Saturday, June 19, 2010


A stroke, or cerebrovascular accident (CVA), occurs when a blocked or burst blood vessel disrupt blood supply to part of the brain causing brain cells to die.

The former is called ischaemic stroke. The underlying condition for this type of obstruction is the development of fatty deposits lining the vessel walls. This condition is called atherosclerosis. Ischaemic stroke accounts for about 87 percent of all cases.

Haemorrhagic stroke results from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. Hemorrhagic stroke accounts for about 13 percent of stroke cases.

As a result of the disruption in blood supply, the affected area of the brain is unable to function, leading to inability to move one or more limbs on one side of the body, inability to understand or formulate speech, or inability to see one side of the visual field.

STROKE has become Malaysia's number three killer after heart disease and cancer, with an average of 110 people dying of it every day according to Dr Tan Chong Tin, senior consultant at the Neurology Clinic of the Universiti Malaya Medical Centre (The Star, October 25, 2005).

Dr Tan said 70% of stroke patients who recovered stopped taking part in social activities, 30% needed assistance in coping with daily life and 15% died within a month.

INTERSTROKE, a large international study, has found that 10 risk factors account for 90 percent of all the risk of stroke, with high blood pressure playing the most potent role (1).

The study presented on June 18, 2010 at the World Congress on Cardiology in Beijing reports that the 10 factors significantly associated with stroke risk are high blood pressure, smoking, physical activity, waist-to-hip ratio (abdominal obesity), diet, blood lipid (fat) levels, diabetes, alcohol intake, stress and depression, and heart disorders(2).

Of that list, five risk factors usually related to lifestyle
  • high blood pressure
  • smoking
  • abdominal obesity
  • diet
  • physical activity
are responsible for a full 80 percent of all stroke risk, according to the researchers.

Targeted interventions that reduce blood pressure and smoking, and promote physical activity and healthy diet, could substantially reduce the burden of stroke.

And the good thing is these lifestyle factors are modifiable.

High blood pressure accounts for a third of all stroke risk, the study found. Those who had a history of high blood pressure were more than two and a half times more likely to suffer a stroke than those who did not.

Your doctor had selected your prescription from a wide array of blood pressure pills with different mechanism of actions to suit your age, gender, your coexisting medical disorders, your occupation and your leisure-time activities. But to a great extent successful treatment of hypertension depends on your compliance with the prescribed medication regime.

Smoking is another major hazard, and is associated with one in five strokes. Smokers have double the stroke risk of non-smokers. Follow our postings on smoking cessation HERE.

Abdominal fat or visceral fat tissue is known to release various inflammatory cytokines (messenger proteins). During the course of ischaemic stroke, inflammatory mechanisms are among the important mediators of brain injury.

The best way to reduce abdominal fat is with exercise. A recent study by Kevin C. Maki et al found that people who exercised regularly and consumed green tea have been found to lose more fat in the total abdominal and the subcutaneous abdominal area than those who had only exercised(3). SEE also how Omega-3 protects against the complications of obesity.

Recommended changes in diet include reducing salt, increasing dietary fibre, and eating enough fresh fruit and vegetables. Besides vitamins, minerals and fibre, fruit and vegetables also contain complex plant components called phytochemicals, which are antioxidants.

Besides being a valuable source of fibre, cereals contain folic acid and are also rich in other B vitamins, such as vitamin B6, which help to lower levels of homocysteine which can help protect against atherosclerosis. You can download the fact sheet on Diet and Stroke HERE

Most people associate becoming more physically active with losing weight, but it can also prevent stroke, the third leading cause of death. In some cases, studies have shown that regular physical activity (five times a week) can cut stroke risk in half. CLICK HERE for more information.
  1. O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, Rangarajan S, Islam S, Pais P, McQueen MJ, Mondo C, Damasceno A, Lopez-Jaramillo P, Hankey GJ, Dans AL, Yusoff K, Truelsen T, Diener HC, Sacco RL, Ryglewicz D, Czlonkowska A, Prof Weimar C, Wang X, Yusuf S, on behalf of the INTERSTROKE investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. The Lancet, Early Online Publication, 18 June 2010 doi:10.1016/S0140-6736(10)60834-3
  2. Most of the risk factors mirror those linked to heart attacks
  3. Maki KC, Reeves MS, Farmer M, Yasunaga K, Matsuo N, Katsuragi Y, Komikado M, Tokimitsu I, Wilder D, Jones F, Blumberg JB, Cartwright Y. Green tea catechin consumption enhances exercise-induced abdominal fat loss in overweight and obese adults. The Journal of Nutrition. 2009 Feb;139(2):264-70.
  4. Picture
  5. There is Life After Stroke. Contact NASAM today

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