Among the stroke survivors, 39 percent of recurrent strokes and 10 percent of post-stroke dementia cases were attributed to pre-stroke cardiovascular risk factors, including high blood pressure; diabetes; low levels of high-density lipoprotein (HDL – the good cholesterol); smoking; and transient ischemic attack (TIA – mini stroke).
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The researchers identified ten risk factors for stroke incidence, all of which are modifiable behaviors, and isolated them as being responsible for about 90 percent of all strokes worldwide, based on analysis of 6,000 subjects from 22 countries. The new study published in the journal The Lancet analyzes risk factor identification by the INTERSTROKE study that collected data from 20,000 subjects in 32 countries across the world. With thousands more patients involved, the researchers hoped to identify the primary causes of stroke in various populations around the world, regardless of age, gender, and subtype of stroke.
Of the 10 modifiable risk factors, the most significant was hypertension.
“It also highlights the importance of funding more research looking into stroke, its causes and possible treatments, to reduce the number of people dying prematurely”.
While smoking caused 12.4 per cent, heart diseases was accounted for 9.1 per cent of strokes.
Now, however, a study conducted by researchers at McMasters University along with contributing scientists from 32 other countries, has concluded that 90 percent of all strokes are, in fact, preventable. “No one wants to have a stroke, but this study suggests that we all have some control in the form of preventing a second stroke and maintaining our mental faculties”.
“We have confirmed the ten modifiable risk factors associated with 90% of stroke cases in all regions, young and older and in men and women”, Dr. Martin O’Donnell, principal investigator for the Population Health Research Institute (PHRI) at McMaster University and study author, said in a news release. The study authors noted, however, that the importance of various risk factors vary in different regions. For example, the PAR for hypertension ranged from 38.8 percent in western Europe, North America and Australia to 59.6 percent in Southeast Asia, the PAR for alcohol intake was lowest in western Europe, North America, Australia and highest in Africa (10.4 percent) and south Asia (10.7 percent), while the PAR for physical inactivity was highest in China.
Atrial fibrillation was found to be having presence in all regions, but it was having greater importance in Western Europe, North America and Australia.
Many of these risk factors are known to also be associated with each other (such as obesity and diabetes), and when were combined together, the total for all 10 risk factors was 91%, which was similar in all regions, age groups and in men and women.
“This is really a public health issue, so it’s about promoting healthy lifestyles and better access to healthy foods and exercise”, he added.
Writing in a linked Comment, Professor Valery L Feigin and Dr Rita Krishnamurthi from the National Institute for Stroke and Applied Neurosciences, Faculty of Health and Environmental Sciences, University of Technology, Auckland, New Zealand, say: “Three key messages can be drawn from this study”.
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“Now is the time for governments, health organizations, and individuals to proactively reduce the global burden of stroke”.
