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    Home > Active Ingredient News > Study of Nervous System > How to deal with the "top killer" of national health?

    How to deal with the "top killer" of national health?

    • Last Update: 2021-11-15
    • Source: Internet
    • Author: User
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    ▎Stroke (commonly known as stroke) of WuXi AppTec's content team has become China’s number one cause of death and disability.
    Its high morbidity, mortality, and disability are a serious threat to the health of the people.
    Families and patients bring heavy burdens and great pains
    .

    In addition, there are many risk factors for stroke and the cause is quite complex, and the time window for first aid treatment is short, so it is necessary to attract enough attention
    .

    October 29, 2021 is the 16th "World Stroke Day".
    The propaganda theme of this year's "World Stroke Day" is "Be aware of stroke symptoms and identify and treat as soon as possible
    .
    "
     At the same time, it should be pointed out that stroke and dementia can promote the risk of each other, and more and more evidence shows that people with fewer vascular risk factors and vascular diseases have better cognitive function and the onset of dementia.
    The rate is also lower
    .

    Progress in pathology, pathophysiology and clinical research has increasingly revealed the interaction between cerebrovascular diseases and neurodegenerative diseases
    .

    As "World Stroke Day" is approaching, the World Stroke Organization (WSO) once again solemnly appealed in a recent seminar: Joint prevention of stroke and dementia! This proposal has been endorsed by all major international organizations dedicated to global brain and cardiovascular health
    .

    The authoritative journal in the field of neurology, The Lancet Neurology, published an editorial for this, and pointed out that how to effectively reduce the risk factors related to stroke and dementia, thereby reducing the huge disease burden, is a huge challenge facing the current public health system, based on the "whole population" as a whole Prevention and control measures will help achieve joint prevention of stroke and dementia! Screenshot source: The Lancet Neurology control of blood pressure brings double "guard" to stroke and dementia! The global burden of disease caused by stroke and dementia is increasing year by year.
    According to the current development trend, it is estimated that there will be 200 million stroke survivors and 106 million dementia survivors by 2050
    .

    At the same time, 12 million patients will die of stroke each year, and 5 million patients will die of dementia, which will put great pressure on the global healthcare system
    .

     Hypertension is the main risk factor for stroke
    .

    The current editorial points out that, globally, the increase in systolic blood pressure is most related to the increase in disability-adjusted life years after stroke (DALY, which refers to the total number of healthy life years lost from illness to death), with more than 50 years in developing countries.
    % Of stroke-related DALY can be attributed to hypertension
    .

    In addition, previous studies have confirmed that hypertension, especially middle-aged hypertension can increase the risk of cognitive dysfunction in the elderly, and dementia is a serious form of cognitive dysfunction, which significantly affects patients' activities of daily living
    .

    Image source: 123RF Based on the results of the latest research, individualized treatment for hypertension patients not only helps to reduce the risk of stroke, but may also be a reasonable choice for the prevention and treatment of cognitive impairment: Lowering blood pressure can slow down cerebral vascular disease (that is, cerebral vascular disease).
    White matter hyperintensity volume is a risk factor for cognitive impairment); intensive blood pressure control (<120 mmHg) can not only reduce the incidence of stroke and cardiovascular events, but also reduce the incidence of mild cognitive impairment (SPRINT study ); Based on the results of multiple clinical trials and longitudinal studies, blood pressure control should be used as a primary prevention intervention for dementia
    .

     On the basis of improving the level of blood pressure monitoring and control, healthy eating, reducing salt intake, and increasing intake of vegetables and fruits will help to further realize the joint prevention of stroke and dementia
    .

    The low- and medium-risk population accounts for a large number of stroke incidents, and the prevention of the whole population is urgent! It is worth noting that the current primary prevention strategies for stroke and cardiovascular disease emphasize more on the prevention of high-risk groups.
    Although such preventive measures are effective for some people, they do not include important life-related measures.
    The high cost of risk assessment and intervention for mode factors (such as poor diet, physical activity, obesity, and alcohol consumption) makes it more difficult to implement in developing countries
    .

