What Are the Causes of Stroke? (Video)

There are several major risk factors for stroke. For an in-depth explanation of each:

• Hypertension
• Diabetes
• High Cholesterol
• Atrial Fibrillation
• Obesity
• Smoking
• Kidney Failure
• Fabry Disease

Hypertension

Seventy percent of people who experience a stroke have hypertension (high blood pressure); it is therefore considered a major risk factor. Hypertension has no symptoms and can be detected only by measuring blood pressure at home or at the doctor. The higher the blood pressure, the greater the risk of stroke, and vice versa: lowering diastolic blood pressure (the lower value of the test) by 6 mmHg leads to no less than a 40% decrease in the risk of stroke.

Regularly measuring, monitoring and carefully regulating blood pressure is important for everyone in order to prevent stroke.

Regulating blood pressure is especially crucial for demographics designated as high-risk. These include people with obesity, people with diabetes, people who consume alcohol, people who do not exercise, and people with a history of high blood pressure.

It is recommended to maintain systolic blood pressure of lower than 140 mmHg, or lower than 130 mmHg for diabetics.

Atrial Fibrillation

Atrial fibrillation is the most common form of cardiac arrhythmia, and its prevalence increases with age. The incidence of atrial fibrillation is less than 1% among people under 60 but reaches almost 10% among people over 80. Atrial fibrillation usually develops in patients with other heart problems such as congestive heart failure, valvular heart disease or coronary artery disease. Cardiac arrhythmia slows the flow of blood between the atria and ventricles of the heart. Blood that does not flow properly tends to coagulate and form blood clots, which can be carried by the bloodstream to the brain and cause embolic stroke.

Patients with atrial fibrillation are at 5-6 times greater risk of stroke than people with a normal heart rate. Fibrillation can be diagnosed with noninvasive tests such as an EKG.

Atrial fibrillation is usually classified by its pattern of appearance over time:

• Persistent atrial fibrillation: two or more episodes
• Paroxysmal atrial fibrillation: recurrent episodes that stop spontaneously within seven days
• Long-standing persistent atrial fibrillation: requires cardioversion with medication or electric shock
• Permanent atrial fibrillation: ongoing atrial fibrillation that continues despite treatment, or when treatment with cardioversion is not suitable

Paroxysmal and long-standing atrial fibrillation are classified as persistent atrial fibrillation based on the pattern of the arrhythmia.

By filling out a short questionnaire, you can evaluate your level of risk for atrial fibrillation, which is a significant stroke risk factor. Your answers in the questionnaire are weighted and used to determine your level of risk. If your risk level is high, you can participate in a diagnostic process that includes using a device for monitoring and detecting arrhythmias that is sent to your home.

Short questionnaire

Diabetes

Strokes are four times more common among people with diabetes (both type 1, which is insulin-dependent, or the more common type 2) than among the general population. This disease might not exhibit any significant symptoms and can be detected with a simple blood test at your HMO. Unregulated diabetes can cause a blockage of the small blood vessels in various organs such as the intestines or kidneys and a blockage of the blood vessels in the brain, leading to stroke.

High Cholesterol

The level of lipids or cholesterol in the blood is a significant risk factor for stroke. It is therefore especially important to maintain low levels of “bad cholesterol” (LDL) and high levels of “good cholesterol” (HDL). You should maintain an overall level of cholesterol in the blood below 190 mg/dL. The recommended ceiling for LDL is 100 mg/dL for healthy people; less than 100 mg/dL for people with risk factors; and less than 70 mg/dL for people who have already had therapeutic catheterization, a heart attack or a stroke.

Smoking

Smoking is a catalyst for developing atherosclerosis and raising levels of coagulation factors in the blood and accelerates damage to the capillary walls of the brain. Smoking has been linked to stroke and many other diseases, so you should quit smoking — now!

Excessive Consumption of Alcohol

Regarding alcohol consumption, it is important to understand the difference between two antithetical behaviors: Drinking alcohol excessively is a risk factor for both ischemic stroke and intracranial hemorrhage. But drinking small quantities of alcohol, especially red wine, has a protective effect against ischemic stroke.

Obesity

The risk of having a stroke is higher among people who are overweight. This risk is highest among those who tend to gain weight in the center of their body — a type of weight gain called “abdominal obesity.” Studies have found that some of these risk factors are linked: Obesity leads to high cholesterol levels, hypertension, and the body developing insulin resistance — which eventually leads to adult-onset diabetes (type 2 diabetes). The ensemble of phenomena described above is called “metabolic syndrome.” But a 5-10% weight loss can lead to a 30% decrease in abdominal fat, thus significantly improving the risk profile for heart disease, vascular disease and stroke.

Professor Natan Bornstein’s lecture about the causes of stroke and how to prevent them:

Fabry Disease

Fabry disease is a hereditary disease caused by a lack of enzyme alpha-galactosidase-A. This leads to the accumulation of a sugar-lipid molecule called Gb3 in various types of cells in the body such as the small blood vessels, nerves, kidneys, and muscles of the heart and brain, damaging the function of these organs.

The disease is related to a gene defect on the X-chromosome, which is one of the sex chromosomes. Women have two X-chromosomes, so they can be carriers without any manifestations of the disease.

One of the main complications of Fabry disease is ischemic mini-strokes, and strokes are common among both men and women with the disease and can occur at a young age. There is a high prevalence of stroke even among female carriers.

Find more details about the disease and its symptoms, diagnosis and treatment here.

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