Stroke, also known as stroke, represented by cerebral hemorrhage and cerebral infarction, is the most common serious cerebrovascular disease in clinical practice. As we all know, hypertension, dyslipidemia and diabetes are closely related to cardiovascular and cerebrovascular diseases, and they are undoubtedly important risk factors that can cause stroke. But what many people don't know is that in addition to the three highs, there are many other factors that are also closely related to the increased risk of stroke, and at least four of them can be detected and intervened through routine physical examinations. Today we will give you a specific talk about these factors.
1. Atrial fibrillation
Clinically, many atrial fibrillations are found during physical examination through auscultation, pulse checking, or electrocardiogram examination. Elderly people over 65 years old who have had symptoms such as palpitation, palpitations, heart beats, and pulse disorders. By doing 24-hour Holter monitoring, the detection rate of atrial fibrillation can be improved. Atrial fibrillation is an abnormality in the electrical activity of the heart, but it can directly cause a disorder of atrial contractile movement. The long-term persistence of atrial fibrillation will make the left atrium prone to blood clots, and once the blood clots fall off, they will be rushed directly into the brain with the arterial blood flow, blocking the cerebral arteries, thus causing cerebral infarction. According to statistics, about 1 in 5 cerebral infarctions are caused by cardiac emboli. By intervening in atrial fibrillation, we can greatly reduce its risk of causing cerebral infarction.
First, transcatheter ablation can be used for atrial fibrillation in patients who meet certain conditions**.
Secondly, the rational use of anticoagulant drugs under the guidance of a doctor can reduce the chance of blood clots forming in the atrium.
In addition, even in patients with atrial fibrillation who are unable to adhere to anticoagulation** for a long time, left atrial appendage closure is also available to reduce the risk of cerebral infarction.
2. Carotid plaque.
Nowadays, carotid ultrasonography has become more and more popular in routine physical examinations, and many people will see the abnormal result of carotid plaque on the physical examination report.
Because the blood flow through the carotid artery eventually flows into the brain, once a blood clot forms on the surface of the carotid plaque, the blood clot can easily be carried into the brain by the blood flow, causing a cerebral infarction.
However, there is no need to worry too much, the risk of cerebral infarction caused by carotid plaque is mainly related to the stability of the carotid plaque itself and whether it causes vascular stenosis.
If the ultrasound shows that the carotid plaque is relatively stable and the patient's blood lipids are not high, it is sufficient to strengthen the intervention of a healthy lifestyle and regularly observe the changes in the carotid plaque.
If the ultrasound shows that the carotid plaque is unstable, or if the patient has elevated blood lipids, the doctor will generally recommend taking a statin lipid-lowering drug for it**. Statins not only lower cholesterol, but also provide very clear cardiovascular protection. In addition, it is possible to stabilize the plaque and even shrink in size. In a more serious condition, plaque has caused significant narrowing of the carotid artery, which in itself can cause symptoms related to cerebral insufficiency, and at the same time, the risk of cerebral infarction is extremely high. Therefore, for such patients, doctors often ask them to take statins and aspirin at the same time, and will prevent cerebral infarction through the antiplatelet effect of aspirin. Some patients may even undergo carotid endarterectomy if necessary**.
3. Luminal infarction. In a considerable number of middle-aged and elderly people's cranial CT or magnetic resonance examination reports, lacunar cerebral infarction can be seen, referred to as luminal infarction. Because cavity infarction does not often cause stroke symptoms such as numbness, weakness, and slurred speech, doctors do not particularly emphasize this**.
Therefore, many people do not take it seriously. In fact, strictly speaking, luminal infarction is a typical manifestation of cerebral small vessel disease, and the presence of cerebral small vessel disease means that the risk of stroke is significantly increased.
Generally, after the detection of a luminal infarction, it is necessary to comprehensively screen for other risk factors for stroke, especially to control blood pressure, because blood pressure control is the most effective way to prevent the occurrence and development of age-related cerebral small vessel disease.
The Chinese Guidelines for the Diagnosis and Treatment of Cerebral Small Vessel Disease 2020 also specifically point out that after evaluation by neurologists, patients with low risk of bleeding can consider taking aspirin to prevent or ** cerebral small vessel disease.
Fourth, high blood homogeneity.
"Hyperhomocysteemia" is an abbreviation for hyperhomocysteinemia. Hyperhomocysteinemia is a common metabolic abnormality that affects from the fetus to the elderly, with an overall prevalence of up to 5% in the population. According to the definition in the expert consensus on the diagnosis and treatment of hyperhomocysteinemia, a blood homocysteine level greater than or equal to 10 can be defined as hyperhomogeneity.
Current research suggests that hyperglycemia is closely related to the occurrence and development of a variety of diseases, including stroke.
Hyperemia can lead to pathological changes in tissues and organs through a variety of mechanisms, such as oxidative damage, DNA methylation, and abnormal metabolism of sulfur-containing compounds. Studies have found that by supplementing nutrients such as folic acid and vitamin B12 and B6, many people can improve their blood pressure.
For the general population with high blood sugar, it is recommended to improve this indicator by increasing the intake of foods such as fresh vegetables, fruits, legumes, fish, whole grains, etc.
For patients with high blood and hypertension, diabetes or other cardiovascular diseases, it is recommended to supplement folic acid, vitamin B12, B6 and other supplements to strengthen the intervention of this indicator.
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In fact, in addition to the four factors we mentioned above, there are also problems such as migraine headaches and sleep apnea, which are also strongly associated with an increased risk of stroke. It's just that they are not often reflected in the medical examination report.
If you find yourself suffering from migraine symptoms or snoring while sleeping, it is best to visit the appropriate clinical department to reduce the risk of stroke through early intervention.
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