Stroke Can Be Prevented: Know Your Risks!

  • By Dr Seinn Mya Mya Aye, Consultant Neurologist

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Stroke is the second leading cause of death in most countries and is one of the leading causes of long-term disability. One in six of us will suffer a stroke in our lifetime. Every two seconds, someone in the world suffers a stroke. Every six seconds, someone dies of stroke. Every six seconds, someone’s quality of life will forever be changed.
Stroke incidence and mortality rates have been increasing in developing countries and Myanmar is not an exception. Increased stroke incidence is likely to be lifestyle changes, poor health knowledge, limited accessibility to health care facilities, economic and social constraints and inefficient primary preventive strategies in health care system.

What is stroke?
Stroke happens when the blood supply to part of the brain is cut off. Without blood, the cells in the affected area of brain become damaged or die. This damage can have different effects depending on where it happens and how much of brain tissue is deprived of blood supply.

Symptoms of stroke
Someone who had a mild stroke may experience temporary weakness of an arm or leg, but those with a more severe stroke may be permanently paralyzed on one side of their body or be unable to speak. If the blood supply is not quickly restored, either on its own or via with medical treatment, the effects may be permanent.
Possible signs and symptoms of stroke include the sudden onset of:
1. Weakness or paralysis of any part of the body.
2. Numbness or a “pins and needles” sensation anywhere in the body.
3. Gait disturbances (trouble walking) or loss of balance and coordination
4. Vision changes, blurred vision, or trouble with eyesight in one or both eyes
5. Dizziness
6. Severe headache that usually is unlike headaches in the past
7. Confusion
8. Inability to speak, slurred speech, or inability to understand speech
9. Loss of sensation in any part of the body
10. Memory loss
11. Behavioral changes
12. Muscle stiffness
13. Difficulty swallowing
14. Involuntary eye movement

Types of stroke
There are two main types of stroke, ischaemic stroke (due to a blocked blood vessel in the brain) and haemorrhagic stroke (due to bleeding in the brain). About 85% of all stroke are due to ischaemic stroke and 15% haemorrhagic.

Mini- stroke or Warning Stroke (Transient Ischaemic Stroke)
It is due to a temporary lack of blood supply to a part of the brain. The affected part of the brain is without oxygen for just a few minutes and soon recovers. This is because the blood clot either breaks up quickly or nearby blood vessels are able to compensate. It shows symptoms similar to a stroke, typically lasts less than five minutes, and does not injure the brain.

Know your risks: Stroke is preventable.
90% of strokes are linked to 10 key risk factors. Try to find out your risks and take actions to reduce the risk of stroke.

1. Control high blood pressure
Risk – Hypertension is linked to almost half of all strokes.
Action – Know and control your blood pressure with lifestyle change, or medication.

2. Do moderate exercise 5 times a week
Risk – Over a third of all strokes happen to people who do not take regular exercise.
Action – Moderate exercise five times a week.

3. Eat a healthy, balanced diet
Risk – Almost a quarter of strokes are linked to poor diet, in particular low consumption of fruit and vegetables.
Action – Eat five or more portions of fruit and vegetables

4. Reduce your cholesterol
Risk – More than 1 in 4 strokes are linked to high levels of ‘bad’ (LDL) cholesterol.
Action – Eat low saturated, non-hydrogenated fats instead of saturated fats.
If you cannot maintain a healthy cholesterol level with diet alone, talk to your doctor about treatments that could help.

5. Maintain a healthy BMI( Body mass Index) or waist to hip ratio
Risk – Almost 1 in 5 strokes are linked to obesity.
Action – A good way to know if you need to lose weight is to divide your waist measurement by your hip measurement. If the number is over 0.9 (man) and 0.85 (woman) your weight is putting you at higher risk of stroke and you would benefit from losing weight.

6. Stop smoking and avoid second-hand exposure
Risk – More than 1 in 10 strokes are linked to smoking.
Action – Stop smoking and getting help to quit increases your chances of success.

7. Reduce alcohol intake
Risk – Over 1 million strokes each year are linked to excessive alcohol consumption.
Action – Reduce our alcohol intake to two units of alcohol a day for men and one for women.

8. Identify and treat atrial fibrillation (Irregular heart beat)
Risk – An irregular heart beat or other heart condition is linked to 9% of strokes.
Action – Talk to your doctor about possible treatments to reduce your risk.

9. Diabetes
Risk – As well as sharing many of the same risk factors, diabetes increases the risk of stroke.
Action – Reducing your risk of diabetes will reduce your risk of stroke. If you have diabetes, talk to your doctor about treatments.

10. Income and education
Risk – Across and within countries low levels of income and education are linked to stroke.
Action – Government policies that address poverty and improve equitable access to healthcare and education will have a positive impact on stroke and other non-communicable diseases.

Stroke is treatable: Recognize stroke symptoms and signs early (FAST) !!!
Acting fast is critical if you suspect that someone may be having a stroke. Immediate treatment of a stroke can minimize long-term effects of the stroke.
F: Face drooping: Can the person smile? Has their mouth or eye drooped?
A: Arm weakness: Can the person raise both arms?
S: Speech difficulty: Speech disturbance. Can the person speak clearly?
Can they understand what you say?
T: Time to act: Time to call /get the person to a hospital immediately
What can we do as health care practitioners?
Health care practitioners should provide information and support to patients and communities and help them take steps that would reduce their lifetime risk of stroke.
What can government and health care system decision makers do?
Government and health care system decision makers should implement population-wide prevention strategies that address the economic and environmental contributors to stroke. They must take the leadership role in developing sustainable, low cost risk assessment and management strategies.



Reference – World Stroke Organization, World Stroke Day 2017)

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