Climate & Health Program, University of Colorado, 13001 East 17th Place Campus Box C290, Aurora, 80045, CO, United States.
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, U.S.A.
Curr Neurol Neurosci Rep. 2024 Oct;24(10):507-515. doi: 10.1007/s11910-024-01370-x. Epub 2024 Aug 24.
The overwhelming majority of stroke burden can be prevented through the pillars of lifestyle medicine: diet, exercise, sleep, substance abuse, stress management, and healthy relationships. Among these, diet confers the greatest attributable risk.
Despite abundant data and integration of lifestyle medicine within major stroke prevention guidelines, several barriers to effective implementation remain. These include lack of emphasis in medical education, integration in hospital certification metrics, reimbursement from medical insurance, and health policy that inadequately addresses social determinants of health. However, both top-down and bottom-up solutions introduced within the last few years are helping to break down these barriers. This review highlights recent literature and interventions that are closing the gap between the theory and practice of stroke prevention through lifestyle risk factors from a US perspective. By strategically targeting the various institutional barriers, it is possible and essential to substantially reduce stroke burden.
目的综述：绝大多数中风负担可以通过生活方式医学的五大支柱来预防：饮食、运动、睡眠、滥用药物、压力管理和健康的人际关系。在这些因素中，饮食带来的可归因风险最大。
最新发现：尽管有大量的数据和将生活方式医学纳入主要中风预防指南，但在有效实施方面仍存在一些障碍。这些障碍包括医学教育中缺乏重视、医院认证指标的整合、医疗保险的报销以及健康政策未能充分解决健康的社会决定因素。然而，在过去几年中引入的自上而下和自下而上的解决方案正在帮助打破这些障碍。本文综述了最近的文献和干预措施，这些措施从美国的角度出发，通过生活方式风险因素，缩小了中风预防理论与实践之间的差距。通过有策略地针对各种制度障碍，大幅降低中风负担是有可能且必要的。
