-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
-
Cosmetic Ingredient
- Water Treatment Chemical
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
*For medical professionals only
Management of common risk factors that can be intervened is important
for effective stroke prevention and control.
of disease to China's health care system.
As the disease with the highest mortality and disability rate, stroke has the characteristics of high incidence, high recurrence rate and high economic burden, which seriously endangers the health
of the Chinese people.
According to domestic and foreign experience, active and effective intervention in stroke risk factors can significantly reduce the incidence of
stroke.
In order to further promote the development of stroke prevention and treatment in China, the sixth expert interview of "Aomei Cloud College: Four Visits by Big Coffee" held on January 5, 2022 specially invited Professor Huang Bi of the First Affiliated Hospital of Chongqing Medical University as the host of the conference, Professor Zhao Pingping of the Second Xiangya Hospital of Central South University, Professor Liu Jingjing of Peking University People's Hospital, and Professor Chen Ruizhen of Zhongshan Hospital Affiliated to Fudan University gathered in the cloud to discuss the positive role
of joint management of blood pressure and lipids in the prevention and treatment of stroke.
active intervention in risk factors,
Reduce the burden of stroke disease
From the perspective of neurology experts, Professor Liu Jingjing pointed out that stroke is one of the
major diseases that endanger national health.
Specifically, stroke often has a rapid onset and rapid progression, which can also lead to adverse outcomes such as limb paralysis, language impairment, dysphagia, and cognitive impairment, which seriously affects the quality of life of patients and causes a huge burden
on patients' families and society.
Studies have shown that in recent years, the epidemic characteristics of stroke are: the overall incidence is increasing, the incidence of patients tends to be younger, and the mortality rate tends to be stable [1].
Professor Chen Ruizhen pointed out that the risk factors for stroke are mainly divided into two types
: interventionable and non-interventional.
Non-interventional factors mainly include: age, gender, race, genetic factors, etc.
; Factors that can be intervened include: hypertension, abnormal glucose metabolism, dyslipidemia, atrial fibrillation and other heart diseases, lifestyle, etc
.
In addition, the results of a stroke risk factor analysis study involving 32 countries around the world (INTERSTROKE) suggest that 90% of stroke can be attributed to 10 common risk factors, of which the important risk factors are: (1) blood pressure
.
High blood pressure is the number one cause of stroke and one
of the controllable risk factors.
(2) Blood lipids
.
For every 1 mmol/L increase in total cholesterol (TC), the risk of fatal or nonfatal ischaemic stroke increases by 25%.
(3) Atrial fibrillation, etc
.
In a meta-analysis of 30 cohort studies, atrial fibrillation significantly increased the risk of stroke [2].
In order to reduce the occurrence of stroke and achieve effective stroke prevention and control, effective management of common risk factors that can be intervened is important
.
Among them, maintaining a healthy lifestyle is the basic measure to treat blood pressure and dyslipidemia, and the main lifestyle improvement methods include: smoking cessation, alcohol restriction, balanced diet, reducing saturated fatty acid and cholesterol intake, increasing the intake
of vegetables, fruits, fish, legumes, whole grains, nuts and foods rich in plant sterols and fiber.
At the same time, patients at high risk of stroke are advised to adhere to regular aerobic exercise
.
Accurately identify the cause of stroke,
Realize the prevention and control threshold forward
with a complex pathogenesis.
"A 2013 national multicenter study confirmed that ischemic stroke accounted for about 77.
8 percent of stroke patients, hemorrhagic stroke patients accounted for about 15.
8 percent, and subarachnoid hemorrhage patients accounted for about 4.
4 percent [3].
The pathogenesis of hemorrhagic stroke is different from that of ischemic stroke, so different types of stroke are treated differently
.
Experts at the meeting agreed that in view of the complexity of the causes of stroke, corresponding primary prevention and intervention
should be carried out for different types of stroke risk factors.
For ischemic stroke caused by atherosclerosis, Professor Zhao believes that lipid-lowering therapy
should be emphasized.
