World Stroke Day 2021: Stroke is a leading cause of death due to neurological diseases in India and has been responsible for 7.4 per cent of the total deaths in the last three decades.
India has seen a dangerous increase in the number of non-communicable diseases and most of the burden is borne by heart disease. According to the Lancet, the incidence of heart disease and stroke in India has increased by more than 50 per cent in the last three decades.
Stroke is a leading cause of death from neurological diseases in India and accounts for 7.4 per cent of all deaths.
According to the Indian Stroke Association (ISA), 17 million people suffer from stroke each year, of whom 6 million die and five million are permanently disabled. Lack of adequate prevention and stroke management facilities causes about eight per cent deaths due to stroke in middle and low-income countries like India.
A stroke occurs when blood flow to the brain is blocked – ischemic stroke (ischemic stroke) or vessel rupture (hemorrhagic stroke). Once a patient has had a stroke, they are more likely to have recurrent strokes.
Therefore, it is important to understand the risk associated with primary and chronic stroke and to be able to reduce them.
A stroke-ready hospital is one with facilities such as a CT scanner (available 24×7) and other procedures required to treat stroke. Direct access to a hospital that is ready for a stroke increases the patient’s chances of being eligible for acute stroke treatment, which has a specific time-window.
Risk factors for stroke
Risk factors for stroke can be divided into two categories – reversible risk factors (hypertension or hypertension, diabetes, dyslipidemia or high cholesterol, inactivity and obesity) and irreversible risk factors (advanced age, male Gender and positive family history).
Another condition that can cause a person to have a stroke is called atrial fibrillation. It is an irregular heartbeat that increases the chances of having a stroke by forming recurrent clots.
Although stroke is considered a disease of the elderly, India, the world’s diabetic capital, finds stroke more common in young people. Smoking, oral tobacco, hookah, unhealthy lifestyle and eating habits increase the risk of stroke.
Hypertension is the most treatable risk factor for both ischemic stroke and hypertensive hemorrhage. Diabetes is the second most important risk factor for ischemic stroke.
Treatment of stroke
The right treatment depends on the type of stroke you have.
CT scans are needed to differentiate between ischemic stroke and cerebral hemorrhage. Other tests may be needed to look at the blood vessels and heart.
People with ischemic stroke or stroke due to clogged arteries are eligible for certain anticoagulant-buster medications. Besides, in some special cases, clogged arteries can be reopened within a certain time window.
People with stroke caused by bleeding may need surgery to reduce the pressure on the brain and control blood pressure.
Specialized units consisting of nurses and physicians trained to treat stroke patients go a long way in preventing disability caused by stroke. These units help prevent complications related to stroke – such as bed sores, tumors in the legs and pneumonia. Rehabilitation therapies such as physiotherapy and speech therapy help to speed up movement. More and more stroke units are needed to prevent stroke-related disorders.
How to prevent stroke?
You can prevent stroke by regularly taking your prescribed medications, including antihypertensive drugs, statins, cholesterol and anti-clotting drugs, aspirin and other antihypertensive drugs. Medications that help maintain blood sugar levels (very close to normal) can also be very helpful in preventing stroke.
Lifestyle changes such as exercise, smoking cessation and a diet rich in fruits, vegetables and low-fat dairy products go a long way in preventing stroke. Reducing the salt intake to five grams a day or one teaspoon a day as recommended by your doctor can help prevent stroke. Movement or activity for a minute to two minutes after each hour of inactivity can be helpful. For weight loss, it may be helpful to limit alcohol intake if you are overweight and within safe limits. Quitting tobacco in all forms, such as oral tobacco, cigarettes and beedi, can be helpful.
Dr. Neetu Ramrakiani is the Director of Neurology at Fortis Escorts Hospital in Jaipur. Stroke is of great interest to him and he is currently in the process of creating a stroke unit at Fortis Escorts Hospital in Jaipur. He has written an editorial in Neuroscience India and is the lead researcher on a pilot program under the Fortis Stroke Registry.