Globally, the stress on World Stroke Day, being observed on October 29, is on prevention of stroke, the second largest cause of mortality and commonest cause of disability. All it takes is some awareness to prevent stroke, says G. Arjundas, senior neurologist.
In the age group 41-60 years, 540 per 1,00,000 people will have a stroke, says Dr. Arjundas. Disability arising out of a stroke is likely to affect this group in their most productive years. This group works out to a substantial proportion of the population at 260 million (as in 2001).
If there are 20 million strokes a year, globally, 15 million survive, but 5 million of them are severely disabled, requiring extensive medical and rehabilitative care. With advances in treatment it is now possible to lower mortality and disability per cent. A dedicated stroke unit will go a long way in ensuring that patients survive and are also able to resume work in a short while.
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Having set up the first stroke unit in the public health sector at the Government General Hospital here, Dr. Arjundas has enough success stories to swear by the importance of such dedicated units to take care of patients who have had strokes.
In the Government General Hospital, for instance, by merely curtaining off four beds near the ICU as the Stroke Unit, thereby making emergency care available round the clock, doctors were able to bring the mortality down to 12 per cent from over 35 per cent. Involving the family in the physiotherapy showed excellent results.
“What is important is to tell people that stroke is preventable if only you take care of your health and make some lifestyle alterations early on.” About 80 per cent of the strokes are caused by hypertension and diabetes, both of which are preventable. “If you take care of the blood sugar and pressure fairly early in life, then the incidence of stroke will drop by 50 per cent.”
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For instance Finland, to cut down on the high incidence of stroke among its citizens due to hypertension, regulated, by law, the amount of salt that could be added to food. This resulted in significant lowering of stroke. Dr. Arjundas says, “You lower the salt, BP drops, and the chances of getting a stroke also falls.”
Controlling blood sugar is equally important. Given the huge genetic load Indians carry for diabetes, he suggests that youngsters with a strong family history of diabetes (and hypertension) are identified early and efforts launched to improve their lifestyle.
Eating healthy, avoiding sweets, exercising well and keeping excess weight gain at bay if started at childhood will have the effect of delaying the disease for a long while.
“If we postpone the onset of diabetes by 10 years, then, the onset of complications by another 10 years, the chances of strokes are less likely.” The moment diabetes is detected, aggressive treatment and lifestyle alterations must be employed.
Key risk factors
Smoking and alcohol consumption are key risk factors, and in combination with hypertension and diabetes, the risk shoots up significantly.
He explains the importance of exercise. Exercising different parts of the body sends extra blood to certain regions of the brain. If there is a vascular reserve in the brain, chances of stroke are much lower. Mental exercise, crosswords and puzzles will increase the brain's cognitive reserve.