The risk factors of ischemic cerebrovascular diseases

1. Big picture

Ischemic cerebrovascular diseases include transient ischemic attack (TIA) and ischemic stroke, caused by insufficient blood flow to part of the brain, retina, or spinal cord. For the exam, the key idea is simple: stroke prevention is risk-factor prevention.

Most ischemic strokes develop because risk factors damage vessels, promote atherosclerosis, increase thrombosis, or create emboli from the heart or large arteries. Modern prevention guidelines still focus on the same major modifiable risks: hypertension, diabetes, dyslipidemia, smoking, obesity, physical inactivity, unhealthy diet, atrial fibrillation, carotid/vascular disease, and excessive alcohol or drug use. High blood pressure remains one of the most important stroke risks.  

For oral exam purposes, always organize ischemic stroke risk factors into:

1. Non-modifiable risks — cannot be changed, but identify high-risk patients.

2. Modifiable risks — can be treated or reduced.

3. Stroke-mechanism risks — large artery disease, small vessel disease, cardioembolism, hypercoagulability, dissection.