Vascular diseases of the nervous system are amongst the most frequent causes of admission to hospital. The annual incidence in the UK varies regionally between
150-200/100 000, with a prevelance of 600/100 000 of which 1/3 are severely disabled.
Better control of hypertension, reduced incidence of heart disease and a greater awareness of all risk factors have combined to reduce mortality from stroke. Despite this, stroke still ranks third behind heart disease and cancer as a cause of death in affluent societies.
Prevention of cerebrovascular disease is more likely to reduce death and disability than any medical or surgical advance in management. Prevention depends upon the identification of risk factors and their correction. Hypertension
Hypertension is a major factor in the development of thrombotic cerebral infarction and intracranial haemorrhage.
There is no critical blood pressure level; the risk is related to the height of blood pressure and increases throughout the whole range from normal to hypertensive, a 6 mm Hg fall in diastolic blood pressure is associated in relative terms with a 40% fall in the fatal and nonfatal stroke rate.
Systolic hypertension (frequent in the elderly) is also a significant factor and not as harmless as previously thought. Cardiac disease
Cardiac enlargement, failure and arrhythmias, as well as rheumatic heart disease, mitral valve prolapse and, rarely, cardiac myxoma are all associated with an increased risk of stroke. Diabetes
The risk of cerebral infarction is increased twofold in diabetes. More effective treatment of diabetes has not reduced the frequency of atherosclerotic sequelae.
Close relatives are at only slightly greater risk than non-genetically related family members of a stroke patient. Diabetes and hypertension show familial propensity thus clouding the significance of pure hereditary factors.
Blood lipids, cholesterol, smoking, diet/obesity, soft water
These factors are much less significant than in the genesis of coronary artery disease. Race
Alterations in life style, diet and environment probably explain the geographical variations more than racial tendencies.
A high blood haemoglobin concentration (or haematocrit level) is associated with an increased incidence of cerebral infarction. Other haematological factors, such as decreased fibrinolysis, are important also. Oral contraceptives
The evidence of pill-related stroke is inconclusive. A recent prospective study has suggested an increased risk of subarachnoid haemorrhage rather than thromboembolic stroke.
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Your heart pumps blood throughout your body using a network of tubing called arteries and capillaries which return the blood back to your heart via your veins. Blood pressure is the force of the blood pushing against the walls of your arteries as your heart beats.Learn more...