Sudden coma
Limb hemiplegia
The tongue is crooked
Partial numbness
The speech is not clear
……
If someone close to you is unfortunate enough to have this happen
Be careful, it could be a stroke!
Stroke, also known as stroke, is a very dangerous cerebrovascular disease. Once it happens, the patient quickly enters a critical situation like the opening chapter.
There are many types of stroke – ischemic stroke, hemorrhagic stroke, etc., but either way, there is one common feature:
There will be different ranges and degrees of brain tissue damage. Therefore, it is very important to identify and prevent strokes in advance.
Strokes do not occur suddenly for no reason. These people are high-risk people with stroke [1]:
People with high blood pressure
Hypertension is one of the most important risk factors for cerebrovascular disease.
Long-term hypertension, which is not properly managed, can cause serious damage to blood vessels inside and outside the skull. It can lead to cerebral infarction and cerebral hemorrhage caused by large angiopathy, as well as white matter looseness, microbleeds, and cerebral atrophy caused by small blood vessel lesions [2].
People who smoke
Tobacco affects blood vessels and blood systems throughout the body, accelerating hardening of blood vessels, resulting in narrowing of blood vessels and fragile plaque.
Harmful substances in tobacco promote platelet aggregation and induce thrombosis; nicotine can also stimulate the sympathetic nervous system, promote vasoconstriction, and increase blood pressure, which is extremely harmful to cerebrovascular vessels [3].
People with high blood lipids
Hyperlipidemia, particularly high cholesterol, is a recognized risk factor for atherosclerosis.
Further progression of atherosclerosis of the intracranial and extracranial blood vessels may cause narrowing of the blood vessels and rupture of plaques, leading to thrombotic events.
People who drink excessively
Long-term heavy alcohol consumption significantly increases the risk of cerebrovascular disease events and is an important risk factor for cerebral hemorrhage [4].
People with diabetes
Diabetes mellitus is a clear risk factor for cerebrovascular disease. People with long-term hyperglycemia, the vascular condition is worse than the average normal person, and it is easy to form blood clots, so the risk of stroke increases.
Patients with type 2 diabetes have a higher risk of mortality, disability, and recurrence than those without diabetes.
Obese people
Overweight and obesity are often accompanied by a higher proportion of "three highs", heart disease, snoring, and an unhealthy lifestyle that significantly increases the risk of cerebrovascular disease.
Strokes tend to occur suddenly, one second while walking and laughing, and the next completely losing their movement and language function.
What are the manifestations of a stroke? Remember this "FAST" mantra [5]:
"F" refers to "Face", which is the face
If you find that your face is crooked and obviously asymmetrical when you make an expression in the mirror, and the saliva flows down the corner of your mouth, then this is a very important warning signal.
"A" means "Arm", which is the arm
When lifting both upper limbs, there is a significant inconsistency in the strength of the two sides, and one side is weak and unable to lift or the force is obviously weak, which indicates the possibility of stroke.
"S" means "Speak", i.e. speaking
Slurred speech when speaking, or sudden incomprehension of the meaning of what others are saying, suggests that a stroke may affect the language center.
"T" stands for "Time" and emphasizes the importance of time
If you find that the people around you have such symptoms, you must call the emergency number in time and send it to the nearest hospital with stroke treatment channels at the first time.
At present, stroke treatment has been popularized in the mainland, and the general county-level hospital has a stroke treatment channel (most cities currently have standardized primary or advanced stroke centers). Early fractional treatment may play a key role in the patient's future quality of life.
In addition to the "FAST" recipe mentioned above, there is actually a Chinese version of "120 Theory":
See if "1" is asymmetrical, "2" is weak on one arm, and listen ("0") hears whether the speech is clear.
Whether it is "FAST" or "120 Theory", it is the essential for quick judgment when a stroke occurs, reminding you to find symptoms in time and seek medical treatment as soon as possible.
There is also a class of stroke called "transient ischemic attacks", commonly known as "small strokes". It can be understood as mild symptoms, short recovery, most of which recover quickly within a few minutes to 1 hour, and are easily overlooked.
30% of these "small strokes" occur in the near future, causing severe disability or life-threatening strokes. Most "small strokes" can be treated, and in order to prevent catastrophic adverse outcomes, what needs to be done is to seek medical attention immediately.
Control blood pressure:
Blood pressure is the most important interventional factor in stroke.
