During my time working in the “Stroke Belt” of the US – a region known for its disproportionately high prevalence of stroke – I saw first-hand the significant impact a stroke can have on someone’s life, and just how crucial early intervention can be in helping recover from the initial event and preventing subsequent strokes. Knowing the signs of stroke and the need to act FAST (face, arms, speech, time) can mean the difference between life and death and many times a life that is overshadowed by disability. No doubt, preventative measures, such as lifestyle changes, are key to reducing the risk of another event.
A leading cause of death and disability
A stroke is a serious, life-threatening condition where blood supply to the brain is reduced or cut off.1 It is the third leading cause of death worldwide, accounting for more than 6 million deaths in 2017.2 It is also a leading cause of disability worldwide, reducing mobility in more than half of survivors aged 65 and over in the US.3 In the US alone, someone has a stroke every 40 seconds and every four minutes, someone dies of stroke.4
The most common type of stroke, an ischaemic stroke, occurs when a blood clot reduces or cuts off blood supply to the brain – accounting for around 87% of all strokes.4 An ischaemic stroke is a serious medical emergency that can lead to brain injury, disability or even death.5 A transient ischaemic attack (TIA) or ‘mini stroke’ is less obvious, with symptoms sometimes only lasting a few minutes.6 While this temporary disruption of oxygen to the brain isn’t associated with permanent disability, a TIA still requires urgent attention as it is a critical warning sign that another potentially more serious event may lurk in the near future.6
A critical window for action
About one in four strokes are recurrent.7 The risk of a recurrent stroke risk is particularly high within the first 30 days.8 This is a critical time for action, both for short- and long-term outcomes. Effective and early treatment of stroke can save a patient’s life and prevent long-term disability.9 Once a patient is stabilised, there is also a need for interventions to reduce the risk of another, potentially disabling or fatal event. Again, early action is crucial here.
The importance of long-term risk management
While early intervention is vital, long-term management focused on reducing risk factors also plays a key role in stroke prevention. In fact, up to 80% of strokes can be prevented with healthy lifestyle changes.10 High blood pressure, type-2 diabetes (T2D), high cholesterol, tobacco use and atrial fibrillation all increase the risk of stroke.5,11 Managing these underlying conditions, eating a healthy diet, exercising regularly, quitting smoking and limiting alcohol intake are all important ways to reduce the risk of a subsequent stroke.5
Chris Sivewright speaks about his personal experience with stroke and the changes he has made to take charge of his health and reduce the risk of another event.
While in practice, I saw the heavy burden stroke can have not only on the patient but on a family and caregivers – but I also witnessed many patients turn their lives around for the better. By recognising the warning signs, acting quickly, following your healthcare team’s guidance and making healthy lifestyle changes, we can all play a part in stroke prevention.
1. American Heart Association. About Stroke; 2020 [cited 03 Nov 2020]. Available from: URL: https://www.stroke.org/en/about-stroke
2. Roth GA et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. The Lancet 2018; 392(10159):1736–88.
3. Centers for Disease Control and Prevention (CDC). Stroke Facts; 08 Sep 2020 [cited 26 Oct 2020]. Available from: URL: https://www.cdc.gov/stroke/facts.htm.
4. Virani SS et al. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association. Circulation 2020; 141(9):e139-e596.
5. National Health Service. Overview: Stroke; 15 Aug 2019 [cited 3 Nov 2020]. Available from: URL: https://www.nhs.uk/conditions/stroke/
6. National Health Service. Overview: Transient ischaemic attack (TIA); 21 January 2020 [cited 3 Nov 2020]. Available from: URL: https://www.nhs.uk/conditions/transient-ischaemic-attack-tia/
7. Hankey GJ. Secondary stroke prevention. The Lancet Neurology 2014; 13(2):178–94.
8. Coull AJ et al. Population based study of early risk of stroke after transient ischaemic attack or minor stroke: Implications for public education and organisation of services. BMJ 2004; 328(7435):326
9. National Health Service. Treatment: Stroke; 15 Aug 2019 [cited 26 Oct 2020]. Available from: URL: https://www.nhs.uk/conditions/stroke/treatment/.
10. American Stroke Association. American Stroke Month Secondary Prevention; 2020 [cited 26 Oct 2020]. Available from: URL: https://www.stroke.org/en/about-the-american-stroke-association/american-stroke-month-secondary-prevention.
11. Stroke Association. Smoking and the risk of stroke; 2017 [cited 04 Nov 2020]. Available from: URL: https://www.stroke.org.uk/sites/default/files/smoking_and_the_risk_of_stroke.pdf.
Veeva ID: Z4-28128
Date of Preparation: November 2020