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Hsu. Vessel Plus 2022;6:18 Vessel Plus
DOI: 10.20517/2574-1209.2021.117

Editorial Open Access

Stroke - the second leading cause of death

Chung Y. Hsu

Graduate Institute of Clinical Medical Science and Clinical Trial Center, China Medical University, Taichung 406040, Taiwan.
Correspondence to: Prof. Chung Y. Hsu, MD, PhD, Graduate Institute of Clinical Medical Science and Clinical Trial Center, China
Medical University, Education Building, 5th Floor, No. 91, Hsueh-shih Road, North District, Taichung 406040, Taiwan.
E-mail: hsucy63141@gmail.com

How to cite this article: Hsu CY. Stroke - the second leading cause of death. Vessel Plus 2022;6:18.
https://dx.doi.org/10.20517/2574-1209.2021.117

Received: 19 Aug 2021 Accepted: 1 Sep 2021 Published: 5 Mar 2022

Academic Editor: Alexander D. Verin Copy Editor: Xi-Jun Chen Production Editor: Xi-Jun Chen

In the World Health Organization (WHO) list of leading causes of death in the world, stroke is ranked
second, behind heart disease (WHO, 2019). While the mortality rate of stroke is lower than that caused by
the number one ailment (heart disease), disability after stroke carries a much greater burden than heart
disease on quality of living. Disability after stroke creates a much more serious socioeconomic burden on
survived patients, their families, and the society compared to heart disease. Prevention of stroke, rather than
therapy, is the top priority in healthcare. Once stroke develops in a patient, the therapeutic options are
limited. Approximately 87% of stroke is caused by cerebral ischemia following blockage of cerebral arteries
secondary to atherosclerosis or blood clots dislodged from the heart or major cerebral arteries resulting in
reduced cerebral blood flow in the region of the brain irrigated by the affected blood vessels . Cerebral
[1]
ischemia results in brain damage secondary to deprivation of oxygen and nutrients provided by cerebral
blood flow. Ischemic brain injury can cause neurological dysfunctions including disorder in mental, motor,
sensory, and other body functions. Starting in the 1980s, neurotoxicity caused by free radicals and
endogenous neurotoxic substances, in particular glutamate, an excitatory neurotransmitter, had been
identified to be the key pathogenetic mechanism underlying ischemic neuronal death . Blocking the
[2]
neurotoxic actions of free radicals and excitatory neurotransmitters, particularly glutamate, had been the
top research field for developing therapeutic agents to treat ischemic stroke and restore neurological
function for over a decade until 1995, after more than one thousand clinical trials failed to establish the
therapeutic efficacy of any neuroprotective agent directed at free radicals or glutamate.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
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