Stress and diet associated with brain bleeds in sub-Saharan Africa

Stress may double the risk of brain bleeds related to high blood pressure, while consuming green leafy vegetables is strongly protective, according to the largest study of stroke in sub-Saharan Africa, presented at the American Stroke Association's International Stroke Conference 2018, a world premier meeting dedicated to the science and treatment of cerebrovascular disease for researchers and clinicians.

Intracerebral hemorrhage - bleeding within the brain - takes a high toll on working-age people in Nigeria and Ghana, with high blood pressure accounting for more than 90 percent of this often-lethal type of stroke.

In a new report from the Stroke Investigative Research and Educational Network, researchers studied 682 patients (average age 53.7 years) at 15 sites in Nigeria and Ghana who experienced brain bleeds. Bleeding strokes accounted for 32.2 percent of all strokes in the study (a much higher percentage than in the United States). Of the bleeding strokes, 93.9 percent were determined to be related to high blood pressure, 7.2 percent to structural abnormalities such as a bulging weak area of a blood vessel, and much smaller percentages to other medical conditions or medication use.

Comparing patients with high blood pressure-related brain bleeds to similar people in the same communities without stroke, the researchers found that the risks were:

• 2.33 times as high in people with diabetes;
• 2.22 times as high in people who reported more stress at home and work;
• 1.69 times as high in people with abnormal cholesterol levels;
• 10.01 times as high in tobacco smokers; and
• 64 percent lower in people who reported eating more green, leafy vegetables.

Researchers say reducing stress and increasing green leafy vegetable consumption may be a novel way to reduce the rates of brain bleeds.