Stroke is the leading cause of disability in the U.S., and the third leading cause of death. Almost 800,000 people in the U.S. have a stroke each year. Although stroke is usually perceived as a condition that afflicts older Americans, it occurs in people of all ages. About 25% of strokes occur in people under the age of 65, and 10-15% occur in those under age 45.1
Yesterday, at the age of 41, Beau Biden, Delaware Attorney General and son of U.S. Vice President Joe Biden, suffered what is being called a mild stroke. As of now, there is no available information as to what type of stroke he suffered. Joe Biden himself suffered from a hemorrhagic stroke due to a ruptured brain aneurysm in 1985 at the age of 45.2
Bret Michaels, of the band Poison and a contestant on The Celebrity Apprentice, suffered a subarachnoid hemorrhage (a type of hemorrhagic stroke) in April at age 47. He was released last week to a rehabilitation facility.3
What is a hemorrhagic stroke?
Most strokes, about 85%, are ischemic strokes, in which blood flow to the brain is blocked either by a clot or atherosclerotic plaque. The remaining 15% of strokes are hemorrhagic strokes, caused by bleeding in the brain due to the rupture of a blood vessel. This may be the rupture of a small, damaged artery or an aneurysm. Hemorrhagic stroke is even more devastating than ischemic stroke – the rapid bleeding into the brain compresses the neural tissue, most often resulting in permanent damage or death.1
What makes the small blood vessels of the brain susceptible to rupture?
Hemorrhagic stroke, on average, affects younger people than ischemic stroke does, and the most common cause of hemorrhagic stroke is high blood pressure.4 Elevated blood pressure places stress on the walls of the small delicate vessels in the brain, and is the foremost risk factor for both ischemic and hemorrhagic strokes. Small vessels contain a much thinner layer of muscle, or no muscle layer at all, making them more susceptible to the effects of elevated pressure.
How to protect yourself from hemorrhagic stroke: Avoid salt!
High blood pressure is the most important risk factor for hemorrhagic stroke, and Americans have a 90% lifetime probability of having high blood pressure. The most effective way to keep blood pressure in a favorable range is to avoid the huge amounts of excess salt that most Americans consume. Stroke mortality is significantly higher in Japan and exceptionally high in certain areas of China where salt intake is high, in spite of low-fat diets.5 It is also well established that Third World countries that do no salt their food are virtually immune to hypertension and strokes.
High-salt consumption may be potentially more dangerous for vegans, vegetarians, and others who have earned low cholesterol levels by eating otherwise healthful diets. Many vegans believe that their low cholesterol levels and decreased atherosclerosis risk make them exempt from all types of cardiovascular disease, but this is not the case. Unlike heart disease, cholesterol is not an important risk factor for hemorrhagic stroke. In fact, low cholesterol levels are associated with increased risk of hemorrhagic stroke. A number of studies both in Japan and in the West have illustrated that fewer animal products and a low serum cholesterol were associated with increased risk of hemorrhagic stroke.6 The plaque-building process that results in atherosclerosis and premature death may in some way actually protect the fragile blood vessels in the brain from rupture due to high blood pressure. A high-salt diet may dramatically increase the risk of hemorrhagic stroke in vegans because they can live longer than the general population and not die from a heart attack first. Of course, excess sodium increases both heart attack and stroke death in all diet styles, but in vegans, a high-salt diet may be even more dangerous. To protect against heart attacks, ischemic strokes, and hemorrhagic strokes, you must dramatically curtail salt consumption.
Excess salt is more dangerous than most people realize. In addition to high blood pressure and stroke, salt contributes to kidney disease, heart disease, osteoporosis, ulcers, and stomach cancer.7 Avoiding salt is an essential component of a health-promoting, disease-preventing diet.
1. Centers for Disease Control: Stroke. http://www.cdc.gov/stroke/
American Heart Association: Stroke. http://www.americanheart.org/presenter.jhtml?identifier=4755
4. Internet Stroke Center. http://www.strokecenter.org/patients/ich.htm
5. Kono S, Ikeda M, Ogata M. Salt and geographical mortality of gastric cancer and stroke in Japan. J Epidemiol Community Health. 1983 Mar;37(1):43-6.
6. Iso HM, Stampfer MJ, Manson JE, et al. Prospective study of fat and protein intake and risk of intraparenchymal hemorrhage in women. Circulation 2001;103:856.
Yano K, Reed D, MacLean C. “Serum Cholesterol and Hemorrhagic Stroke in the Honolulu Heart Program.” Stroke 1989;20(11): 1460-1465.
7. Tsugane S, Sasazuki S. Diet and the risk of gastric cancer. Gastric Cancer 2007;10(2):75-83