Stroke remains one of the leading causes of mortality and morbidity globally. And yet, for the most part, we can prevent the condition. It is noteworthy that we identify the risk factors that potentiate the propensity of suffering a stroke. Then, we can mitigate them. It is not surprising that the risk factors accounting for cardiovascular events like myocardial infarction also play a crucial role in perpetuating cerebrovascular diseases like stroke. So, an endeavour to control such risk factors will inadvertently play a significant role in stroke prevention.
Risk factors are either modifiable or non-modifiable. The former, you can take measures to change them: the latter, they are unchangeable. In stroke prevention, understanding each of the categories is paramount.
Non-modifiable risk factors are age, race and ethnicity, gender, family history, and genetic risk factors like sickle cell disease. Modifiable risk factors include hypertension, diabetes mellitus, obesity, dysregulated lipid profile, atrial fibrillation, structural heart disease, carotid artery stenosis, and sedentary lifestyle.
It is not surprising to encounter a patient with more than one risk factor. He is African, obese, diabetic, hypertensive, with high cholesterol.
In many instances, stroke prevention involves tackling these risk factors, especially the modifiable ones, to reduce the probability of suffering a stroke. Prevention takes the form of either being primary or secondary. For primary stroke prevention, we target individuals with a potentiated risk of a cerebrovascular event and guide them on reducing the risk. Such individuals haven’t suffered a stroke yet. For secondary prevention, we help the patients who have suffered a stroke to try and recover from it. And halt a similar catastrophe. The interventions overlap.
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The risk of stroke increases with age. Stroke is more pronounced among Africans than whites. More men suffer strokes than women. Family history and genetic factors like sickle cell disease, cerebral amyloid angiopathy also increase the risk of stroke. You may have nothing to do with most of these risk factors.
However, modifiable risk factors like hypertension, diabetes, obesity, high blood cholesterol: you are the change agent. You are responsible for what you devour and how you consume it. A sedentary lifestyle (uncontrolled alcohol consumption, smoking and lack of physical exercise) potentiates the propensity of suffering a stroke. Some risk factors like atrial fibrillation may not show any clinical features until disaster strikes. So, any suspicion should warrant cautionary measures. Occasionally, check-in at the hospital for a medical check-up that involves a cardiovascular examination beyond blood pressure measurement. You may be surprised.
You ought to understand each of the risk factors and how they increase the risk of suffering stroke. And that’s our next series of articles. So, keep up in the loop such that you don’t miss out.