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Preventing Stroke Is More Important Than Its Treatment

Stroke is the second most common cause of death in India. Diabetics and hypertensive, specially, need to follow the right prevention strategies.

Stroke (Paralysis) is a clinical syndrome associated with loss of brain function caused by either an interruption of blood supply to the affected brain area (known as ischemic stroke) or by a spontaneous haemorrhage in the brain (known as haemorrhagic stroke ).

Stroke is the most important cause of severe disability and even with the best care, residual neurological problem remains in most of the patients. Maximum improvement occurs within the first 3 months and after 1 year, only minimal improvement can be expected. Moreover, it is the third commonest cause of death in the world. Despite all preventive measures, there is always a risk of recurrence and it varies from 10-20% within 1 year. The bad news is that the incidence is high and still rising. It increases with age and has certain important modifiable risk factors of which hypertension, diabetes and obesity stand out the major ones.

It is very important to identify these risk factors because preventing stroke is more essential than treating it. As a doctor, identifying the patients at risk of stroke and managing those risks is of utmost importance. For the patients, it is important to be aware of the risk factors and modify them with the help of the family physician. One should be familiar with the following risk factors:

- Hypertension: The risk of stroke increases with rising blood pressure and the incidence increases by 45% for every 7.5 mm Hg rise in blood pressure above 130/80. Of people who have hypertension, 30% do not know that they have it, 30% are only controlled and the remaining are uncontrolled.

- Diabetes: It is associated with a three fold increased risk of stroke and the risk of recurrence is five folds. Therefore, with an increasing prevalence of diabetes, it is essential to achieve a good glycemic control (HbA1c<7%) with the help of your specialist.

- High cholesterol: The progression of atherosclerosis is directly related to total cholesterol and LDL levels and inversely to HDL cholesterol. Managing high cholesterol and Triglycerides levels is extremely important for prevention.

- Lifestyle Modifications:
a. Stop smoking (25% increased risk with smoking).
b. Reduce obesity with diet restriction and exercises.
c. Avoid alcohol.

There are many other subsets of risk factors for stroke but since majority of the events occur in diabetic and hypertensive patients, it is essential for this high risk group to be extremely aware and watchful of Stroke.

Dr Arun Kedia is a consultant physician and intensivist at Lifeworth hospital, Raipur. His field of interests include cardio-diabetes and rheumatology. He is also a consultant in HIV medicine and is a part of many national and international research activities
Connect to your hero Dr Arun Kedia at kediaarun@yahoo.com

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