I.V. Therapy: Stroke Risk And Prevention

Intravenous drug abuse carries a high risk of stroke from blood clots (cerebral embolisms). Cocaine and other illegal drugs have been closely linked to strokes, even in healthy people with no prior health issues. Injecting drugs, including heroin, can cause infections that may lead to a stroke. For example, bacteria from endocarditis can enter the bloodstream and block a blood vessel in the brain. Long-term drug use can also increase the risk of stroke by damaging blood vessels in the brain and the heart, increasing the risk of high blood pressure.

IV drug abuse and stroke risk

Intravenous (IV) drug abuse carries a high risk of stroke from blood clots (cerebral embolisms). Drug use is increasingly identified as a reason for stroke among young adults, even those without prior health problems.

Drugs such as cocaine and amphetamines can cause an immediate surge in blood pressure, which can lead to a brain bleed. They can also constrict or narrow blood vessels in the brain, reducing blood flow and causing a blockage. This can lead to a stroke during or immediately after drug use.

In addition, people who inject drugs are at risk of infections such as endocarditis, which can also lead to stroke. Bacteria can enter the blood and grow over the heart valves and vessels. A clump of bacteria can then break off and travel to the brain, blocking a blood vessel and causing a stroke.

Long-term drug use can also increase the risk of stroke by causing damage to blood vessels in the brain and the heart, which can lead to conditions like high blood pressure—the leading risk factor for stroke. Weakened blood vessels may also rupture and cause a stroke.

The symptoms of a drug-induced stroke are the same as those of strokes caused by other issues and include:

• Face drooping or slumping
• Weakness or numbness in the arms and legs
• Slurred speech or trouble speaking
• Confusion or memory problems
• Sudden vision changes
• Loss of balance or difficulty walking

If you or someone you know is experiencing any of these symptoms, call 911 or your local emergency number immediately. It is important to seek immediate medical attention to reduce the risk of long-term complications, including death.

High blood pressure and strokes

High blood pressure, or hypertension, is when blood flows with too much force, putting extra pressure on the arteries. This excess pressure stretches the arteries beyond their healthy limit and can cause small tears. Over time, high blood pressure damages arteries throughout the body, creating conditions that make arteries more likely to burst or clog. Weakened or blocked arteries in the brain create a much higher risk for stroke.

A stroke happens when a blood vessel to the brain is narrowed or blocked by a clot (ischemic stroke) or bursts (hemorrhagic stroke). When that happens, part of the brain is no longer getting the blood and oxygen it needs, and brain tissue starts to die. Your brain controls your movement and thoughts, so a stroke threatens your ability to think, move and function. Strokes can also affect language, memory and vision, and severe strokes may even cause paralysis or death.

High blood pressure is the leading cause of stroke and is the number one controllable risk factor for stroke. Nearly half of American adults have high blood pressure, but many don't know it because it has no apparent symptoms. Regularly checking your blood pressure is crucial, as is managing high blood pressure to reduce your risk of stroke.

Several factors can increase your risk of high blood pressure, including family history, age, lack of physical activity, poor diet, gender-related risk patterns, obesity, drinking too much alcohol, and smoking tobacco. However, high blood pressure can be checked, lowered and controlled through lifestyle changes and medication. Eating a healthy diet, including reducing salt intake, engaging in regular physical activity, and maintaining a healthy weight can all help to lower blood pressure.

Diabetes and strokes

People with diabetes are twice as likely to have a stroke as people without diabetes. This is because diabetes causes blood sugar levels to rise, damaging blood vessels and nerves over time. This can lead to a build-up of fatty deposits or clots in the blood vessels, which can block blood flow to the brain and cause a stroke.

Risk Factors

People with diabetes have longer periods of high blood sugar than those without diabetes, especially if their condition is not well-controlled. This makes them more susceptible to vascular endothelial dysfunction, increased early-age arterial stiffness, systemic inflammation, and thickening of the capillary basal membrane.

