weaken and then rupture, which causes cerebral hemorrhage.

2. Heart disease

Heart disease is present in 25% of stroke patients. Due to angina, myocardial infarction, valvular heart disease, or atrial fibrillation, abnormal blood flow within the heart can cause blood to stagnate partially in the heart, leading to thrombus formation. If the thrombus breaks off, flows through the blood vessels, and blocks a cerebral blood vessel, cerebral infarction occurs.

3. Diabetes

Diabetes is also an important disease that causes arteriosclerosis, and it is often accompanied by other causes of arteriosclerosis such as hypertension and hyperlipidemia. When you have diabetes, in addition to an increase in strokes caused by arteriosclerosis, lacunar infarctions, in which small arteries become blocked, also occur frequently. Patients whose diabetes is not well controlled also tend to be left with more severe neurological disabilities after a stroke.

4. Previous history of stroke

In patients who have had a stroke once, if no treatment is given for risk factors, the chance of recurrence is quite high. Specifically, the recurrence rate is about 8 to 10 per 100 patients each year. Even in the case of a transient ischemic attack, in which a blood vessel is temporarily blocked and then opens on its own, returning to normal within 24 hours, about 40% eventually develop cerebral infarction.

5. Hyperlipidemia

When total cholesterol and low-density lipoprotein in the blood increase, arteriosclerosis is promoted, and when high-density lipoprotein increases, arteriosclerosis is inhibited. If hyperlipidemia is present, cholesterol deposits in the blood vessels cause arteriosclerosis that narrows the vessels, thereby increasing the risk of stroke.

6. Smoking

When you smoke, catecholamines in the blood increase due to sympathetic nervous system stimulation, and arteriosclerosis is induced, raising the risk of stroke by 2 to 3 times.

7. Obesity and dietary habits

In obese patients, the frequency of hypertension and diabetes is high, so arteriosclerosis develops easily, increasing the risk of stroke.

8. Alcohol

Chronic alcoholism or heavy drinking can cause arrhythmia, impaired myocardial contraction, hypertension, and cerebral vasoconstriction, increasing the risk of stroke.

9. Other risk factors for cerebral hemorrhage

If a person has a cerebral aneurysm, arteriovenous malformation, or a bleeding disorder, the risk of cerebral hemorrhage is significantly higher. People with these risk factors should consult a doctor in advance and consider taking the necessary preventive measures.

10. Lifestyle habits

Avoid staying in cold places for long periods in winter or suddenly going out into a cold place. In particular, elderly people with hypertension or obesity should be especially careful in places such as toilets and bathhouses, where rapid changes in temperature or blood pressure can occur. This is because cold weather causes blood vessels to constrict, raises blood pressure, and makes blood vessels more likely to rupture.

You should exercise regularly. If the energy the body consumes through physical activity is less than the energy it takes in, there is an energy surplus, which causes obesity. To maintain energy balance, rather than leaving insufficient exercise unchecked and drastically reducing food intake, you should maintain proper nutrition, move your body frequently, and expend energy accordingly. In addition, moderate exercise is effective for relieving stress and improving insomnia. For full-time homemakers or people who do mostly sedentary work, exercise of about 200–300 Kacl per day for men and 100–200 Kacl per day for women is ideal.

• Avoid overwork and get enough sleep.

• In daily life, do your best to relieve stress.

• Prevent constipation and try to maintain good bowel habits.

• Be careful not to consume excessive amounts of salt. To help prevent high blood pressure, it is recommended to keep salt intake within 10 g per day.

• To prevent arteriosclerosis, avoid foods high in cholesterol and eat plenty of vegetables and fruits.

So far, we have looked at ways to prevent stroke.

In the next installment, we will learn about abdominal pain.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal