5 things you need to know about strokes

There are an estimated 17 million strokes worldwide each year. While stroke incidence and mortality rates in high income countries have been on the decline, progress remains slow and uneven. In low-to-middle-income countries stroke incidence is rising.

Warnings are also being issued in face of evidence that the risk factors for stroke such as hypertension, obesity, diabetes, and smoking, are on the rise in both high and low-income countries and among increasingly younger populations.

The potential impact of this on the total number years lived with disability is clear and the trend goes some way to explaining why the number of years lived with disability due to stroke have increased by 33% in the last ten years.

And yet 90% of strokes are associated with just 10 risk factors that we can all do something about. Addressing these risk factors would not just prevent stroke, they would have a major impact on rates of other non-communicable diseases including Alzheimer's, cancer, heart disease and diabetes. So, if we are going to step up the rate of change so that we don’t lose millions more years of human potential, what can we do to accelerate progress on stroke prevention?

1. As individuals, we can get accurate information about our individual lifetime risk of stroke. Many current clinical assessment tools don’t include key lifestyle considerations and others categorize people as low, medium or high risk. The Stroke Riskometer, which is widely translated and endorsed by stroke experts at the World Stroke Organization, can help you to accurately predict your lifetime risk based on key stroke risk factors and compares that risk to other people of your age.

2. ‘Knowing your numbers’ will also help reduce your risk of stroke. Blood pressure and cholesterol level checks will help you and your doctor to understand and address your risk for stroke and cardio-vascular disease. High-blood pressure is associated with almost half of all strokes and the risk level for stroke is lower than that for cardio-vascular disease. Getting blood pressure and cholesterol under control either with lifestyle changes or talking to your clinician about medication is critical to stroke prevention.

3. Getting support from others will take you further than going it alone. Many of us know that we need to stop smoking, eat more healthily and take more exercise, but making change is hard. People who get support with making change do better than those who go it alone. Tapping into support groups and online networks and mobilizing your family and friends can help you make the changes you need to reduce risk. We all have good reasons to prevent stroke, so getting other people on board widens the impact.

4. As healthcare practitioners, it is critical that health practitioners understand how medical conditions such as hypertension, diabetes and atrial fibrillation contribute to stroke risk, especially when combined with other modifiable and non-modifiable risks such as age. Alongside providing information, advice and support with lifestyle change, healthcare professionals should ensure that patients with a history of cardiovascular conditions are offered preventive treatments that will help them to reduce their stroke risk. Health professionals are of course important advocates for our patients, advocating for more equitable access to healthcare and for policies that would promote community health is part of our role. The capacity of individuals to make a difference can be severely limited by educational and economic inequalities, barriers in access to healthcare and levels of investment in services.

5. As policy-makers, developing and implementing population based approaches such as tobacco control, alcohol and sugar taxation and health promoting environments, will support individuals to make healthier choices. Removing financial barriers to healthcare – in particular developing sustainable, low cost, risk assessment and management strategies - is also essential not just to achieving development goals, but to delivering a world free from stroke.