Why are Chinese people most prone to stroke?

2020-09-03 | Elephant Guild Original |

Stroke is the number one killer that ravages China, and the number one cause of life loss for Chinese people. Each year, 1.96 million Chinese people die of stroke, which is equivalent to one Chinese dying of stroke every 16 seconds.

Compared with other countries, the Chinese people’s risk of stroke is also very prominent. Among the two major categories of stroke, the incidence of ischemic stroke in China is 1.36 times the world average, and the incidence and death of hemorrhagic strokeThe rate is twice the world average.

Although medical conditions have improved in recent years, in a horizontal comparison with more than 110 countries, China is still one of the countries with the most severe strokes:

· The age-standardized incidence rate of ischemic upper and hemorrhagic lower strokes in various countries in 2010 per 100,000 people. Northeast Asia such as China and Russia are the most frequent areas of stroke

Stroke is not the patent of dying old people. Among 15-49-year-old youth and middle-aged Chinese, stroke and traffic accidents are also the two main causes of death, causing nearly 270,000 deaths each year.

Why are Chinese people most vulnerable to stroke?

Love to eat salt, smoke, and work overtime

The main risk factors for stroke are hypertension and hyperlipidemia. According to the American College of Cardiology's hypertension standards systolic blood pressure greater than 130 mm Hg, diastolic blood pressure greater than 80 mm Hg, 46.4% of adults in China sufferThere is high blood pressure. A large part of these people will be the reserve force for stroke and heart disease patients. The proportion of these two types of diseases in the death toll from the disease is also more than 40%, which may not be a coincidence.

One of the reasons for the spread of high blood pressure is that the Chinese are one of the most salty people in the world. Excessive salt intake can increase blood pressure by 5mm Hg or more.

·Daily sodium intake per capita in countries around the world

The most salt-eaters in the world are almost all concentrated in Central Asia and East Asia with the center of western China. Among them, Central Asian countries such as Kazakhs like to eat salty because of the long-standing animal husbandry tradition and the need for saltMarinate meat and dairy products to increase the shelf life of food.

In East Asia such as China and Japan, they fell in love with salt for the opposite reasons. The scarcity of animal ingredients in history has made East Asians rely on fermented soybean products and monosodium glutamate to provide protein flavor to food. Whether it is soy sauce or yellow sauce, Doubanjiang, Soy Sauce or MSG, Chicken Essence, all contain high salt content.

·All kinds of East Asian soy sauce

In 2018, China and other East Asian and Southeast Asian countries consumed most of the world's MSG

Most Chinese people have a dietary habit of loving sauce and salty, coupled with the modern food processing and fast food industry's tendency to use salt for quality and flavoring, this has made the salt intake of hundreds of millions of Chinese people increasingly ridiculously high.

· After Chinese food was introduced overseas, the high-salt flavor was spread all over the world: the British "Salt Action" organization found that the salt content of a single serving of fried rice in British Chinese food is equivalent to 11 packets of potato chips

Another reason for stroke is smoking, because the nicotine and carbon monoxide released by tobacco can damage blood vessels, cause thrombosis, and increase the risk of stroke. Chinese people love smoking, and under the tobacco monopoly system, China owns more than 60%Male smokers.

· Researchers such as Marie Ng classify 187 countries and regions into six categories according to smoker density and daily smoking. The areas where men smoke the most the red area above are almost all concentrated in China, Japan, and the former Soviet and Eastern campsRegions. The common point of these regions is that they have implemented tobacco monopoly for a long time. Tobacco monopoly not only provides generous fiscal revenue, but also cultivates vast and loyal smokers for the country

Moreover, in great contrast with other countries, most of the kind and lovely Chinese smokers do not know that smoking can cause stroke. According to the World Health Organization project statistics, Chinese people’s ignorance of the relationship between smoking and stroke ranks the world’sFirst.

·The proportion of smokers in different countries who do not believe or know that smoking causes the risk of stroke, heart disease and lung cancer

There are also many Chinese smokers who are forced to smoke because overtime work requires smoking to refresh themselves.

The continuous fatigue and mental stress caused by overtime work also increase the risk of stroke. According to a survey by Lin Ruoting and others, when the monthly working hours exceed 170 hours equivalent to 40 hours a week, the mortality and disability caused by cardiovascular and cerebrovascular problemsThe rate has soared over time, and the risks of drivers and the information and communication industry are particularly serious. 996, ICU is not a false statement.

· Lin Ruoting et al. calculated the cardiovascular and cerebrovascular risks based on the labor insurance records of more than 7.2 million workers in various industries in Taiwan. The risk of suffering from minor diseases decreased after working hours exceeded 185. It is presumed that the labor insurance records tend to include death and disability.Cases, records of minor diseases are missing

In addition, there are many Chinese people who are not fat but have a bulging belly. This type of abdominal/central obesity accounts for 40%-50% of the total population, and those with abdominal obesity are more likely to accumulate visceral fatPenetrates into blood vessels, causing cerebrovascular diseases.

