I previously explained the major risk factors for having a stroke. In particular, elevated systolic blood pressure, diabetes, and smoking are the strongest risk factors for stroke deaths in middle age.[1] [2] Now let’s look at less obvious risk factors for cerebrovascular disease.

Other stroke risk factors

I previously mentioned that environmental exposures and lifestyle habits significantly influence your risk for a stroke. Now I want to look at these in detail, along with ways to reduce these other risk factors.

We can all agree that you simply cannot smoke and expect to live a long healthy life like my father. He is 86 years old, takes no prescription medications, has never smoked, and swims a mile a few times per week. I give credit for his stellar health largely to his good genes, but also to how he has modified his genetic expression through his healthy and active lifestyle.

We know that genetic code is what causes the development of all your body cells and chemistry. The good news is, genes that code for a disease expression can be partially or completely turned off—or on—based on one’s lifestyle and environment. This is called epigenetics.

Therefore, if you have (or have a genetic risk for developing) high blood pressure or diabetes, you can modify this genetic risk. Consider the following contributors to cerebrovascular disease:

• Stress, anger, and depression[3] are independent risk factors for a stroke. Hostility is the “Achilles’ heel” of the heart. Your brain arteries (just like your heart arteries) are adversely affected by stress and frustration via the stress hormones adrenalin, cortisol, and the chemicals these trigger.

• Radiation exposure oxidizes LDL-cholesterol and makes it sticky on the wall of the heart or brain arteries. Sticky cholesterol is a major component of atherosclerosis development. The children of the terrible Chernobyl, Ukraine nuclear accident had the highest levels of oxidized LDL.[4] There is no doubt that ionizing (higher energy) forms of radiation include plain x-rays, Computed Tomography (CT) scans, Positron Emission Tomography (PET) scans, and radiation therapy which are known to damage healthy DNA.[5] Even laptop computers do pose some risk of excessive radiation that can adversely affect health.[6] Furthermore, you may have read that you don’t need to worry too much about cell phones, hair dryers or microwave radiation exposure because these are non-ionizing (lower energy) forms of radiation and have not been proven to cause cancer in humans.[7] However, these low-intensity electromagnetic frequencies (EMFs) subtle and accumulative. As reported in the Lancet[8] there is real concern about EMFs as they apparently have an oscillatory similarity to certain electrochemical activities of the body and can be disruptive on the cell level.

• Heavy metal exposure (chronically): The metals mercury and antimony are concentrated through the food chain and become toxic to blood vessels.

• Hormones and antibiotics: Anabolic steroid implants are routinely used to maximize animal livestock growth and therefore profitability. Such ‘foreign’ hormones are called xenoestrogens and are also found in plastics, spermicidals, detergents, and personal care products. These all are potential causes for the immune system to react slowly with inflammation leading to atherosclerosis.

• Refined sugar: The average American consumes 32 teaspoons of added sugar per day according to 1999 U.S. Food and Drug Associations estimates.[9]

• Refined sugar consumption in higher amounts:

• can increase your systolic blood pressure[10] contributes to diabetes[11] and metabolic syndrome[12] can cause atherosclerosis[13] correlates strongly with peripheral vascular disease[14]

• Hydrogenated oils and trans-fats promote atherosclerosis even more than saturated (animal) fats do.[15] Several studies have clearly shown that trans-fats are closely associated with heart attacks.[16]

• Diet high in animal products and low in plant fiber: atherosclerosis rates apparently begin to climb with animal protein consumption above 10% of the diet. In the 1998 Journal of Cardiology, the researchers of the China Study reported their analysis of 65 counties and 130 villages in rural China.[17] There, animal protein intake was very low at only 1/10th of the U.S. average. Also, their fat intake was less than half of that found in the U.S., and their fiber intake was three times higher than in the U.S. The average cholesterol levels comparing Chinese to Americans were 127 mg/dL versus 203 mg/dL in the U.S. They found the death rate to be 16.7-fold greater for U.S. men and 5.6-fold greater for U.S. women compared to their Chinese counterparts.

• Chlamydia bacteria apparently trigger an inflammatory response inside the artery wall. Chlamydia pneumoniae is present in atherosclerotic lesions throughout the arterial tree and is almost always absent in healthy arterial tissue.[18] Testing and treatment for this bacteria are available through your doctor.
   

