Why are there more and more cerebral infarction patients in China, while the number in the United States is decreasing? There are 2 points more important than folic acid supplementation

"What can I do now? I will be inseparable from the wheelchair for the rest of my life, so I regret it." Lao Zhang was very annoyed.

The 58-year-old Lao Zhang lives a more casual life on weekdays. He is inseparable from alcohol and tobacco. In terms of diet, he also likes to eat braised pork, barbecue, frying, and hot pot. He rarely touches fruits and vegetables.

About 3 years ago, during a physical examination at the unit, Lao Zhang was found to have high blood lipids. The doctor told Lao Zhang to pay attention to controlling blood lipids, improving his lifestyle and diet is the key, and he can also dispense some medicine if necessary.

But Lao Zhang can be said to be in the left ear and out of the right ear. He thinks that his "health is not bad", so what happened before, and what happened after that, and he didn't go to the hospital to review his blood lipids.

Last week, Lao Zhang sat on his chair and watched TV after dinner . When he was drinking water, he suddenly became unsteady and the water glass fell directly to the ground . Lao Zhang leaned over and tried to pick it up, but he couldn't move his hands and feet, fell to the ground , and was rushed to the hospital by his family.

After examination, it was found that Lao Zhang's blood lipids were very high, total cholesterol 15.44mmol/L, triglyceride 4.10mmol/L, low density lipoprotein 6.43mmol/L, which belonged to severe hyperlipidemia . Subsequently, a cranial magnetic resonance imaging was performed and a diagnosis of "acute massive cerebral infarction" was made.

Due to the timely delivery to the doctor, Lao Zhang's life was saved, but he was left with sequelae and paralyzed limbs. He may be inseparable from a wheelchair in this life.

1. Why are there more and more cerebral infarction patients in China, while the number in the United States is decreasing?

According to WHO statistics, there are 13 million cerebral infarction patients in the world every year, and China accounts for 40%, which is 5.51 million. There are 2.5 million new strokes in China every year, and the morbidity and mortality of stroke ranks first in the world.

Faced with the huge amount of data, we can't help but ask: Why is the obesity rate higher in European and American countries, but the stroke incidence rate in China is higher?

A review of stroke in China shows that its high incidence is related to factors such as hypertension, hyperlipidemia, hyperglycemia, smoking, drinking, low intake of fruits and vegetables, and high-salt diet . Among them, hypertension is the first to bear the brunt.

A previous sample analysis of 5,000 stroke cases in Zhongshan Hospital also confirmed this, and about 92.3% of stroke patients had primary diseases of hypertension.

Among them, H-type hypertension is very dangerous and is the type of hypertension that is most likely to cause stroke. Hypertension and hyperhomocysteinemia are two elements of H-type hypertension.

Homocysteine ​​(Hcy) is mainly a product formed after the metabolism of methionine in the protein ingested in the body, and then metabolized into the biologically active substances needed by the human body, but if you want to convert it, you need to rely on folic acid and vitamin B12. and other substances, if lacking, the Hcy level is easy to rise, which induces H-type hypertension.

According to the third national health and nutrition survey in the United States, about 2/3 of patients have elevated Hcy due to lack of folic acid and vitamin B12. Therefore, if you want to reduce its level, supplementing folic acid in time is an effective measure.

Therefore, the United States has taken a strong intervention , mandatory folic acid supplementation, and the addition of folic acid to flour has greatly improved the levels of folic acid and Hcy. This may be one of the reasons why cerebral infarction patients in the United States are declining.

In addition, Chinese people have lower control over chronic diseases such as "three highs" and lower awareness of disease prevention.

In terms of folic acid supplementation, Yang Jingang, deputy chief physician of Fuwai Hospital, Chinese Academy of Medical Sciences, said that eating folic acid is also important, not just buy some folic acid to eat, it has prerequisites, such as high blood pressure and homocysteine High-level people recommend adequate folic acid supplementation to prevent stroke .