· According to different standards, the central obesity rate of Chinese people is between 40%-50%. According to WHO standards, waist circumference of men> 94cm and waist circumference of women> 80cm are central obesity. According to the WGOC standard for Chinese people, Chinese adult menWaist circumference ≥85cm, female waist circumference ≥80cm belongs to central obesity

High blood pressure and high blood fat caused by eating salty smoking and working overtime and high-calorie diet can be reversed by a healthy lifestyle. Patients with persistently high blood pressure and blood lipids can also take long-term antihypertensive and lipid-lowering drugs to control their condition.

The problem is that most hypertension and hyperlipidemia patients in China do not know their condition. Those who know hypertension and hyperlipidemia also have a large proportion of people who would rather believe in unreliable folk prescriptions such as black beans in vinegar and goji berries.Unwilling to continue taking serious blood pressure and lipid-lowering drugs.

In developed countries such as Europe and the United States, stroke is easier to control than heart disease, and the fatality rate of stroke is generally far lower than that of heart disease. In China, the fatality rate of stroke remains high all the year round, which is equivalent to the fatality rate of heart disease; and, Disability and paralysis caused by stroke are more common and serious than heart disease.

·In the United States, strokes account for only about one-fifth of heart disease deaths, while in China they are basically the same

This is because, in terms of stroke treatment, the popularization of surgery and first aid procedures in China are still relatively backward and need to be improved.

Fear of surgery, slow first aid

Ischemia stroke accounts for 85% of all strokes, and atrial fibrillation and carotid artery stenosis produce thrombus into the brain, which is the main cause of ischemic stroke. Atrial fibrillation and carotid artery stenosis have mature treatment options.However, only about 2% of Chinese patients with atrial fibrillation use warfarin and other symptomatic treatments; the operation rate of patients with severe carotid artery stenosis is less than 10%.

For example, when it comes to stent surgery, the first thing most people think of is the "heart stent" used to prevent myocardial infarction. In contrast, carotid artery stent CAS and carotid endarterectomy CEAIt can prevent stroke and reduce carotid artery stenosis, but many Chinese people have never heard of it. Very few patients seek surgery. The annual carotid artery interventional operation is only a few tenths of the cardiovascular interventional operation.

·Carotid artery interventional surgery was popularized in Europe and America in the 1980s, but it is still far from popular in China

This may be because patients at high risk of myocardial infarction often have unbearable pain such as angina. The severe pain and fear will force the patient to take effective surgery. Patients at high risk of stroke often have no symptoms of severe pain, and it is difficult for patients to notice, even inIt was discovered during the physical examination. Because of the lack of awareness of prevention and the care of the cost, I often don’t bother to perform the operation.

Because there are too few patients undergoing atrial fibrillation treatment and carotid artery interventional treatment, many patients who have accumulated blood clots in their bodies unknowingly usher in the most dangerous moment-a stroke attack.

When a stroke occurs, first aid is required within 3 hours, thrombolysis and thrombus removal for ischemic stroke, anticoagulation and hematoma removal for hemorrhagic stroke. However, because the patient and family members do not understand the symptoms of stroke, Only 16% of patients with ischemic stroke can be sent to the hospital within 3 hours after onset.

· FAST principle: By "whether the face is crooked, whether there is an arm that cannot be raised straight, and whether the speech is illegible, it can be judged whether it is a stroke. If one of them is met, the emergency call should be called immediately to buy time

After admission, due to the poor connection between departments, time is often lost in the complicated process of emergency consultation, payment, assessment, blood test, imaging examination, etc. Only 1.3% of patients with ischemic stroke canReceive thrombolytic treatment in time. Although some domestic hospitals have opened up a green channel for stroke emergency treatment to simplify the process, more hospitals still need to join and follow up.

· Fan Wei played a stroke in "Little Treasure and Lao Cai"

References:

  • 1. Wang Longde and others, "China Stroke Prevention and Treatment Report 2018 Summary", Chinese Journal of Circulation, February 2019, Volume 34, Issue 2.

  • 2.Wang Wenzhi et al., Prevalence, Incidence, and Mortality of Stroke in China,Circulation. 2017;1358:759–71.

  • 3.Sung Kyu Ha, Dietary Salt Intake and Hypertension, Electrolyte Blood Press. 2014 Jun; 121: 7–18.

  • 4.Marie Ng et al., Smoking Prevalence and Cigarette Consumption in 187 Countries, 1980-2012,JAMA. 2014;3112:183-192.

  • 5.http://www.who.int/zh/news-room/fact-sheets/detail/the-top-10-causes-of-death

  • 6.http://www.cdc.gov/nchs/products/databriefs/db289.html

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