Eliminate or reduce these contributors and you will certainly modify your genetic expression for cerebrovascular disease. Additionally, a baby aspirin (81 mg) daily is recommended if you are at any significant risk for a stroke.

In my final report on stroke in middle age I’ll share with you the nutrient supplements proven to lower cerebrovascular disease development you should know about.

To longevity and feeling good,

Michael Cutler, M.D.

[1] Rastenyte D, Tuomilehto J, Domarkiene S, Cepaitis Z, Reklaitiene R. Risk factors for death from stroke in middle-aged Lithuanian men: results from a 20-year prospective study. Stroke. 1996 Apr;27(4):672-6. PubMed PMID: 8614928. https://www.ncbi.nlm.nih.gov/pubmed/8614928 [2] Tuomilehto J, Rastenyte D, Jousilahti P, Sarti C, Vartiainen E. Diabetes mellitus as a risk factor for death from stroke. Prospective study of the middle-aged Finnish population. Stroke. 1996 Feb;27(2):210-5. PubMed PMID: 8571411. https://www.ncbi.nlm.nih.gov/pubmed/8571411 [3] Mittleman MA, Maclure M, et al. Educational attainment, anger, and the risk of triggering myocardial infarction onset. Archives of Internal Medicine 1997, 157:769-775. Also, Jiang W, Babyak M, Krantz DS, et al. Mental stress-induced myocardial ischemia and cardiac events. JAMA 1996, 275:1651-1656. [4] Per Stephen Sinatra, M.D. the preventive Cardiologist presentation at the Fourth World Conference on Nutritional Medicine, May 2004, Nikko Hotel, San Francisco, CA. [5] https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation [6] Bellieni CV, Pinto I, Bogi A, Zoppetti N, Andreuccetti D, Buonocore G. Exposure to electromagnetic fields from laptop use of "laptop" computers. Arch Environ Occup Health. 2012;67(1):31-6. PubMedPMID: 22315933. https://www.ncbi.nlm.nih.gov/pubmed/22315933 [7] https://www.cancer.gov/about-cancer/causes-prevention/risk/radiation/cell-phones-fact-sheet#q4 [8] Hyland GJ. Physics and biology of mobile telephony. Lancet 2000 Nov 25;356(9244):1833-6. [9] Kantor, LS. A dietary assessment of the U.S. food supply. Nutrition Week 1999; 29(3):4-5. [10] Preuss, H. G. “Sugar-Induced Blood Pressure Elevations Over the Lifespan of Three Substrains of Wistar Rats.” J Am Coll of Nutrition, 1998;17(1) 36-37. [11] Sucrose Induces Diabetes in Cat. Federal Protocol. 1974;6(97). [12] Yoo, Sunmi et al. “Comparison of Dietary Intakes Associated with Metabolic Syndrome Risk Factors in Young Adults: the Bogalusa Heart Study” Am J Clin Nutr. 2004 Oct;80(4):841-848. [13] Schmidt A.M. et al. “Activation of receptor for advanced glycation end products: a mechanism for chronic vascular dysfunction in diabetic vasculopathy and atherosclerosis.” Circ Res.1999 Mar 19;84(5):489-97. [14] Postgraduate Medicine. Sept 1969:45:602-07. [15] Valenzuela A, Morgado A. Trans fatty acid isomers in human health and in the food industry. Biol. Res. 32(4):273-87. [16] Willett WC, Sampfer MJ, Manson JE, et al. Intake of trans fatty acids and the risk of coronary artery disease among women. Lancet 1993. 341: 581-85; Ascherio A, Hennekens CH, Buring JE, et al.Trans-fatty acids intake and risk of myocardial infarction. Circulation 1994. 89 (1):94-101; Lichtenstein AH, Trans-fatty acids and cardiovascular disease risk. Curr. Opin Lipidol. 2000. 11(1):37-42. [17] Campbell TC, Parpia B, Chen J. Diet, lifestyle, and the etiology of coronary artery disease: the Cornell China study. Am J Cardiol 1998 Nov 26;82(10B):18T-21T. [18] Grayston JT, Kuo C-C, Campbell LA, Wang SP, Jackson L. Chlamydia pneumonia and cardiovascular disease. Cardiologia1997;42:1145-51.