Abstract
Recent scientific statements and international guidelines have concluded that several aspects of diet and various elements of poor lifestyle lead to elevated blood pressure and increased global risk including stroke. Of the well-documented and modifiable risk factors, this chapter will focus on smoking, whose prevalence remains very high, salt intake – one of the most important dietary measures – and alcohol consumption, which is less well documented but particularly intriguing and provocative. In the recently published INTERSTROKE study, these were shown to be significant risk factors for ischemic and hemorrhagic stroke. Global lifestyle modifications were shown to be more beneficial than the treatment of single risk factors. Multifactorial interventions within the framework of primary and secondary prevention are required, and lifestyle changes should be part of a holistic approach aiming to reduce total cardiovascular, cerebrovascular, and renal risk. Ultimately, patient adherence to dietary and lifestyle advice and modification is crucial. Major efforts by physicians, nurses, the medical and scientific community in general and governments are needed to reduce risk and improve the health of the population. Hic Rhodus, hic salta.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Hankey GJ (2012) Nutrition and the risk of stroke. Lancet Neurol 11:66–81
Meschia JF et al; American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translation Biology; Council of Hypertension (2014) Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 45:3754–3832
Wannamethee SG et al (1995) Smoking cessation and the risk of stroke in middle-aged men. JAMA 274:155–160
He FJ, MacGregor GA (2009) A comprehensive review on salt and health and current experience of worldwide salt reduction programmes. J Hum Hypertens 23:363–384
O’Donnell M et al (2013) Salt intake and cardiovascular disease: why are the data inconsistent? Eur Heart J 34:1034–1040
Strazzullo P et al (2009) Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ 339:b4567
He FJ, MacGregor GA (2002) Effect of modest salt reduction on blood pressure: a meta-analysis of randomized trials. Implications for public health. J Hum Hypertens 16:761–770
He FJ, MacGregor GA (2003) How far should salt intake be reduced? Hypertension 42:1093–1099
Tikk K et al (2014) Primary preventive potential for stroke by avoidance of major lifestyle risk factors the european prospective investigation into cancer and nutrition-heidelberg cohort. Stroke 45:2041–2046
Zhang Y et al (2012) Lifestyle factors and antihypertensive treatment on the risks of ischemic and hemorrhagic stroke. Hypertension 60:906–912
Lawrence M et al (2010) An exploration of lifestyle beliefs and lifestyle behavior following stroke: findings from a focus group study of patients and family members. BMC Fam Pract 11:97–108
Campbell N, Spence J (2008) Stroke prevention and sodium restriction. Can J Neurol Sci 35:278–279
WHO (2011) Global status report on alcohol and health. WHO, Geneva
WHO (2014) Global status report on alcohol and health. WHO, Geneva
Lim SS et al (2012) A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1999–2010: a systematic analyses for the Global Burden of Disease Study 2010. Lancet 380:2224–2260
Smyth A et al (2015) Alcohol consumption and cardiovascular disease, cancer, injury, admission to hospital and mortality: a prospective cohort study. Lancet 386(10007):1945–1954, Published online
Connor PJ (2015) Alcohol burden in low-income and middle-income countries. Lancet 386:1922–1924. http://dx.doi.org/10.1016/S0140-6736(15)00235-4
Kiechl S, Willeit J (2014) Complex association between alcohol consumption and myocardial infarction. Circulation 130:383–386
Rothwell JA et al (2013) Phenol-Explorer 3.0: a major update of the Phenol-Explorer Database to incorporate data on the effect of food processing on polyphenol content. Database (Oxford). 2013; published on line; doi: 10.1093/database/bat070
Larsson SC (2014) Coffee, tea and cocoa and the risk of stroke. Stroke 45:309–314
Draijer R et al (2015) Consumption of a polyphenol-rich grape-wine extract lowers ambulatory blood pressure in mildly hypertensive subjects. Nutrients 7:3138–3153
Lacoste L et al (2001) Acute and delayed antithrombotic effects of alcohol in humans. Am J Cardiol 87:82–85
Nilssen O et al (2005) Alcohol consumption and its relation to risk factors for cardiovascular disease in the north-west of Russia: the Arkhangelsk study. Int J Epidemiol 34:781–788
Yang HK et al (2015) Different effect of alcohol consumption on hypertension according to metabolic health status. J Hum Hypertens. doi:10.1038/jhh.2015.102
Mukamal KJ, Ronskey R (2011) Association of alcohol consumption with selected cardiovascular disease outcomes: a systematic review and meta-analysis. BMJ 342. Published online 2011 Feb 22. doi:10.1136/bmj.d671
Mukamal KJ et al (2005) Drinking frequency, mediating biomarkers and the risk of myocardial infarction in women and men. Circulation 112:1406–1413
Volcik KA et al (2008) Relationship of alcohol consumption and type of alcoholic beverage consumed with plasma lipid levels: differences between Whites and African Americans of the ARIC study. Ann Epidemiol 18:101–107
Angelantonio D et al (2009) Emerging risk factor collaboration: major lipids, apolipoproteins and risk of vascular disease. JAMA 302:1993–2000
Mukamal KJ et al (2001) Alcohol consumption and haemostatic factor: analysis of the Framingham offspring cohort. Circulation 104(12):1367–1373
Hillbom M (1998) Alcohol consumption and stroke: benefits and risk. Alcohol Clin Exp Res 22:352s–358s
Lian C (1915) L’alcoholisme, cause d’hypertension arterielle. Bulletin de l’Academie de Medicine 74:525–528
