Relationship between obesity among Australian adults and stroke risk impacting

cardiovascular and nervous system

Introduction
The prevalence of obesity has been on a steady incline among Australian adults.
Approximately two in three Australian adults are diagnosed with obesity (The Relationship
between Overweight, Obesity and Cardiovascular Disease a Literature Review Prepared for
the National Heart Foundation of Australia-AIHW, 2017). Obesity severely impacts quality
of life of the individual while also negatively impacting their health. Although many factors
can influence presence of excess body fat, this essay will discuss the common cause of
obesity which is due to sustained energy imbalance (World Health Organization, 2022). The
energy imbalance occurs due to increase in calorie intake while low calorie expenditure.
Obesity is diagnosed by the calculation of body mass index (BMI), which will be further
discussed in the essay (Overweight and Obesity - Obesity Hypoventilation Syndrome |
NHLBI, NIH, 2022). Obtaining a BMI of above 30 kg /m2 is diagnosed as obese. Stroke and
obesity share major correlation as it is estimated that by each unit increase in BMI scale, it
results in a five percent increase in stroke risk (How Obesity Affects Stroke Risk | Ochsner
Lafayette General, 2022). Stroke is caused when blood circulation to the brain, controlled by
cardiovascular system, fails leading to nervous system failure (Brain Basics: Preventing
Stroke | National Institute of Neurological Disorders and Stroke, 2022). Therefore, this essay
will analyse, how does stroke impact the nervous and cardiovascular system among obese
Australian adults?

Connection between stroke and obesity

Stroke can be caused due to two reasons, blockage (ischemic stroke) or breakage
(haemorrhage stroke) of artery to the brain (Moawad, 2022). Ischemic strokes are the most
common types of strokes and are usually due to fatty substance build up around the arteries
blocking blood flow (usually present in obese individuals). Stroke is most prevalent in adults
especially after the age of 45 (Kelly-Hayes M, 2010). Stroke can be controlled by multiple
nonmodifiable risk factors such as sex and ethnicity, however, this essay will focus on
modifiable risk factors which can be controlled by lifestyle habits. A habit of consuming in a
calorie surplus lead to obesity and increased BMI. Furthermore, obese individuals tend to
develop high blood pressure as it requires more effort for the cardiovascular system to
circulate blood across the body (Kernan et al., 2013). High blood pressure is one the leading
causes of stroke. Adults suffering from obesity suffer from atherosclerosis and development
of thromboembolism which can result in blockage or breakage of artery which is the direct
cause of a stroke (Malowney, 2019). Excess amount of adipose tissue (increased BMI)
increases inflammation and remodelling of tissue which can encourage atherosclerotic
process which in turn increases stroke risk (Kernan et al., 2013b). Therefore, causes of stroke
is closely related to the presence of obesity in the individual, especially when the individual is
over the age of 45.
Impact of stroke on nervous system
Brain is a major organ of the nervous system and is responsible for multiple operations across
the body. Impact of stroke on the nervous system depends on the location, severity and
number of strokes (Johns Hopkins Medicine, 2019). The brain is divided into three sections,
cerebrum (right and left hemisphere), cerebellum (front and top hemisphere) and brain stem
(American Association of Neurological Surgeons, 2019). Hence, depending on where the
stroke occurs, different function of the nervous system can be affected (figure 1). Clinical
evidence has shown that adults diagnosed with obesity have a strong association with
neurological disorders. This tends to increase chances of severe strokes on obese adults as
they tend to have weaker neurological capabilities (O’Brien et al., 2017).

