Role of diet-related factors in cerebral aneurysm formation and rupture

Abstract

Cerebral aneurysms (CAs) are dilations of the wall of an artery in the brain filled with blood. The prevalence of unrupted CA in general population is estimated at approximately 3%. Ruptured aneurysms are the cause of 85% of spontaneous subarachnoid hemorrhage (SAH) cases. The formation of cerebral aneurysms results from various factors, including chronic inflammation, hemodynamic stress and vascular wall remodeling. Reactive oxygen species may induce the endothelial dysfunction possibly through the activation of Nuclear Factor Kappa-B, which is a key regulator of the proinflammatory genes. Hypertension may additionally increase the hemodynamic stress and activate the local renin-angiotensin system. The aim of this review was to assess the role of selected diet-related factors in the formation and rupture of cerebral aneurysms. It appears that inadequate intake of dietary antioxidants, hyperhomocysteinemia, hypertension (including incidental elevated blood pressure) and alcohol consumption may increase the risk of intracranial aneurysms. Individuals at high risk of CA formation and/or rupture should consume adequate amounts of antioxidant vitamins (vitamin C, vitamin E and carotenoids), B vitamins (vitamin B 6 , vitamin B 12 and folate), flavonoids and n-3 fatty acids, limit alcohol and caffeine consumption and regularly control their blood pressure. Vegetables, fruits, grains, pulses, nuts and fish, as well as herbs, spices and tea, should be the major components of the daily diet. Due to the synergistic effect of various dietary components on health, Mediterranean diet or Dietary Approach to Stop Hypertension (DASH) diet, as they meet abovementioned requirements and have high anti-inflammatory potential, are thus recommended for the prevention of cerebral aneurysm formation and rupture. STRESZCZENIETętniaki mózgu to ograniczone poszerzenia światła naczynia krwionośnego wypełnione krwią. Występowanie tętniaków mózgu w ogólnej populacji wynosi około 3%, a pęknięcie tętniaka jest przyczyną 85% przypadków krwotoku do przestrzeni podpajęczynówkowej. Na powstanie tętniaka mózgu wpływa wiele czynników, w tym przewlekły stan zapalny, stres hemodynamiczny i przebudowa ścian naczyń mózgowych. Reaktywne formy tlenu mogą nasilać dysfunkcję śródbłonka m.in. poprzez aktywację jądrowego czynnika transkrypcyjnego NF-κB, który jest głównym regulatorem genów związanych z przebiegiem procesu zapalnego. Ponadto wysokie ciśnienie tętnicze krwi może nasilać stres hemodynamiczny oraz aktywować lokalny układ renina-angiotensyna-aldosteron. Celem artykułu był przegląd piśmiennictwa dotyczącego roli wybranych czynników związanych z dietą i z ryzykiem powstania i pęknięcia tętniaków mózgu. Wydaje się, że niewystarczająca podaż składników o działaniu antyoksydacyjnym, hiperhomocysteinemia, nadciśnienie tętnicze (w tym nagłe skoki ciśnienia tętniczego krwi) oraz spożycie alkoholu mogą zwiększać ryzyko rozwoju tętniaków mózgu. Osoby o podwyższonym ryzyku powstania i/lub pęknięcia tętniaka mózgu powinny więc stosować dietę o odpowiedniej zaw...

Effect of Cross Theoretical Model of Behaviour Change and Motivation Interview on Self-Management Behaviour

“…According to studies, the recurrence rate of intracranial aneurysm after endovascular interventional therapy is up to 20.8%–36%, and patients who have risk factors including smoking, alcoholism, hypertension, diabetes mellitus, and hyperlipidemia often face risks of multiple or postoperative recurrence [ 14 , 15 ]. The related factors of intracranial aneurysm rupture are not only bound up with the size and location of the intracranial aneurysm but also strongly bound up with patients' self-protection, emotional management, blood pressure control, medication compliance, and changes of bad living habits [ 16 , 17 ].…”

Oxidative Stress in the Pathogenesis of Aorta Diseases as a Source of Potential Biomarkers and Therapeutic Targets, with a Particular Focus on Ascending Aorta Aneurysms

“…Consistent with these recent discoveries about HT, it has also been described that the Mediterranean diet can positively impact the cardiovascular system thanks to its antioxidant effects [ 70 ]. Precisely, two studies have tested the risk of abdominal aortic and cerebral aneurysms in relation to Mediterranean diet adherence [ 71 , 72 ]. They have been conducted on a very large sample and have demonstrated that a Mediterranean diet based on a high consumption of fruits, vegetables, wholegrains, legumes, nuts, fermented dairy products, fish, and olive and/or rapeseed oil; moderate consumption of alcohol; and low consumption of processed and unprocessed red meat may represent a positive factor for the prevention of two forms of aneurysm [ 71 , 72 ].…”

Oxidative Stress Inside the Pathogenesis of Ascending Aorta Aneurysms: A Clearer Vision for Identifying Promising Biomarkers and Therapeutic Targets

“…The data obtained have demonstrated the HT capacity of selectively inhibiting the protein glycation reaction in human insulin, and of counteracting the AGE-induced cytotoxicity by acting on sirtuins levels and oxidative stress, as well as on inflammatory response [62] Consistent of these recent discoveries on HT, it has been also reported that Mediterranean diet may positively impact the cardiovascular system thanks to its antioxidant effects [63]. Precisely, two studies have tested the risk of abdominal aortic and cerebral aneurysms in relation to Mediterranean diet adherence [64,65]. They have been conducted on very large sample size and have demonstrated that a Mediterranean diet based on high consumption of fruits, vegetables, wholegrains, legumes, nuts, fermented dairy products, fish, use of olive and/or rapeseed oil, moderate consumption of alcohol, and low consumption of processed and unprocessed red meat, may represent a positive factor for the prevention of two forms of aneurysm [64,65].…”

“…Precisely, two studies have tested the risk of abdominal aortic and cerebral aneurysms in relation to Mediterranean diet adherence [64,65]. They have been conducted on very large sample size and have demonstrated that a Mediterranean diet based on high consumption of fruits, vegetables, wholegrains, legumes, nuts, fermented dairy products, fish, use of olive and/or rapeseed oil, moderate consumption of alcohol, and low consumption of processed and unprocessed red meat, may represent a positive factor for the prevention of two forms of aneurysm [64,65]. No studies there are about AsAA and Mediterranean diet until now.…”