Prevention of cerebrovascular disease

Cerebrovascular disease represents a major cause of morbidity and mortality worldwide, especially among individuals over 65 years of age.

It represents a fact that usually suddenly changes the capacities and autonomy of the patient. The prognosis of these patients worsens due to the frequency with which recurrences or concomitant vascular disorders occur in other body systems (peripheral vascular disease, coronary angiopathy), a fact that has great repercussions on functionality and quality of life.

The main risk factors for cerebrovascular disease are age, gender, high blood pressure, ischemic heart disease, cardiac arrhythmias, dyslipidemia, diabetes mellitus, and asymptomatic carotid stenosis. Other risk factors related to this pathology include the presence of hematological alterations, smoking, alcoholism, hyperuricemia, among others. Age and sex are the only non-modifiable risk factors.

High blood pressure is the main risk factor for ischemic and hemorrhagic cerebrovascular disease. Its strict control, through lifestyle modifications (low-salt diet, moderate exercise, weight control), and drug treatment when the above measures are not sufficient will reduce the risk of cerebrovascular accidents.

The presence of ischemic heart disease as a risk factor seems to be related to the existence of generalized atherosclerosis, a pathophysiological phenomenon that underlies most vascular disorders in adulthood.

Cardiac arrhythmias, especially chronic atrial fibrillation, increase the risk of stroke by seven to seventeen times compared to healthy individuals. Non-rheumatic atrial fibrillation is the most common cause of cerebral embolism in patients over sixty years of age, being one of the leading causes of mortality in the medium and long term. For this reason, in the presence of this type of arrhythmias, it is very important to consider the preventive treatment of embolisms through anticoagulant treatments, always taking into account their risks and benefits.

Dyslipidemias are also risk factors for cerebrovascular disease. Its strict control at any age through a diet low in saturated fat and drug treatment when dietary measures do not control lipids to acceptable levels will reduce the risk of stroke.

diabetes mellitus increases between 1.5 and 3 times the probability of suffering a cerebrovascular accident, especially of atherothrombotic origin, with respect to the healthy population, being considered, additionally, as an aggravating factor of the picture that predisposes to recurrences and complications in other organs and medium and long-term systems. Diabetic patients must maintain long-term metabolic control to reduce the risk of cerebrovascular disease. Likewise, to reduce the risk of developing diabetes in adults, it is important to control overweight and exercise.

smoking is an independent risk factor for the development of cerebrovascular disease, in addition to contributing to other factors such as ischemic heart disease and generalized atherosclerosis. It is important not to smoke or quit smoking as soon as possible.