Figure 1: Anatomical
position of the major
parts of the brain (O’Brien
et al., 2017)
The cerebrum controls movement, sensation, thinking, speech,
reasoning, memory, emotion and vision. Therefore, a stroke in the cerebrum will impair these
functions of the brain. Furthermore, cerebrum is divided into left and right hemisphere,
depending on the side of the stroke the specific impairment of the functions will be different
(American Association of Neurological Surgeons, 2019). The left hemisphere of the
cerebrum is responsible for the right side of the body and the right cerebrum is responsible
for the left side of the body. Therefore, stroke in the cerebrum would impair voluntary
movement of the body. Furthermore, obese individuals are less active, hence, their movement
tends to decline at an aggressive rate (O’Brien et al., 2017).
The cerebellum is responsible for receiving sensory information from sensory neurons
through the spinal cord. The cerebellum is for coordinating and controlling muscle activity,
balance, fine movement and coordination (Johns Hopkins Medicine, 2019). Even though
strokes in the cerebellum are rare, the effects are severe. Ataxia (inability to walk and
problem with coordination), headache, dizziness, vomiting and nausea are the four main
symptoms of stroke in the cerebellum.
Brainstem is a major part of the brain and is responsible for multiple essential functions.
Heartbeat, breathing and blood pressure are all controlled by the brainstem (American
Association of Neurological Surgeons, 2019). Brainstem is also involved in controlling eye
movement, speech, chewing, swallowing and hearing. Death is a possibility with brainstem
strokes due to their vital role in sustaining the body. Other symptoms consist of coma, vision
loss, weakness or paralysis, imbalance and incoordination, inability to control body
temperature, breathing and heart function problems (Johns Hopkins Medicine, 2019). Adults
with obesity normally suffer with breathing issues, hence, stroke in the brainstem further
complicating breathing results in severe complications (Overweight and Obesity - Obesity
Hypoventilation Syndrome | NHLBI, NIH, 2022).
Stroke can leave long lasting effects on the nervous system, even after being treated. Stroke
can cause permanent cognitive damage to the ability to learn new skills, plan and problem
solve. Neurological complications following a stroke is the leading cause of death (Verywell
Health, 2019). Therefore, stroke has a major negative impact on the nervous system of obese
adults.

Impact of stroke on cardiovascular system

Heart is a major organ of the cardiovascular system and is responsible for mainly all
functions of this system. An observational study conducted observed a group of 93,627
patients that had suffered a stroke for a year. The study found that the patients who had
suffered the stroke and were obese were twice as likely to experience a heart related
complication when compared to peers with no leading factor (Verywell Health, 2019).
Following a stroke heath related problem deaths are second after neurological complications.
Obese adults carry excess fatty material present in their arteries (figure 2). Hence, recovery
for an obese individual after a stroke is extremely difficult (Obesity and Heart, 2021). The
heart beats abnormally following a stroke and undergoes arterial fibrillation (irregular
heartbeat) and arterial flutter (rapid heartbeat). In either case the heart is under immense
strain after a stroke. Additionally, irregular heartbeat can cause a pool of blood in the atria
leading to farther clotting. If these clots progressive into the bloodstream ending up in
coronary arteries, it might lead to another blockage in the brain, stroke (Verywell Health,
2019). Other complications obese adults after strokes face are acute coronary syndrome,
angina and heart failure. Stroke impacts the cardiovascular system by effecting the speed and
rhythm at which the heart pumps. This causes irregularities and additional complication
which can lead to death (Obesity and Heart, 2021).
Individuals with existing heart complication such that of an obese adult will take more
aggressive damage to their cardiovascular system.

Figure 2: comparison between artery of

normal individual and an obese individual
(Stanford Health Care, 2014)
Stroke can cause permanent damage to the cardiovascular system by changing causing
physical changes to the heart. Stroke can sometimes release harmful chemicals into the
bloodstream which can impair hearts functions (Obesity and Heart, 2021).
Treatment and prevention
Prevention or treatment following a stroke require the individual to make lifestyle changes
and adapt to a healthy diet to maintain their energy balance. The obese individual should
exercise regularly to increase the calorie output and avoid any other factors that could
contribute to worsening their symptoms such as alcohol and smoking (Stroke - Prevention,
2017). These changes aid in decreasing the chances of having arterial blockage with fatty
substances, decrease high blood pressure and decrease high cholesterol levels. Therefore,
adapting to this lifestyle will help the obese individuals to avoid another stroke and increase
their quality of life.

Conclusion
Stroke has major impact on both nervous and cardiovascular system of obese adults.
Depending on the location of the stroke, it can inhibit various functions performed by the
nervous system. Stroke can attack three main regions of the brain, cerebrum, cerebellum and
brainstem. Stroke can also leave long lasting permanent impact on cognitive functions and
heart rhythms. Individuals with obesity undergoing a stroke will face difficulty recovering as
they are prone to suffer from cardiovascular and neurological problems. Stroke will worsen
their condition by further damaging these systems. However, prevention and treatment are
possible if major lifestyle changes are made. These include diet plan, regular exercise and
avoiding smoking and alcohol to allow for stroke risks to decrease and increase quality of
life.
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