In general, the blood pressure of patients with hypertension drops below 140/90mmHg;
Patients with diabetes mellitus, coronary heart disease, heart failure, and chronic kidney disease with proteinuria can be further reduced to less than 130/80mmHg if they can tolerate it;
Hypertensive patients aged 65 to 79 have blood pressure dropd below 150/90mmHg, and if tolerated, they can be further reduced to below 140/90mmHg;
Blood pressure drops below 150/90 mmHg in patients with hypertension 80 years of age and older [2].
Quit smoking:
The harm of smoking to cerebral blood vessels is extremely serious. For the health of cerebrovascular diseases. Quitting smoking is the only way out.[3] If it is difficult to quit smoking, you can also use medical means and drugs to help quit smoking.
Control of hyperlipidemia
Lifestyle modifications help improve the lipid profile. If necessary, drugs can be used to strictly control low-density lipoprotein cholesterol (LDL-C) as the standard of treatment for stabilizing plaque and preventing recurrence in patients with cerebrovascular disease.
Stop drinking:
Alcohol intake should be limited to less than 2 standard cups per day (≤50 mg); men should drink less than 14 drinks per week (≤350 mg); and women should drink less than 9 drinks per week (≤225 mg)[4]. It is best not to dip the wine without sticking.
Glucose reduction standard:
Lifestyle changes in diabetes combined with medication can significantly increase blood glucose compliance. Elderly people, patients with multiple drug combinations, and patients treated with insulin should be monitored to avoid hypoglycemia [7].
Balanced diet:
The Mediterranean dietary pattern is a recognized healthy diet for patients with cerebrovascular disease. In patients with high blood pressure, a low-sodium dietary pattern helps to reduce blood pressure to meet standards. For patients with hyperlipidemia, a high-quality, low-fat diet contributes to the stabilization of blood lipids.
Diabetic patients moderately control the proportion of carbohydrates, which helps to control blood sugar. In addition, fresh fruits, vegetables, high-quality protein, and adequate drinking water are all necessary health foundations for patients with cerebrovascular disease.
Weight Control:
Authoritative health guidelines recommend a body mass index (BMI = weight kg/height m2) of 18.5 to 24.9 kg/m; the waist circumference should be less than 80 cm for women and less than 94 cm for men [1].
Stay active:
Choose the physical activity that suits you to reduce the risk of stroke. For example, walking (preferably brisk walking), jogging, cycling, swimming or other dynamic exercises, 30 to 60 minutes each time 4 to 7 days a week.
High-risk patients (e.g., advanced age, heart disease, patients with unstable blood pressure or blood sugar, patients at high risk of falls, and patients with osteoarticular disease) should follow the advice of their doctor and develop a personalized exercise program under the premise of safety [1].
You who have been working in the case for a long time should also understand this knowledge, and from a young age, you must develop a healthy lifestyle, in order to have a positive physical and mental state, to accept the challenges in life [8]!
Review expert: Wang Chunxue
Director of the Department of Neuropsychiatry and Clinical Psychology of Beijing Tiantan Hospital, Vice Chairman of the Sleep Disorder Branch of the Chinese Stroke Society, Deputy Editor-in-Chief and Director of the Editorial Department of the Chinese Journal of Stroke
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National Guidelines for the Prevention and Management of Hypertension at the Grassroots Level 2020 Edition. [J]. 2021, 13(04): 26-37.
[3] LARSSON S C, BURGESS S, MICHA LSSON K. Smoking and stroke: A mendelian randomization study [J]. Annals of neurology, 2019, 86(3): 468-71.
[4] O'KEEFE J H, BHATTI S K, BAJWA A, et al. Alcohol and cardiovascular health: the dose makes the poison… or the remedy [J]. Mayo Clinic proceedings, 2014, 89(3): 382-93.
Huang Wei, Bi Qi. Recent progression of transient ischemic attacks[J]. Chin J Neurology, 2014, 9(10): 874-9.
Peng Bin, Wu Bo. Guidelines for the diagnosis and treatment of acute ischemic stroke in China[J]. China Journal of Stroke, 2018, 51(09): 666-82.
[7] KNOWLER W C, BARRETT-CONNOR E, FOWLER S E, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin [J]. N Engl J Med, 2002, 346(6): 393-403.
[8] PUTAALA J. Ischemic Stroke in Young Adults [J]. Continuum (Minneap Minn), 2020, 26(2): 386-414.
Editors: Wei Luo, Guo Qian, Zhang Liang
Typesetting: Han Ningning | Proofreader: Wu Yihe
Operations: Li Yongmin | Coordinator: Wu Wei