     In addition, people with low risk of cardiovascular disease ultimately account for the majority of strokes and cardiovascular events (about 80%)
    .

    Based on the above considerations, it is not enough to prevent and control people at high risk of stroke and acute cardiovascular events
    .

    Therefore, the World Stroke Organization advocates that, based on the prevention and control of high-risk groups, the prevention and control of the entire population is also urgent! Image source: 123RF Considering that stroke and dementia have some of the same risk factors that can be intervened to a large extent, the World Stroke Organization recommends the use of a combined prevention strategy for stroke and dementia.
    The primary prevention measures based on the whole population need to achieve the following Criteria: (1) The effect has sufficient evidence; (2) It can potentially cover a large range of people; (3) It can be used to prevent stroke and dementia at the same time; (4) The expenditure is low and can be widely implemented
    .

    After analyzing all alternative strategies, there are currently 4 types of programs that meet the above criteria at the same time: Reduce stroke, dementia, cardiovascular disease-related risk factors (including adverse metabolic factors: high systolic blood pressure, High fasting blood sugar, high body mass index [BMI], high LDL-C, renal insufficiency; dietary structural factors: high sodium diet, high red meat intake, low fruit intake, low vegetable intake, low grain intake, alcohol consumption ; Environmental or occupational factors: PM2.
    5 pollution, solid fuel-related household air pollution, high or low environmental temperature, lead exposure; smoking/second-hand smoke exposure; lack of physical activity, etc.
    ) and other non-communicable disease related risk factors (such as Exposure to environmental risk factors such as air pollution; promote related free application software from the perspective of the whole population, thereby improving the life>
    .

     The latest research explorations in population-wide prevention show that: Evidence from a large cohort study shows that controlling only five life>
    .

    At present, the app has received international recognition including WSO, World Federation of Neurological Diseases (WFN), World Heart Federation (WHF) and European Stroke Organization (ESO)
    .

    Evidence from a number of large randomized controlled trials shows that healthy diet, moderate exercise, and cognitive training can improve or maintain the overall cognitive function of middle-aged and elderly people.
    At the same time, lowering blood pressure will reduce the risk of dementia
    .

    Summary Whether it is stroke or dementia, it can be prevented as soon as possible, and it can be prevented at the same time
    .

    It is hoped that there will be more innovative, effective, economical and widely implemented prevention strategies in the future to curb the rapid growth of the burden of disease
    .

    Related reading From the "three highs", arteriosclerosis to daily life, how can different people prevent stroke? China's prevention and control regulations are released, that's all! China's blockbuster research is on the NEJM: Simply changing to potassium-containing salt substitutes can reduce strokes and deaths for high-risk groups! Sub-Journal of The Lancet: Stroke is the second leading cause of death in the world.
    Changing these 19 factors can mostly be preventable! JAMA: The 20-year traditional strategy should be refreshed! For the prevention of ischemic stroke, these six types of drugs are expanding treatment options.
    JAMA China Data: What is the relationship between stroke and thrombosis in the heart "small hole" in 1/4 of adults? References[1] see Insight, Declaration.
    "A socialdimension for brain health: the mounting pressure.
    " Lancet Neurol 19(2020): 487.
    [2] Brainin, Michael, et al.
    "Global preventionof stroke and dementia: the WSO Declaration.
    " The Lancet.
    Neurology 19.
    6(2020): 487-488.
    Disclaimer: WuXi AppTec's content team focuses on introducing global biomedical health research progress
    .

    This article is for the purpose of information exchange only.
    The opinions expressed in the article do not represent the position of WuXi AppTec, nor does it mean that WuXi AppTec supports or opposes the views in the article
    .

    This article is not a treatment recommendation either
    .

    If you need guidance on treatment plans, please go to a regular hospital for treatment
    .

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