According to a detailed analysis on the subject of strokes, a team of medical researchers have concluded that 90 % of strokes are preventable.
The study which was published in ‘The Lancet’, was led by Dr Martin O’Donnell and Prof Salim Yusuf of the McMaster University, along with collaborators from 32 countries.
It is a build up on the pre-existing information attained from the first phase of the INTERSTROKE study, which had identified ten modifiable risk factors for stroke, after tests conducted on 6000 participants from 22 countries.
High blood pressure (hypertension) is the most important modifiable risk factor for a stroke, and it along with 9 other factors, contributes to making up for 90 % of the cases.
This information has been deduced after a study of nearly 27000 people, conducted across the world, in every continent. Though, hypertension remains as the primary and the most important risk factor in all areas.
The estimated overall disease burden (known as PAR) that could be reduced if an individual risk factor were eliminated, was 47.9 percent for hypertension, 35.8 percent for physical inactivity, 23.2 percent for poor diet, 18.6 percent for obesity, 12.4 percent for smoking, 9.1 percent for cardiac (heart) causes, 3.9 percent for diabetes, 5.8 percent of alcohol intake, 5.8 percent for stress, and 26.8 percent for lipids.
But, in different areas the percentile division also varies.
The PAR for hypertension in western Europe, North America, and Australia is around 38.8 %, and in Southeast Asia, it is 59.6 %.
Likewise, the PAR for alcohol intake is low for the populations in western Europe, North America, Australia, while it is highest in Africa, at 10.4, and south Asia, at 10.7 %.
The PAR for physical inactivity is highest in China.
Hence, depending upon the region and the dominating risk factors in that area, reduction strategies can be formulated.
Professor Valery L Feigin and Dr Rita Krishnamurthi from the National Institute for Stroke and Applied Neurosciences write in a linked comment- “Three key messages can be drawn from this study. Firstly, stroke is a highly preventable disease globally, irrespective of age and sex. Second, the relative importance of modifiable risk factors and their PAR necessitates the development of regional or ethnic-specific primary prevention programmes, including priority settings such as focusing on risk factors contributing most to the risk of stroke in a particular region (as determined by PAR). Third, additional research on stroke risk factors is needed for countries and ethnic groups not included in INTERSTROKE, as well as definitive cost-effectiveness research on primary stroke prevention in key populations (eg, different age, sex, ethnicity, or region).”
They also added, “It should also be emphasised that stroke prevention programmes must be integrated with prevention of other major non-communicable diseases that share common risk factors with stroke to be cost-effective. We have heard the calls for actions about primary prevention. Now is the time for governments, health organisations, and individuals to proactively reduce the global burden of stroke. Governments of all countries should develop and implement an emergency action plan for the primary prevention of stroke.”