Stroke is a type of adverse clinical event that immediately affects the brain but is linked to your heart. It is one of the leading causes of deaths in India. According to the recent report by the Indian Stroke Association, stroke burden in India has increased by nearly 100% in the past few decades.
When the blood supply to a part of the brain is interrupted or reduced, a stroke is caused. This happens when the brain tissue is stopped from getting its oxygen and nutrients, causing the brain cells to die in minutes.
The heart and all the blood vessels that pump and circulate blood around the body, including the brain, make up the cardiovascular system. A stroke can be caused by plaque (fatty substances) buildup that narrows a vessel (ischemic stroke) or blood leakage from a burst artery and clots in the vessel supplying blood to the brain (hemorrhagic stroke).
There are many factors to keep in mind when it comes to risk of stroke:
Increasing Age: Our arteries gradually narrow and get harder as we age. They are also more prone to getting clogged with fatty material, increasing the risk of a stroke. As a result, the risk of stroke rises with age, with the incidence doubling every decade beyond the age of 45, and over 70% of all strokes occurring after the age of 65.
High Blood Pressure: High blood pressure is the single biggest cause of concern when it comes to a stroke. The heart works harder to pump blood when having blood pressure. This then can strain the heart, damage the blood vessels, and thus increase risk of hemorrhage or clots. For this, one must do regular checks of the blood pressure and work with one’s doctor to keep it under control.
High Cholesterol: Cholesterol is a fat that is processed by the liver and found in the blood stream. While there are two types of cholesterol, LDL also known as the “bad cholesterol” is what one should be wary of. This can build up and clog the blood vessels. For this, one must limit the amount of fat intake and opt for plant-based food as per a prescribed diet by a healthcare professional.
Diabetes: Diabetes has long been recognized as a risk factor for stroke. It can produce pathologic changes in blood arteries in various locations, and if cerebral vessels are directly damaged, it can lead to stroke. Furthermore, patients with uncontrolled glucose levels have a greater death rate and poorer post-stroke outcomes.
Atrial fibrillation: Atrial fibrillation (heart arrhythmia) is a common heart rhythm condition that puts one at risk of a stroke. In atrial fibrillation, the blood pools in the heart's upper chambers and forms blood clots. If a blood clot forms in the upper chamber on the left side of the heart (left atrium), it has the potential to break loose and travel to the brain, blocking an artery, and causing a stroke.
Family history: High blood pressure, stroke, and other related disorders are likely to be influenced by genetic factors. A stroke can be caused by several hereditary illnesses, including sickle cell disease. People who have a family history of stroke are at increased risk.
Despite the number of risks, reducing the number of controllable risk factors is the best way to prevent a stroke.
This would require a few simple changes to your lifestyle that include quitting smoke, losing weight, eating a balanced diet low in sodium, saturated fats and trans-fats, moderate alcohol intake (no more than two small drinks per day), exercising regularly to stay physically fit, maintaining a good control of existing medical conditions such as diabetes, high blood pressure, and high cholesterol.
To confirm a stroke diagnosis, doctor may make an assessment by reviewing personal and family medical history of heart diseases or stroke, examining blood samples, measuring electrical activity in the heart through Electrocardiogram (ECG), assessing for any abnormalities in the heart function and structure through Echocardiogram. He might also measure electrical activity in the brain through Electroencephalogram (EEG), basis which the treatment is given.
Some of these medical conditions, such as narrowed arteries, heart rhythm disorders, and blood clots forming in the heart, can also be addressed through interventions using various advanced devices and implants to treat underlying conditions that pose the risk of a stroke occurring. Besides medical management, arrhythmias can be treated using ablation therapies for example, and clots in the hearts can be prevented from entering the blood vessel through left atrial appendage closure procedure. These are to be opted for only after due consultation with a qualified physician.
Stroke is a medical emergency that needs prompt medical attention. Timely diagnosis of risk factors and sometimes preventive treatment is aimed at avoiding strokes, which besides being fatal, can be both emotionally and financially draining for the patients and their loved ones.
(Dr Praveen Chandra is the Chairman, Interventional & Structural Heart Cardiology, Medanta Medicity, Gurugram)