Genetic
Predisposition
A familial history
of cerebral vascular accidents is one of the strongest
predictors of whether or not an individual will suffer a
stroke.
Age
Older people have
a much higher risk of stroke. Eighty three percent of
strokes occur in individuals over 59 years of age. Most
first strokes occur in people in their 60's and 70's.
Gender
Men are more
likely to have strokes, and at an earlier age than women.
Women are catching up rapidly and in fact more women than
men die from heart attacks.
Primary
Hypertension
Primary
hypertension refers to elevated blood pressure.
Diastolic pressure is measured while
the heart is relaxing. Systolic blood pressure is measured
while the heart is contracting. Normal blood pressure is 120
systolic over 80 diastolic, while high blood pressure is a
pressure greater than 140/90. During strenuous exercise, a
normal person's blood pressure will creep up into the
abnormal range temporarily. In cases of hypertension, blood
pressure remains high, regardless of activity level. Some people will have a high blood pressure reading when their pressure is taken in a doctor's office. It's referred to as the white coat syndrome.
Untreated
hypertension increases the risk of ischemic stroke by
pushing plaque up against the arterial walls. It also
increases the risk of hemorrhagic stroke by causing pressure
against the arterial walls which could weaken them over
time.
Smoking and
obesity further increase the risk of vascular problems in
those who have hypertension. Losing weight and exercising
regularly will be a big help with blood pressure
management.
Smoking
Smoking greatly
increases an individual's risk of vascular disease
independently of primary hypertension. Smokers are twice as
likely as non-smokers to have heart attacks and strokes
Eating Red Meat
A study in the journal, Nature Medicine (2013), points out that carnitine is a compound in red meat that is also in some energy drinks. Certain bacteria in the digestive tract convert carnitine into TMAO which promotes athersclerosis, or a thickening of the artieries. Researchers led by Stanley Hazen, chief of cellular and molecular medicine at the Cleveland Clinic, tested the carnitine and TMAO levels of omnivores, vegans and vegetarians. Robert A. Koeth et a.l 2013 examined records of 2,595 patients undergoing cardiac evaluations. Patients with high levels of TMAO, the more carnitine in the blood, were more likely to develop cardiovascular disease, heart attacks, stroke and death. A number of other studies have linked consumption of red and processed meat with cardiovascular disease and some cancers.
Diabetes
Diabetes promotes
arteriosclerosis, thus increasing vulnerability to vascular
problems. Diabetes and hypertension are a particularly
dangerous combination.
High
Cholesterol
High density
lipoprotein (HDL) is the "good" cholesterol. Low-density lipoprotein (LDL) is the "bad"
cholesterol. It is alright to have high levels of HDL,
but a high concentration of LDL is a health risk as is high levels of triglycerides. Levels of LDL should be under 100 mg/dl. Levels of HDL should be between 40 and 60 but ideally be a little over 60. Overall
cholesterol levels should be under 200. Triglyceride levesl should be under 150 mg/dl. Betwen 150-199 is borderline. Above 200 is high.
Cholesterol
damages the lining of blood vessels, exposing the underlying
smooth muscle tissue. This muscle tissue bulks up when
exposed directly to blood. Plaque is primarily composed of cholesterol
build up and smooth muscle cells.
Some feel that the
relationship between cholesterol levels and stroke is not
clear-cut. A minority of physicians feel that high
cholesterol is not a significant factor in 80-90% of
strokes. Most disagree.
Many medical
professionals today (2011) feel that inflammation of the
arteries as measured by C reactive protein may be a better prognostic indicator than
level of cholesterol.
Niacin in relatively high doses (1. 5 grams) effectively raised my "good" cholesterol from 34 to 60. Before you try it you must see your doctor.
Hematological
Disorders
Polycythemia,
hemophilia and hyperuricemia can all increase an
individual's risk of stroke. Polycythemia is a thickening of
the blood due to an increase in the number of cells.
Hemophilia is a thinning of the blood which prevents it from
coagulating. Hyperuricemia involves an elevation of the
level of uric acid in the blood. (This is the cause of
gout.)
Congestive Heart
Failure
Congestive heart
failure occurs when the heart can no longer beat with
sufficient strength and the lungs fill with fluid. This
increases the number of red blood cells, thickening the
blood and thus increases the risk of stroke. One sign of congestive heart failure is swollen ankles. Many years ago this condition was called dropsy.
Arrythmias
Some arrythmias
can cause the formation of embolisms, leading to an ischemic
stroke.