Risk factors for development of cerebrovascular stroke
Petrović, G.
Medicinski Pregled 53(3-4): 207-214
2000
ISSN/ISBN: 0025-8105 PMID: 10965691 Document Number: 524207
Nowadays stroke has a dominant place in the structure of neurological morbidity. According to data of the World Health Organization, stroke is the third highest cause of morbidity and mortality in the developed countries of the world, immediately following ischemic heart disease and malignant diseases. The appearance of the disease is influenced by many etiological factors, that is risk factors. Natural risk factors are: heredity, sex, age, geographical and climatic factors. Other diseases being risk factors include: hypertension, heart disease and diabetes. Bad habits as risk factors are: eating habits, obesity, smoking, alcoholism and physical and mental inactivity. The paper presents a review of risk factors, their categorization and the influence of each individual risk factor on the development of stroke. Hereditary factors have a significant role in development of stroke and they may serve as a basis for determining the person's susceptibility to stroke in a certain period of life. SEX: It has been proved that persons of female sex in the period prior to menopause are less susceptible to atherosclerosis risk and its side effects--ischemic heart disease and stroke. It is due to the fact that in this period of life women have a higher concentration of high-density lipoproteins, which are known to protect blood vessels against atherosclerosis. AGE: The incidence of stroke is higher at an older age, although nowadays there is evidence that younger people may develop the disease as well. It has been noticed that the frequency and intensity of insult are connected with abrupt changes of the front (weather conditions with certain values of atmospheric factors). A high correlation between the frequency of cerebrovascular insult and abrupt change of the front is evident during spells of warm front in cold months and during spells of cold front in warm months. Moreover, changes during the circadian cycle are of utmost importance. Hypertension is one of the factors contributing to the development of cerebrovascular insult, apart from heart diseases and diabetes. The most frequent heart diseases correlating with stroke are: endocardial diseases, myocardial diseases in the form of chronic heart failure or heart attack, atrial fibrillation, hypertrophy of the left chamber and congestive heart failure. Diabetes as an associated risk factor correlates with stroke. A special emphasis is placed on nutrition as a risk factor in development of stroke. Inadequate nutrition contributing to the development of stroke is primarily nutrition which includes a high percentage of fats and leads to hyperlipoproteinemias. Therefore the basic principle in the nutrition of a patient with hyperlipoproteinemias is to limit the overall intake of fats, to reduce the quantity of saturated fats and to increase the intake of unsaturated fatty acids. In order to prevent stroke it is recommended to consume sea fish, legumes rich in diet plant fibres, oats and corn cereals, whole grain rice, fruit and vegetables rich in vitamins C and E. It has been proved that obesity or increase in body weight increases the risk of developing stroke by 1.4 to 2.5 times. Smoking accelerates the process of atherosclerosis leading to the incidence of myocardial and brain stroke. In proportion to the length of smoking and the number of cigarettes, a relative risk of development of stroke goes from 2.4 to 6.1 for men and from 3 to 3.7 for women. A research performed by Finnish authors has shown that in chronic alcoholism the risk of developing stroke is twice as high in men and five times as high in women in relation to the general population. Alcohol reduces the regional cerebral flow by its toxic effect on the cerebral metabolism and thus induces vasospasm and hemoconcentration. (ABSTRACT TRUNCATED)