Modifiable risk factors for ischemic stroke

Ischemic stroke is the third leading cause of death after cardiac disease and cancer in the developed countries. In patients older than 65 years old, ischemic stroke is one of the main causes of disability. They are also responsible for approximately 4.5 million deaths each year globally. The aim of the present study was to review the literature about the modifiable risk factors related to the development of ischemic stroke. The method οf this study included bibliographic research from both reviews and researches from literature, mainly of the last 8 years. The words used in pub med data base, referred to the modifiable risk factors related to the development of ischemic stroke. Results: In the majority of research studies, responsible risk factors for ischemic stroke are classified according to their ability of modification, in modifiable and non–modifiable risk factors. Some of the modifiable risk factors have been fully documented whereas some others need further research. The main modifiable risk factor is hypertension because on the one hand it promotes atherosclerosis and, on the other hand, leads to deteriorative changes and constrictions of small brain vessels. Atrial fibrillation is the most significant risk factor for ischemic stroke, since it is responsible for more than 50% of thromboembolic cases. Also, patients with diabetes mellitus are in higher risk for developing ischemic stroke compared to healthy population, whereas the danger is increasing in insuline-depented individuals. Increase of lipids in blood and disorders of cholesterol are responsible for atherosclerosis in coronary vessels and carotid. More in detail, carotid stenosis >50% in individuals over than 65 years old consist a significant risk factor for ischemic stroke. Though, the relation of smoking to ischemic stroke is still not fully understood, however smokers are in high risk for developing ischemic stroke for the reason that smoking is significantly related to atherosclerosis. Furthermore, blood diseases and mainly sickle-cell disease is responsible for ischemic stroke because the progressive narrowing of blood vessels prevents oxygen from reaching the brain and other tissues. Conclusions: As it is supported by published evidence, the main modifiable risk factors for stroke are hypertension, atrial fibrillation, diabetes mellitus, carotid stenosis, smoking and sickle-cell disease. Taking into account that these factors are modifiable and consequently predictable, the organization of educational programs in individuals of high risk is a matter of great importance.

Keywords: Stroke, ischemic etiology, modifiable risk factors