2. To prevent cerebral infarction, folic acid supplementation is not enough

First of all, folic acid supplements are the first choice for food supplements. In fact, as long as you have a reasonable diet, you can basically get enough folic acid from the diet . If necessary, you can also supplement with medicine under the guidance of a doctor . At the same time, during folic acid supplementation, try to avoid foods rich in vitamin C, spicy or greasy foods, tea, alcohol, etc., so as not to affect the absorption of folic acid.

But to prevent cerebral infarction, folic acid supplementation alone is not enough.

Chen Sijiao, chief physician of geriatric cardiovascular disease at the First Affiliated Hospital of China Medical University, pointed out that the two main risk factors for cerebral infarction are hypertension and atrial fibrillation. According to the Asia-Pacific cohort study, for every 10 mmHg increase in systolic blood pressure, the risk of stroke in Asians increased by 53%, and the risk of fatal myocardial infarction increased by 31%. In contrast, patients with atrial fibrillation have a 5-fold increased risk of ischemic stroke.

Therefore, to prevent stroke, in addition to supplementing folic acid, it is more important to:

1. Control blood pressure

Many people may not know that they have high blood pressure, or they may not pay attention to it after diagnosis, which is not acceptable. Hypertensive patients should take interventions in lifestyle, diet, weight, etc. If the blood pressure cannot be controlled, drug treatment should be administered as soon as possible.

And pay attention to regular monitoring of blood pressure, at the same time should also control the basic chronic diseases such as hyperlipidemia, hyperglycemia, atrial fibrillation.

2. Quit smoking and drinking

Nicotine and other harmful substances in smoke can damage the intima of blood vessels, cause vasoconstriction, and induce cerebral infarction; while alcohol can excite sympathetic nerves, increase heart rate and cardiac output, increase blood pressure, and lay a hidden danger for the occurrence of stroke. So if you want to prevent stroke, it is best to quit smoking and drinking.

In short, if you want to prevent stroke, you need to do it from many aspects such as life and eating habits, and folic acid supplementation alone is not enough.

3. There are 3 kinds of situations on the head, beware of cerebral infarction coming

Cerebral infarction does not come suddenly, and some signals are often sent out in advance. Everyone must seize these signals and intervene in time to reduce the damage caused by cerebral infarction .

1. Numbness of the face

One of the typical manifestations of cerebral infarction is numbness on one side , and it is often accompanied by deviated eyes and mouth. It is mainly caused by abnormal brain, which affects the command of movement and language.

2. Drooling on one side

If one side is always drooling when sleeping, you should also be alert for a cerebral infarction. When cerebral infarction, it can make the muscles and nerves uncoordinated, especially the impact on the oral cavity, it is easy to appear this situation.

3. Blurred vision, choking when drinking water

When a cerebral infarction occurs, the lack of blood supply to the brain will also affect the retinal function, and suddenly there will be temporary blurred vision or conscious blackness in front of the eyes, or even temporary blindness, but it will soon recover .

In addition, the human body's swallowing and coughing functions are also controlled by the brain. Once a cerebral infarction occurs, its function will naturally be affected, and it may cause choking and swallowing difficulties when drinking water .

4. Headache, dizziness

If dizziness and severe headache occur suddenly for no reason, you should also be alert to the precursors of cerebral infarction, especially in middle-aged and elderly people.

Conclusion: Cerebral infarction has five characteristics: high morbidity rate, high mortality rate, high self-mutilation rate, high treatment cost, and high recurrence rate. Therefore, early prevention is very important. Once abnormality is found, timely and reasonable treatment.

References:

[1] "Why are there more cerebral infarctions in China, but fewer in the United States? New Cognition: Deficiency of Folic Acid Needs National Attention". Chronic Diseases. 2021-03-06

[2] "How to supplement folic acid? Eat healthier with these foods! ". Human Health. 2022-06-12

[3] "Cerebral infarction does not come from the sky. If this symptom occurs in the head, be alert to the distress signal sent by the brain". Neurology Channel of the Medical Community. 2020-08-20

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