Additionally, people with diabetes are more likely to have other conditions that increase the risk of heart disease and stroke, such as high blood pressure and obesity. According to the American Heart Association (AHA), 16% of adults over 65 with diabetes die from a stroke, and 68% die from some form of heart disease.

Prevention

While people with diabetes are at a higher risk of having a stroke, they can reduce this risk by controlling their blood sugar levels and making certain lifestyle changes. This includes maintaining a healthy weight, eating a healthy diet with lots of vegetables and little unhealthy cholesterol, exercising regularly, and treating high blood pressure.

It is also important for people with diabetes to attend their diabetes health checks to monitor blood sugar, blood pressure, cholesterol, and kidney function, and to seek advice and support with healthy lifestyle choices.

Alcohol use and strokes

Excessive alcohol consumption is a major cause of strokes worldwide. Drinking too much alcohol can lead to a number of conditions that are associated with strokes.

Hypertension

Alcohol increases blood pressure and high blood pressure is associated with over half of all strokes. Regularly drinking alcohol can lead to damage to the circulatory system, which in turn increases the risk of stroke.

Atrial Fibrillation

Excessive alcohol consumption can trigger a heart condition called atrial fibrillation (AF). People with AF are five times more likely to experience a stroke. AF can cause blood to clot in the heart, and if these clots break up or dislodge, they can travel to the brain and cause a stroke. People who have AF-related strokes are more likely to die or be seriously disabled following the stroke. Alcohol can also interact with medications prescribed to treat AF. For example, drinking alcohol while taking the blood-thinning medication Warfarin can increase the risk of bleeding in the brain (hemorrhagic stroke).

Diabetes

Alcohol changes how the body responds to insulin, the hormone that helps turn sugar in the blood into energy. This can lead to type 2 diabetes, which increases the risk of stroke.

Being Overweight

Regularly drinking large amounts of alcohol can lead to weight gain and obesity, which increases the risk of stroke. Alcohol is very high in calories, and obesity can also lead to high blood pressure and diabetes, both of which are risk factors for stroke.

Liver Damage

Excessive alcohol consumption can cause liver damage, which can prevent the liver from producing substances that help blood to clot. This can increase the chance of bleeding in the brain, known as a hemorrhagic stroke.

Recommendations

To reduce the risk of stroke, it is recommended that men should have no more than two drinks per day, and women should have no more than one drink per day. To lower the short-term risks associated with alcohol consumption, it is advised to set and stick to a limit, drink more slowly, drink with food, and alternate alcoholic drinks with water.

Illegal drugs and strokes

Drug abuse can cause strokes, even in otherwise healthy people who are using drugs for the first time. Drug use can damage blood vessels in the brain and the heart, increasing the risk of high blood pressure, which is the leading cause of strokes.

Cocaine

Cocaine can cause a sudden stroke during or immediately after use. It increases blood pressure, which can lead to a brain bleed, and causes the blood vessels in the brain to narrow or spasm, reducing blood flow to the brain.

Heroin

People who inject drugs, including heroin, are at risk of infections that can lead to a stroke. For example, endocarditis is an infection of the heart's inner lining, where bacteria can enter the blood and grow over the heart's valves and vessels. A clump of bacteria can then break off and travel to the brain, blocking a blood vessel and causing a stroke.

Amphetamines

Amphetamines, like cocaine, are sympathomimetic, meaning they cause a sudden and volatile increase in blood pressure. With long-term use, the stress on the blood vessels can cause weakening, and ruptured blood vessels may cause a stroke.

Phencyclidine

Phencyclidine, or PCP, is a stimulant that increases blood pressure. There have been a few reported cases of PCP-associated stroke, all of which were hemorrhagic.

Lysergic Acid Diethylamide (LSD)

There have been a small number of reported cases of stroke associated with LSD use, all of which involved ischemic stroke in patients under the age of 25. Similar to ergot alkaloids, LSD affects serotonin receptors and may cause vessel constriction.

Marijuana

There is some evidence to suggest that marijuana use may be linked to an increased risk of stroke. However, the link is not yet firmly established, and more research is needed.

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