Stroke prevention

Sometimes I get asked why I write mainly about scams and point out the mistakes of others instead of giving positive solutions. The reason is simple – to put it lightly, over 95% of “alternative medicine” is a scam, which is why it’s so important to warn against charlatans. I have a silent hope that after explaining for the umpteenth time how people are deceived – at least one person will think twice when seeing on the Internet another miraculous method that diagnoses and cures all diseases.

Stroke is a nasty thing. Very few people survive it, and those who do – almost never make it back to full health. It’s also extremely common – one in six middle-aged people will have a stroke, and one in 20 people die from it. And the worst part is that there aren’t enough clear causes, and as a result – it’s extremely hard to come up with good prevention techniques.

Most cases are when blood vessels become blocked, in which case we call it an ischemic stroke. In others, there is a rupture of a blood vessel, in which case we talk about hemorrhagic stroke. It is rarer, but much more dangerous.

Since we are dealing with two different conditions, different methods of prevention will also be discussed. The hemorrhagic stroke will be the first to go.

There are a number of myths about it. The most important is the “copper deficiency” theory. One alternative guru claimed that aortic aneurysms are caused by copper deficiency because a friend told his colleague that his uncle once failed to give copper to his animals and they died of aneurysms. This evidence is so strong that the internet believed it without any reservation. True, a severe copper deficiency can lead to blood vessel problems, but copper levels in aneurysm victims are identical to those in healthy people:

https://www.ncbi.nlm.nih.gov/pubmed/3995240

This does not mean that copper (and other elements) cannot influence the risk – after examining their levels in the victims’ blood, it was found that they had lower levels of copper, zinc, magnesium and manganese, and increased lead, cadmium and iron. It is not known, however, whether this reflected the impact of these elements on health, or maybe the diet and lifestyle of these people – a more diversified diet will necessarily be richer in useful things, and smokers will have a higher concentration of lead and cadmium.

You need to take a closer look at several factors, as the seemingly obvious conclusions can be very misleading.

First, low cholesterol is known to be a risk factor. Moreover, statin use is also a risk factor, so theoretically the possibility “maybe it is an effect of a diet that lowers cholesterol and, by the way, for an entirely different reason, increases the risk of a stroke.” is less likely.

Second, one of the key suspects is insulin-like growth factor 1 (IGF-I). It is necessary for the proper functioning of blood vessels. Its low level is clearly associated with the risk of this disease, as with many other conditions. On the other hand, it is suspected of promoting cancer development …

Thirdly – and here we have a problem – both the anti-cholesterol diet and the use of statins lower IGF-I.

As you can see, the seemingly obvious solution is “let’s raise your cholesterol!” it may turn out to be misleading. You may just need to eat a IGF-I boosting diet. It is possible that the solution lies elsewhere – in some other factor that is interdependent with those mentioned. It is impossible to deduce which strategy is the right one.

It is known that the use of vitamin E supplements increases the risk, Yes, it does – quacks convincing that this vitamin saves lives lied.

http://www.bmj.com/content/341/bmj.c5702

There is currently a clinical trial in which 20,000 people will be taking vitamin D3 for 5 years. This will allow you to determine whether supplementation prevents heart attacks, cancer, and various types of strokes. Studies to date do not show that it has any effect on the risk of stroke, with the exception of the use of high doses, which seem to increase the risk very much (note from 2022 – the trial has ended, vitamin D3 does not have any spectacular effect)

Physical activity reduced the risk by almost 40%, and often studies showed that it had no effect when other factors were taken into account (e.g. a physically active person did not smoke cigarettes at the same time, which false the result)

http://www.escardio.org/Journals/E-Journal-of-Cardiology-Practice/Volume-4/vol4no25-Title-Physical-Activity-Cuts-Stroke-Risk

It is known that the use of aspirin significantly increases the risk of a hemorrhagic stroke (but also reduces the risk of a heart attack and ischemic stroke).

The greatest risk factor is high blood pressure – people with a it are 3.5 times more likely to have a stroke than people with normal blood pressure. However, it must be taken into account that high blood pressure has its causes, it is possible that these causes increase the risk “incidentally”. Comparing the frequency of strokes in people who have taken antihypertensive drugs and in those who have not, it can be seen that every third hemorrhagic stroke can be prevented by taking pills.

https://www.ncbi.nlm.nih.gov/pubmed/10657416

Smoking cigarettes increases the risk almost 2.5 times.

There is sometimes an opinion that small doses of alcohol help prevent strokes – this is half true, they slightly reduce the risk of an ischemic type of stroke, while for a hemorrhagic one the risk increases linearly.

Increased intake of magnesium and potassium is believed to significantly lower the risk, and salt to increase it. However, there is no solid evidence in the form of placebo controlled studies, as you know – foods high in potassium contain lots of other healthy substances at the same time, and those that contain sodium – lots of harmful. However, hypertensive rats that received a potassium supplement died less frequently – a benefit far greater than might be expected from the reduction in their blood pressure.

A high homocysteine ​​level doubles the risk of a stroke, as does the MTHFR mutation, but to a much lesser extent.

https://www.ncbi.nlm.nih.gov/pubmed/12907815

As you can see, there are no simple answers: “eat this supplement, you will be healthy”. Unfortunately, medicine doesn’t work that way, the human body is too complicated.

In the case of a much more frequent ischemic stroke, the matter is simpler. Here the risk factors are clearer, it is much easier to avoid them.

It is known that the diet has a very high protective potential – both vegetarian and Mediterranean diets reduced the risk by several dozen percent.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3790565/

It is not known what effect Dr. Ornish’s diet would have – it reduced the risk of a heart attack to almost zero, and as the mechanism is similar here, it can be suspected that it would also be successful in this case.

The consumption of fish is important – it is estimated that each portion per week reduces the risk by 2%

https://www.ncbi.nlm.nih.gov/pubmed/16242601

Statins reduce the risk, as does low cholesterol.

Ischemic stroke victims have significantly lower zinc levels, suggesting that zinc deficiency is a very important risk factor.

https://www.ncbi.nlm.nih.gov/pubmed/20852753

However, it is possible that the mechanism is slightly different here. Women using contraception have a much greater risk of stroke. Birth control pills cause zinc levels to drop. Maybe the lack of this element is dangerous, or maybe the pills are dangerous for another reason, and the zinc deficiency is detected in the victims somehow by the way?

The remaining risk factors are similar to the first type of stroke – high blood pressure or smoking are dangerous, physical activity and high levels of IGF-I protect, vitamin C has no effect.

Summarizing, in just a few sentences, what you need to do to minimize the risk of a stroke:

  • follow a diet similar to the Mediterranean or Ornish diet
  • supplement with omega 3 or eat fatty species of fish
  • use methods of increasing IGF-I that do not increase the risk of other diseases – in practice, this means magnesium supplementation
  • supplement zinc (which will additionally increase the IGF-I level), but at the same time remember to supplement copper, which disappears from the body when you overdo it with zinc
  • keep moving, the more the better
  • replace regular salt with “diet” salt which is a mixture of sodium chloride and potassium chloride
  • in the case of a terrible diet – additionally supplement with potassium
  • control blood pressure

Unfortunately, there is no miraculous “silver bullet”, a magical supplement that protects us from a stroke. You have to take into account all factors and minimize each of them separately, each time achieving a dozen to several dozen percent lower risk.

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