Why are there more and more patients with cerebral infarction in China, but they are decreasing in the United States? There are 2 points more important than folic acid

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

58-year-old Zhang lives a more casual life on weekdays. He never leaves alcohol and tobacco. In terms of diet, he also likes to eat braised pork, barbecue, deep-fried, hot pot, etc. He rarely touches fruits and vegetables.

About 3 years ago, Lao Zhang was found to have hyperlipidemia during a physical examination at his work unit. The doctor told Lao Zhang to pay attention to controlling blood lipids. Improving the way of life and diet is the key, and if necessary, he can also prescribe some medicine.

But Lao Zhang can say that his left ear goes in and his right ear goes out, and he thinks he is "in good health", so what he was like before, he will still be like that after that, and he didn't go to the hospital for a blood lipid check.

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

After examination, the blood test found that Lao Zhang's blood lipids were very high, with total cholesterol 15.44mmol/L, triglyceride 4.10mmol/L, and low-density lipoprotein 6.43mmol/L, which belonged to severe hyperlipidemia . Afterwards, he was diagnosed with "acute massive cerebral infarction" by head MRI.

Thanks to timely medical treatment, Lao Zhang's life was saved, but he was left with sequelae and paralyzed limbs. He may not be able to live without a wheelchair for the rest of his life.

1. Why are there more and more patients with cerebral infarction in China, but they are decreasing in the United States?

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

In the face of huge data, we can't help asking questions: Why is the obesity rate higher in European and American countries, but the stroke incidence rate is higher in China?

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 vegetables and fruits, and high-salt diet , among which hypertension bears the brunt.

A previous sample analysis of 5,000 stroke cases by Zhongshan Hospital also confirmed this point. About 92.3% of stroke patients had primary hypertension.

Among them, H-type hypertension is very dangerous and is the most likely type of hypertension to cause stroke. Hypertension and hyperhomocysteinemia are the 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 biologically active substances needed by the human body, but the transformation needs to rely on folic acid and vitamin B12 If there is a lack of substances such as Hcy, the level of Hcy will easily increase and induce 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, timely supplementation of folic acid is an effective measure.

Therefore, the United States has taken a strong intervention , mandatory supplementation of folic acid, and adding folic acid ingredients to flour has greatly improved the levels of folic acid and Hcy. This may be one of the reasons why the number of patients with cerebral infarction in the United States is decreasing.

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

In terms of folic acid supplementation, Yang Jingang, deputy chief physician of Fuwai Hospital of the Chinese Academy of Medical Sciences, said that taking folic acid is also very particular. It is not enough to just buy some folic acid and eat it . High people recommend adequate folic acid supplementation to prevent stroke .

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

First of all, food supplements are the first choice for folic acid supplementation. In fact, as long as you eat a reasonable diet, you can basically get enough folic acid from your diet . If necessary, you can also take medical supplements 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 food, tea, alcohol, etc., so as not to affect the absorption of folic acid.

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

Chen Sijiao, senior cardiovascular chief physician 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 10mmHg increase in systolic blood pressure, the risk of stroke in Asian populations increases by 53%, and the risk of fatal myocardial infarction increases by 31%. 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 do not pay attention to it after diagnosis, which is not acceptable. Patients with high blood pressure should intervene in lifestyle habits, diet, weight, etc. If they still cannot control their blood pressure, they must take drug treatment as soon as possible.

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

2. Quit smoking and drinking

Hazardous substances such as nicotine in cigarettes 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, raise blood pressure, and bury hidden dangers for stroke. Therefore, to prevent stroke, it is best to quit smoking and drinking.

In short, in order to prevent stroke, it needs to be carried out in many aspects such as life and eating habits, and folic acid supplementation is not enough.

3. There are 3 situations on the head, be alert to the coming of cerebral infarction

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

1. Facial numbness

A typical manifestation of cerebral infarction is numbness on one side , often accompanied by crooked mouth and eyes, which is mainly caused by abnormalities in the brain that affect the command of movement and language.

2. Drooling on one side

If one side is always drooling while sleeping, you should also be alert to the onset of cerebral infarction. When cerebral infarction can cause muscle and nerve incoordination, especially the impact on the oral cavity, this situation is easy to occur.

3. Blurred vision, choking on drinking water

When a cerebral infarction occurs, the insufficient blood supply to the brain will also affect the function of the retina. Sudden temporary blurred vision or blackness in front of the eyes may occur, or even sudden blindness for a while, but it will recover soon .

In addition, the swallowing and coughing functions of the human body are also controlled by the brain. Once a cerebral infarction occurs, its functions will naturally be affected, and there may be choking and coughing when drinking water, and difficulty swallowing .

4. Headache, dizziness

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

Summary: Cerebral infarction has five characteristics: high morbidity, high mortality, high self-injury rate, high treatment cost, and high recurrence rate. Therefore, early prevention is very important. Once abnormalities are found, timely and reasonable treatment should be given.

References:

[1] "Why are there more cerebral infarctions in China, but the United States is decreasing year by year?" New cognition: the lack of folic acid needs national attention". Chronic Disease World. 2021-03-06

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

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

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