Statins are the drug of choice for cholesterol-lowering therapy, so a moderate-strength statin such as pravastatin
is an initial treatment.
At the same time, the dose should be appropriately adjusted according to the patient's individual lipid regulation efficacy and tolerance to prevent the risk of
cerebral hemorrhage caused by lipid-lowering therapy.
Professor Liu Jingjing agreed very much with this, and pointed out that stroke caused by atrial fibrillation can often be life-threatening and seriously affect the quality of life of
patients.
"The prevention and treatment of this type of stroke is different
from stroke caused by cerebral atherosclerosis.
" Professor Liu Jingjing said, "Because the 'killer' of blood vessel blockage is the emboli that the heart sheds, not the cerebral arteries themselves
.
Cerebral blood vessels do not have time to form new blood vessels
until the emboli are detached.
Therefore, patients with atrial fibrillation have a larger infarction area and are more likely to have severe symptoms
such as hemiplegia, visual or speech disorders, and dysphagia.
For stroke caused by atrial fibrillation, Professor Huang Bi proposed: "Reasonable anticoagulation therapy is an effective measure
to prevent stroke related to atrial fibrillation.
"The benefits and risks should be assessed before determining whether a patient is a candidate for anticoagulation, and anticoagulation should only be initiated if the benefit of preventing embolic events clearly outweighs the risk of bleeding
.
"
Based on clinical experience, Professor Chen Ruizhen believes that stroke is related to many lifestyles, so he advocates adjusting unhealthy diet, strengthening physical exercise and attaching importance to health examination to delay the occurrence and development
of stroke.
She pointed out that hypertension is the most important risk factor for stroke in Chinese groups, especially the abnormal increase
in blood pressure in the early morning.
According to statistics, people with high blood pressure are 2.
158 times more likely to become high-risk groups of stroke than people with non-hypertension [4], so the control of hypertension is also of great significance
to reduce the incidence of stroke.
A meta-analysis of 16 clinical trials confirmed that aggressive antihypertensive therapy in people with normal high-value blood pressure was associated with a 22 percent lower risk of stroke compared with placebo [5].
Regarding the results of the study, Professor Huang Bi emphasized: "For any hypertensive patient, lifestyle interventions such as reducing sodium intake, reasonable diet, weight control, smoking cessation, alcohol restriction, and rational medication use are effective blood pressure management methods
.
”
summary
Stroke seriously endangers national health, and the current incidence and disability rate of stroke are worrying.
The INTERSTROKE study shows that common risk factors for stroke include high blood pressure, hyperlipidemia, heart disease and poor lifestyle
.
For different types of stroke risk factors, targeted medication treatment should be taken to implement precise prevention and control measures
.
In addition, lifestyle interventions for people at high risk of stroke are essential
to reduce the occurrence and progression of stroke.
This material is for healthcare professionals only and should not be distributed
to non-healthcare professionals.
References:[1].
Practice Guidelines for Comprehensive Management of Primary Cardiovascular Diseases 2020[J].
Chinese Journal of Medical Frontiers (Electronic Edition),2020,12(08):1-73.
[2].
Outline of "Chinese Stroke Prevention and Treatment Report 2019"[J].
Chinese Journal of Cerebrovascular Diseases,2020,17(05):272-281 [3].
Overview of Chinese Cardiovascular Health and Disease Report 2020[J].
Chinese Journal of Circulation,2021,36(06):521-545.
) [4].
ZHU Boya,TAN Xiaodong,GU Yaohua,CHEN Qi,ZHOU Qing,PENG Shuzhen.
Effects of stroke risk factors on cerebrovascular function[J].
Chinese Journal of Public Health,2022,38(10):1264-1268.
) Chinese Guidelines for the prevention and treatment of hypertension (2018 revised edition)[J].
Chinese Journal of Cardiovascular Disease,2019,24(01):24-56.
) [6].
Interview video: https://studioyszimg.
yxj.
org.
cn/1672825352366.
mp4
more cardiovascular medication tips?
Come to the "Doctor Station Web Page Version" and take a look 👇
