Understanding Stroke: Early Signs, Risk Factors & Prevention Strategies

Stroke is a leading cause of death and disability worldwide, affecting millions of people each year. Recognising the early signs of a stroke and understanding the risk factors are critical for prevention and timely intervention. With lifestyle changes and environmental factors contributing to an increased risk, it is essential to raise awareness about how factors like high blood pressure, obesity, and air pollution can significantly elevate the chances of stroke. In this guide, we explore the early symptoms of stroke, the role of air pollution, and the impact of conditions like hypertension and obesity on stroke risk.

What are the signs and symptoms of a stroke that everyone should be aware of, and what immediate actions should be taken if someone suspects a stroke?

Recognising the signs of a stroke and acting quickly is essential, so everyone should be aware of the warning signs and what to do if they occur. These are subtle signs to detect stroke. 

BE FAST is the acronym to detect early stroke. 

B - loss of balance

E- loss of vision

F- Facial palsy

A- Loss of arm strength

S- loss of speech

T - Time to act

Whenever we see the above signs go into the nearest hospital to rule out the type of stroke as ischemic blockage type or hemmorhagic Or bleeding type. 

How significant is the role of air pollution in increasing stroke risk, and what measures can individuals take to mitigate this risk?

Air pollution plays a significant role in increasing stroke risk by contributing to inflammation, hypertension, and cardiovascular disease. Air pollution increases the oxidative stress and causes hardening of arteries and dylipidemia. Both ischemic and hemmorhagic stroke can occur with pollution. 

Measures to Mitigate Risk:

Limit Exposure- Stay indoors on days with high pollution levels to reduce your risk of exposure to harmful air particles. Using air purifiers can significantly improve indoor air quality, helping to create a safer environment for you and your family.

Avoid Outdoor Exercise During High Pollution- On days when air quality is poor, opt for indoor workouts to avoid inhaling pollutants that can harm your cardiovascular system. This ensures you maintain your fitness without compromising your health.

Maintain a Healthy Lifestyle- Adopting a balanced diet rich in fruits, vegetables, and whole grains can strengthen your cardiovascular health. Regular exercise and avoiding smoking also play crucial roles in reducing your overall stroke risk.

Regular Health Check-ups- Monitoring your blood pressure and cholesterol levels regularly helps identify potential health risks early on. Early intervention can prevent complications and reduce the likelihood of a stroke.

Can you elaborate on how high blood pressure and obesity are linked to stroke incidence? What preventive strategies do you recommend?

High BP hardens the artery and makes it less elastic. Eventually, it damages the intima or inner layer of the vessel. Obesity leads to dyslipidemia and cholesterol deposits in the wall of vessels leading to stenosis or blockage. Compliance with BP medications and cholesterol-lowering drugs is essential. Walk regularly, low salt diet, green leafy vegetables and avoidance of fried items are the preventive measures. 

Some of the preventive strategies are:

Maintain a Healthy Weight- Aim for a balanced diet and regular exercise to achieve and maintain a healthy weight. Losing even a small percentage of body weight can significantly lower blood pressure.

Monitor Blood Pressure- Regularly check your blood pressure and consult your healthcare provider if it's elevated. Early detection and management are crucial for stroke prevention.

Adopt a Heart-Healthy Diet- Emphasize fruits, vegetables, whole grains, lean proteins, and healthy fats while reducing salt, sugar, and saturated fats. The DASH (Dietary Approaches to Stop Hypertension) diet is particularly effective.

Increase Physical Activity- Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week. Incorporate strength training at least twice a week.

Limit Alcohol Consumption- If you drink alcohol, do so in moderation. Excessive drinking can raise blood pressure and contribute to weight gain.

Quit Smoking- Smoking damages blood vessels and significantly increases stroke risk. Seek support and resources to help quit.

Manage Stress- Practice stress-reduction techniques such as mindfulness, meditation, or yoga. Chronic stress can negatively impact blood pressure and overall health.

Regular Health Check-ups- Regular visits to your healthcare provider can help monitor risk factors and ensure proactive management of blood pressure and weight.

What do you think are the most critical risk factors contributing to the rising incidence of stroke, particularly in low- and middle-income countries?

In low- and middle-income countries, several critical risk factors are driving the rising incidence of stroke. Smoking and excessive alcohol consumption contribute significantly to vascular damage and increased stroke risk. Additionally, lifestyle factors such as poor diet, physical inactivity, and high stress levels exacerbate the problem. Insufficient sleep also plays a role in negatively impacting cardiovascular health.

Given the increase in stroke cases over the past few decades, what advancements in treatment or rehabilitation have you seen that give you hope for better outcomes?

Recent advancements in stroke treatment and rehabilitation offer significant hope for better outcomes. Clot-buster drugs, such as tissue plasminogen activator (tPA), can dissolve blood clots when administered within a specific time frame after stroke onset, greatly improving recovery chances.

Additionally, mechanical thrombectomy has emerged as a revolutionary option for certain patients, especially those experiencing an ischemic stroke. This procedure involves physically removing a clot from a blood vessel in the brain, ideally performed within a few hours of stroke symptoms.

For someone with a family history of stroke, what proactive steps would you recommend they take to lower their risk?

For someone with a family history of stroke, taking proactive steps to lower risk is crucial. First, avoid acquired risk factors like smoking and excessive alcohol consumption, as these significantly increase stroke risk. Regularly monitor blood pressure and blood sugar levels, as hypertension and diabetes are major contributors to stroke.

Engaging in regular exercise, such as walking or cycling for at least 150 minutes a week, helps maintain a healthy weight and lowers blood pressure. Adopting a balanced diet rich in fruits, vegetables, whole grains, and healthy fats can also promote heart health.

Prioritising good sleep is essential, as poor sleep can elevate blood pressure. Additionally, managing stress through mindfulness or relaxation techniques is beneficial. Finally, schedule regular health check-ups with your healthcare provider to monitor your cardiovascular health and address concerns early, allowing for effective risk management.

What role does diet play in stroke prevention, particularly regarding sugar-sweetened beverages and omega-6 fatty acids?

Diet plays a crucial role in stroke prevention, particularly in relation to sugar-sweetened beverages and omega-6 fatty acids. Sugar in beverages damages the vessels slowly and adds extra oxidative stress to blood. Antioxidants which are widely available in our diet are sufficient enough to prevent ongoing vessel damage. However, omega fatty acids and Vitamins can be taken to boost the ongoing vessel damage. While omega-6s play a role in inflammation, they should be part of a diet that includes plenty of antioxidants, such as fruits and vegetables, to combat oxidative stress. Additionally, incorporating omega-3 fatty acids—found in fish and flaxseeds—can further protect blood vessels and reduce inflammation.

The author is Consultant, Neurologist and Neurovascular Intervention, BLK-Max Super Speciality Hospital, Delhi

Dr. Pratik Kishore

Guest Author Consultant, Neurologist and Neurovascular Intervention, BLK-Max Super Speciality Hospital, Delhi