Metabolic Syndrome and its Profound Effect on Prevalence of Ischemic Stroke

Abstract

Ischemic stroke represents a leading cause of death worldwide and the leading cause of disability in the United States. Greater than 8% of all deaths are attributed to ischemic stroke. This rate is consistent with the heightened burden of cardiovascular disease deaths. Treatments for acute ischemic stroke remain limited to tissue plasminogen activator and mechanical thrombolysis, both of which require significant medical expertise and can only be applied to a select number of patients based on time of presentation, imaging, and absence of contraindications. Over 1,000 compounds that were successful in treating ischemic stroke in animal models have failed to correlate to success in clinical trials. The search for alternative treatments is ongoing, drawing greater attention to the importance of preclinical models that more accurately represent the clinical population through incorporation of common risk factors. This work reviews the contribution of these commonly observed risk factors in the clinical population highlighting both the pathophysiology as well as current clinical diagnosis and treatment standards. We also highlight future potential therapeutic targets, areas requiring further investigation, and recent changes in best-practice clinical care.

Keywords: Ischemic Stroke; Metabolic Syndrome.

Figure 1

Balance of vasodilator-associated and vasoconstrictor-associated signaling molecules is altered in hypertension. Damage to endothelial cells can lead to the development of hypertension and vice-versa. Further damage can result in release of pro-thrombotic factors leading to platelet adhesion and thrombosis, producing ischemic stroke.