Release date: 2007-09-06
Dr. Sacco of the United States cited Northern Manhattan research data to explore the latest research advances in risk factors for ischemic stroke.
Dr. Sacco pointed out that with the aging of the population, by 2010, 18 million people worldwide will die from vascular diseases such as stroke and myocardial infarction. However, from the pyramidal map of risk factors for ischemic stroke (Fig. 1), it can be seen that the underlying population will gradually progress to the top and eventually suffer from moderate disease. Therefore, stroke prevention in the underlying population is worthy of attention and needs to reduce their risk of stroke. Risk factors such as age, gender, and ethnicity are uncontrollable in this population, and male, African-American, and Hispanic Americans are at higher risk of stroke. Other adverse lifestyle habits such as reduced exercise, smoking, and alcohol abuse are controllable risk factors.
Risk factors that can be controlled at the intermediate level include blood pressure, blood sugar, blood lipids, and abdominal circumference. Northern Manhattan studies have shown that as systolic blood pressure increases, the risk of ischemic stroke increases. For the sake of convenience, the dangerous blood pressure is defined as 140/90 mmHg, but in practice, the risk of systolic blood pressure of 139 mmHg is higher than 138 mmHg. Therefore, it is necessary for clinicians to raise awareness of continuous risk factors similar to blood pressure. If these continuous risk factors are converted into classification risk factors, it is possible to ignore their risk. In addition, metabolic syndrome has gradually received attention as a risk factor for stroke in recent years.
Higher risk factors include subclinical diseases and biomarkers such as carotid plaques. More than 60% of carotid stenosis increases the risk of stroke, but large carotid plaques are rare. In the Northern Manhattan study, 75% of the subjects had very small plaques and a thickness of only about 1.9 mm. They were not suitable for angiography and did not reach the level of surgery, but this was clearly a risk factor. In addition, the plaque surface is not smooth, the risk of stroke is 6.8% in 5 years, while that of smooth plaque is 2.8%, and the risk of plaque-free can be reduced to 1.3% (Figure 2). In addition, carotid intima-media thickness is also one of the risk factors for stroke. At present, there are studies to try to find genotypes that lead to an increased risk of stroke, but the results are still relatively small. ——Midi Medical Network
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