Sesso HD et al (2008) Alcohol consumption and the risk for hypertension in women and men. Hypertension 51:1080–1087
Husain K et al (2014) Alcohol-induced hypertension: mechanism and prevention. World J Cardiol 26:245–252
Sarti C et al (2003) Are changes in mortality form stroke caused by changes in stroke event rates or case fatality? Results from the WHO MONICA Project. Stroke 34:1833–1840
Anderson P et al (2009) Reducing the harm done by alcohol: evidence for effectiveness and cost-effectiveness. Lancet 373:2246
Conrad A (2011) Exposure to tobacco smoke. In: Bernahrd D (ed) Cigarette Smoke Toxicity. Weinheim: Wiley-VCH Verlag & Co. KGaA; 2011:69–92
WHO global report: mortality attributable to tobacco, p 392 in WHO global report: mortality attributable to tobacco (2012), Geneva, World Health Organization, 2012
Ueno K et al (2014) Possible involvement of endogenous opioid system located downstream of α7 nicotinic acetylcholine receptor in mice with physical dependence on nicotine. J Pharmacol Sci 124:47–53
WHO Report on the Global Tobacco Epidemic, 2008: The MPOWER package. Geneva, World Health Organization, 2008
Messer B, Bernhard D (2014) Smoking and cardiovascular disease. Mechanisms of endothelial dysfunction and early atherogenesis. Atheroscler Thromb Vasc Biol 34(3):509–515
Messner B et al (2012) Apoptosis and necrosis: two different outcomes of cigarette smoke condensate-induced endothelial cell death. Cell Death Dis. doi:10.1038/cddis.2012.162
Csordas A, Bernhard D (2013) The biology behind the atherothrombotic effects of cigarette smoke. Nat Rev Cardiol 10(4):219–230
Jha P et al (2013) 21st century hazards of smoking and benefits of cessation in the United States. N Engl J Med 368:341–350
Gupta A et al (2015) Plaque echolucency and stroke risk in asymptomatic carotid stenosis: a systematic review and meta-analysis. Stroke 46:91–97
Narkiewicz K et al (2015) Is smoking a causative factor of hypertension? Blood Press 14:69–71
Zeng G et al (2012) Does cigarette smoking exacerbate the effect of blood pressure on the risk of cardiovascular and all-cause mortality among hypertensive patients? J Hypertens 30:2307–2313
Naik P, Cucullo L (2015) Pathobiology of tobacco smoking and neurovascular disorders: untied strings and alternative products. Fluid Barriers CNS 12:25. doi:10.1186/s12987-015-0022-x
Hossain M et al (2011) In vitro assessment of tobacco smoke toxicity at the BBB: do antioxidant supplements have a protective role? BMC Neurosci 12:92
Thun MJ et al (2013) 50-year trends in smoking-related mortality in the United States. N Engl J Med 368:351–364
Shah RS, Cole JW (2010) Smoking and stroke: the more you smoke the more you stroke. Expert Rev Cardiovasc 8(7):917–932
O’Donnell MJ et al (2010) Risk factors for ischemic and intracerebral hemorrhagic stroke in 22 countries (the INTERSTROKE study): a case control study. Lancet 376:112–123
Shinton R, Beevers G (1989) Meta-analysis of relation between cigarette smoking and stroke. BMJ 298:789–794
Peters SS et al (2013) Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts. Stroke 44:2821–2828
Pirie K et al; Million women study collaborators (2013) The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in UK. Lancet 381:1297–1305
Aburto N et al (2013) Effect of lower sodium intake on health: systematic review and meta-analyses. BMJ 346:f1326
Sarikaya H et al (2015) Stroke prevention – medical and lifestyle measures. Eur Neurol 73:150–157
Perry J, Beevers D (1992) Salt intake and stroke: a possible direct effect. J Hum Hypertens 6:23–25
Tomonari T et al (2011) Is salt intake an independent risk factor of stroke mortality? Demographic analysis by regions in Japan. J Am Soc Hypertens 5:456–462
Pimenta E et al (2009) Effects of dietary sodium reduction on blood pressure in subjects with resistant hypertension: results from a randomized trial. Hypertension 54:475–481
Bray GA et al; DASH Collaborative Research Group (2004) A further subgroup analysis of the effects of the DASH diet and three dietary sodium levels on blood pressure: results of the DASH-Sodium Trial. Am J Cardiol 94:222–227
He FJ et al (2011) Does reducing salt intake increase cardiovascular mortality? Kidney Int 80:696–698
He F et al (2014) Salt reduction in England from 2003 to 2011: its relationship to blood pressure, stroke and ischemic heart disease mortality. BMJ Open. doi:10.1136/bmjopen-2013-004549
Sasaki N (1979) The salt factor in apoplexy and hypertension: epidemiological studies in Japan. In: Yamori Y (ed) Prophylactic approach to hypertensive diseases. Raven, New York, pp 467–474
Karppanen H, Mervaala E (2006) Sodium intake and hypertension. Prog Cardiovasc Dis 49:59–75
Cook N et al (2014) Lower levels of sodium intake and reduced cardiovascular risk. Circulation 129:981–989
D’Elia L et al (2011) Potassium intake, stroke, and cardiovascular disease a meta-analysis of prospective studies. J Am Coll Cardiol 57:1210–1219
Larsson SC et al (2011) Dietary potassium intake and risk of stroke: a dose-response meta-analysis of prospective studies. Stroke 42:2746–2750
National Institute for Health and Clinical Excellence (NICE). Guidance on the prevention of cardiovascular disease at the population level. http://guidance.nice.org.uk/PH25. Accessed Nov 2015
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Vrdoljak, A., Jelaković, B., Lović, D. (2016). Comorbidities Often Associated with Brain Damage in Hypertension: Salt and Alcohol Intake and Smoking Habits. In: Coca, A. (eds) Hypertension and Brain Damage. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-32074-8_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-32074-8_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-32072-4
Online ISBN: 978-3-319-32074-8
eBook Packages: MedicineMedicine (R0)