Unhealthy Habits: A Fast Track To Strokes

An unhealthy lifestyle can increase the risk of stroke. Lifestyle factors such as smoking, excessive alcohol consumption, physical inactivity, an unhealthy diet, obesity, and stress can contribute to a higher risk of stroke. Making healthy lifestyle choices, such as quitting smoking, reducing alcohol intake, engaging in regular physical activity, maintaining a healthy weight, and managing stress can help decrease the chances of having a stroke. It is important to work with a healthcare team to identify risk factors and make gradual lifestyle changes to improve overall health and reduce the risk of stroke.

Smoking and vaping

Smoking

Smoking is a well-established risk factor for stroke and is responsible for up to 18% of all strokes in Western populations, including the USA. It is dangerous to the individual and those exposed to second-hand smoke. It is the leading cause of preventable disease, disability, and death in the USA, causing approximately one in five deaths.

Smoking increases the risk of stroke in a dose-response relationship, meaning the more one smokes, the higher the risk of stroke. For example, women who smoke 1 to 14 cigarettes per day have an age-adjusted relative stroke risk of 2.2, while those who smoke 25 or more cigarettes per day have a relative risk of 3.7.

Smoking is highly prevalent in the USA, with about 14 out of every 100 adults smoking cigarettes regularly, or 34.2 million Americans. Smoking prevalence is higher among males, younger adults aged 25-44, American Indian/Alaska Natives, those with lower education levels, and individuals below the poverty line.

Vaping

The use of electronic cigarettes, or vaping, has markedly increased over recent years, especially among youth and young adults. Vaping products can lead to airway and lung injury and have been shown to affect the vasculature, specifically the endothelium (inner lining of blood vessels). A recent study showed that vaping caused acute changes in flow dynamics, consistent with endothelial dysfunction, and decreased haemoglobin saturation, suggesting microvascular dysfunction and stiffening of the aorta.

The role of vaping in stroke risk is less clear. One study claimed that there was an increased risk of stroke in current e-cigarette users with concomitant or former use of combustible cigarettes compared to sole combustible cigarette use. However, this study did not show an increased risk of stroke in sole e-cigarette users compared to non-smokers, and the validity of these findings has been questioned due to the statistical methods used.

The economics of smoking and vaping make intervening in these public health crises challenging. Tobacco companies spend billions of dollars on advertising, far outspending tobacco prevention initiatives. They target specific groups, including young adults, women, and ethnic groups, with tailored marketing campaigns.

Increasing the cost of cigarettes to the consumer has been shown to decrease overall cigarette consumption while increasing state revenue. However, many states do not use these funds for tobacco prevention and treatment, and most states spend significantly less than what is recommended by the CDC for tobacco prevention programs.

The revenues obtained from tobacco sales by state and national governments are substantially less than the direct and indirect costs of tobacco use, including direct healthcare costs, lost wages, and disability. As a result, non-smoking individuals in society substantially contribute to the monetary costs of smoking-related diseases.

Poor diet

• Excessive Sodium Intake: While sodium is essential for the body, too much of it can lead to high blood pressure and damaged arteries, increasing the risk of heart disease and stroke. The average American consumes about 3,400 mg of sodium per day, far exceeding the recommended limit of 2,300 mg.
• Sugary Beverages and Processed Foods: Consuming sugary drinks and processed foods, especially those high in salt and saturated fats, can contribute to high blood pressure and increase the risk of stroke.
• Low Fruit and Vegetable Intake: The average American diet falls short of the recommended intake of fruits and vegetables, which are rich in antioxidants and essential nutrients. Increasing the consumption of these food groups can help reduce the risk of stroke.
• High-Salt and High-Glycemic Index Diets: A high-salt diet can lead to hypertension and strain the heart. Additionally, a diet with a high glycemic index and glycemic load has been associated with an increased risk of stroke mortality, particularly in women.
• Low Whole Grain Intake: Studies suggest that a diet rich in whole grains may help reduce the risk of stroke by providing essential micronutrients.
• Coffee Consumption: While the relationship between coffee and stroke is controversial, some studies indicate that excessive coffee consumption may transiently increase the risk of ischemic stroke onset, especially among infrequent drinkers.
• Low Flavonoid Intake: Flavonoids, found in fruits, vegetables, and beverages like tea and red wine, have antioxidant, anti-inflammatory, and antithrombotic properties. A high intake of flavonoids may reduce the risk of stroke.
• Low Carotenoid Intake: Carotenoids, found in fruits and vegetables, have antioxidant properties and are associated with a reduced risk of stroke.
• Inadequate n-3 Polyunsaturated Fats: n-3 polyunsaturated fats, found in fish like salmon and trout, have beneficial effects on multiple cardiac disorders. Their consumption is recommended to reduce the risk of stroke and other cardiovascular events.

Lack of physical activity

Exercise is one of the most important things you can do for your health. It can lower your chances of having a stroke by reducing your risk of other health conditions, such as obesity, high blood pressure, high cholesterol, and diabetes.

The American Heart Association recommends that stroke survivors should engage in strength training to increase their independence in activities of daily living. They should also do flexibility training to increase their range of motion and prevent deformities, as well as training to enhance balance and coordination. Each of these exercise modalities should be carried out at least twice a week to improve functional outcomes after a stroke.

Additionally, aerobic exercise of moderate intensity should be performed at least three days a week for 20 to 60 minutes per session. This will increase physical activity capacity, improve walking and independence, and reduce the risk of cardiovascular disease.

There is a general consensus that regular physical activity may reduce the risk of stroke recurrence in survivors. However, this is based mainly on the effect of exercise on surrogate markers of stroke risk, and prospective clinical endpoint studies are lacking.

Alcohol consumption

Moderate alcohol consumption, defined as less than one drink per day, is associated with a lower risk of ischemic stroke compared to either abstaining from alcohol or consuming more than two drinks per day. One to two drinks per day provide protection against ischemic stroke but not hemorrhagic stroke. On the other hand, consuming five or more drinks per day is considered high-risk behaviour and significantly increases the likelihood of both types of strokes. There is some evidence that women benefit more than men from moderate alcohol consumption in terms of stroke risk reduction.

It is worth noting that alcohol can inhibit coagulation, which may explain its direct relationship with hemorrhagic stroke. However, this same effect seems to offer protection against ischemic strokes when alcohol is consumed in moderation. Additionally, alcohol consumption can raise levels of high-density lipoprotein (HDL), often referred to as "good cholesterol," which is associated with a reduced risk of stroke.

While moderate alcohol consumption may provide some protective effects, excessive drinking can have detrimental consequences on health. Therefore, limiting alcohol intake to one or two drinks per day is recommended to maintain a lower risk of stroke.

Stress

When stressed, the body releases hormones like adrenaline, which makes the heart beat faster and blood pressure rise. While this is normal in the short term, if stress becomes prolonged, it can lead to long-term high blood pressure, which is a leading cause of strokes.

People who experience high levels of stress or prolonged stress may also be more prone to narrowing of the arteries (atherosclerosis), another risk factor for strokes.

To reduce the risk of stress-induced unhealthy habits, it is important to find healthy ways to manage stress, such as exercising, eating healthily, and reaching out to friends and family for support.

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