Stroke (cerebrovascular accident) is a disease that is caused by a sudden disorder of blood circulation in an area of the brain. When blood does not arrive, that area loses its function. Suddenly, there are things that the body cannot do and those are the symptoms. There are two types of stroke: cerebral infarction or ischemic stroke that occurs because a clot blocks an artery and blood cannot flow; and the brain hemorrhage or hemorrhagic stroke that appears when the blood vessel breaks and blood spills into the brain. Both share the same alarm signs and if only one of them appears, you must call 112.
In Spain, About 120,000 people suffer a stroke and around 25,000 die each year. The projections of the Spanish Society of Neurology (SEN) suggest that, in less than 15 years, the number of stroke cases will increase by 35%. Furthermore, if preventive measures are not taken, a 45% increase in deaths for this reason and a 25% increase in the number of survivors with disabilities is expected in the next 10 years in Europe.
The good news is that a significant proportion of cases can be avoided if controlled modifiable risk factors such as blood pressure, cholesterol levels and diabetes, reduce alcohol and tobacco consumption, follow a healthy diet and practice regular physical exercise.
Now, a study published in ‘Neurology’, the medical journal of the American Academy of Neurology, suggests that people with diseases or habits such as hypertension, atrial fibrillation (an irregular heart rhythm) or smoking, not only have a higher risk of suffer a stroke but also can suffer more serious strokes than people without these risk factors.
«Stroke can cause disability or even death, but there are various risk factors that people can modify with a change in lifestyle or medication. Our results highlight the importance of controlling stroke risk factors, especially high blood pressure, atrial fibrillation and smoking, to prevent a serious and disabling stroke,” says the author of the research, Catriona Reddin, PhD at the University of Galway (Ireland) and member of the American Academy of Neurology.
26,948 people from 32 countries with an average age of 62 years participated in the study. In this group, half of the people had suffered a stroke and the other half had not. Stroke-free participants were matched by age and sex to people who had suffered a stroke. Of the patients with stroke, 4,848 had a severe one and 8,612 had a mild to moderate one.
Severe stroke was defined as one with outcomes ranging from the inability to walk or care for oneself without assistance to the need for constant nursing care or death. Mild to moderate stroke was defined as having outcomes ranging from no symptoms to needing some help with self-care but the ability to walk without the help of another person.
The researchers determined the following risk factors for each person: blood pressure greater than 140/90 mm Hg; atrial fibrillation; diabetes; high cholesterol; smoking; alcohol consumption; diet quality; physical inactivity; psychological and social stress; and excess body fat around the waist (waist-hip ratio).
The researchers compared the importance of risk factors for suffering a severe stroke and a mild to moderate stroke with those of people who had not suffered one.
74% of patients with severe stroke had hypertension, compared with 72% of patients with mild to moderate stroke. Regarding atrial fibrillation, 11% of patients with severe stroke had the pathology compared to 9% of patients with mild to moderate stroke. In both groups, 30% were active smokers.
After adjusting for age, sex, country, and type of stroke, the researchers found that people with high blood pressure were 3.2 times more likely of having a severe stroke and 2.9 times more likely to have a mild to moderate stroke than people without this condition.
They also discovered that people with atrial fibrillation were 4.7 times more likely of suffering a severe stroke and 3.6 times more likely to suffer a mild to moderate stroke than people without this pathology.
People who smoked were 1.9 times more likely of suffering a severe stroke and 1.7 times more likely to suffer a mild to moderate stroke than people who did not currently smoke.
«Our findings emphasize the importance of controlling high blood pressure, which is the most important modifiable risk factor for stroke worldwide. “This is particularly relevant for low- and middle-income countries that have rapidly rising rates of high blood pressure and stroke at younger ages,” notes Reddin.
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