I’m a stroke survivor
Growing up, I associated October 2nd with Gandhi Jayanti – a day to celebrate the birth and life of Mahatma Gandhi. That changed around 3:30 pm on October 2nd 2016, when I had a stroke shortly after a refreshing Sunday afternoon walk in the park. I was in my late 60s and in good health. I never thought much about stroke – until that day when it struck me. I am one of the lucky few – among the 10% of stroke survivors – who make a complete recovery within the first 30 days.
Are you at risk for a stroke? Could it happen to you?
Some statistics
According to the National Institute of Health data from 2022, about 795,000 people in the United States have strokes, and 137,000 of them die. 10% of the survivors recover completely in a month or less and 25% recover with only minor impairments. Close to two-thirds of survivors are not so fortunate. 40% experience moderate-to-severe impairments that. require special care, 10% of patients require long-term care, and 15% die shortly after.
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A growing concern
There’s a growing concern related to stroke in the US medical community. According to the American Heart Association, new cases of a debilitating and often deadly type of stroke that causes bleeding in the brain have been increasing in the U.S., growing at an even faster rate among younger to middle-aged adults than older ones.
Stroke is the fifth leading cause of death in the U.S. and the leading cause of disability around the world. Sustained efforts during the first decade of this century to control blood pressure, diabetes, atrial fibrillation and dyslipidemia (a major risk factor for cardiovascular disease and stroke) resulted in a decrease in the overall incidence of stroke in the US. However, since 2011 it has been rising again, and the rise among adults between 18 and 50 – in the prime of their lives – has set off alarm bells in the health-care community.
According to a recent study by the US Centers for Disease Control and Prevention (CDC), the overall prevalence of stroke rose by 8% between 2011 and 2022. The largest increase in stroke prevalence was in younger adults: 15% in the 18-44 age group and 16% for the 45-64 age group – a significant increase in stroke prevalence for these groups compared to previous years. While stroke is still most prevalent in seniors over 65, this rising rate among younger adults is highly concerning.
Why is this happening?
Researchers point to a number of likely risk factors for the rise in stroke cases among younger adults. Key among these is the growing prevalence of obesity, high blood pressure, diabetes, and other cardiovascular risk factors among younger adults. In addition, lifestyle factors such as poor diet, lack of physical activity, and excessive alcohol consumption contribute to the risk. 23% of people aged 18 to 39 have hypertension, which doubles a person’s risk for stroke. The opioid epidemic, increased drug use, obesity, and long-term effects for COVID-19 survivors are also frequently mentioned.
In addition, the relentless fast pace of today’s society causes prolonged stress for many. This directly or indirectly contributes to an increase in many of the health and lifestyle factors listed above.
These conditions and lifestyle choices can weaken or damage the arteries, causing clots to form. A stroke occurs if a clot blocks or ruptures the blood vessels carrying oxygen and nutrients to the brain. In the United States, ischemic strokes (caused by a blocked blood vessel) account for about 87% of all strokes (and 60% of those for people under 50); while Intracerebral hemorrhagic (ICH) strokes (caused by a ruptured blood vessel) account for about 15%.
Alert for South Asians
The risk factors for cardiovascular disease and stroke are by and large the same. The impact of ethnicity on heart health is well established. An article I wrote for India Currents last year, If You Are An Asian Indian Immigrant, Pay Attention!, highlighted the fact that Asian Indians in the US were at 3-4 times higher risk of developing coronary heart disease than white Americans. It’s not surprising that South Asians have a significantly higher risk for stroke as well. You can access a good brochure on reducing the risk of stroke for South Asian people here by the UK Stroke Association here.
Prevention
To decrease the chances of stroke, we need to address the risk and lifestyle factors described above. What’s good for heart health is in general good to reduce stroke risk. Adopt a heart-healthy brain-healthy diet. Exercise and engage in regular physical activity. Use alcohol in moderation and avoid drug use. Do not smoke. Get a cardiovascular and metabolic checkup, and address any specific issues or risk factors uncovered. Mitigate or control prolonged stress.
Early detection: BEFAST
Recognizing the signs of a stroke is just as important as prevention. Unless a stroke is treated in a timely manner, rapid and irreversible damage to brain tissue can result. According to National Institute of Health (NIH) medical guidelines, a stroke should be treated within 3 hours of the onset of symptoms, as this is the timeframe for administering a clot-busting medication called tissue plasminogen activator (tPA) which can significantly improve recovery chances for an ischemic stroke, the most common type of stroke. Many stroke trauma centers strongly recommend being seen within 90 minutes.
The acronym BEFAST (Balance, Eyes, Face, Arms/legs, Speech and Time) is very helpful to recognize that you’ve had a stroke and need to act swiftly. Immediately following a stroke, one or more of the following signs will be noticeable:
- Your speech may be slurred or confused.
- a feeling of dizziness;
- problems balancing, or sudden vomiting;
- Your sight may be unclear, with double or blurred vision;
- One side of the face and/or mouth may be pulled lopsided;
- You may feel weakness on one side, particularly in the arms and/or legs;
- You may be unable to hold up an arm or leg.
A swift response is essential; time lost is brain lost! Call 911 and get to the emergency department of the nearest hospital. Amanda Werner, the Stroke Program Manager at the University of Colorado’s Health system points out that “you lose 1.9 million brain cells each minute that brain tissue doesn’t get blood flow, so every minute counts.”
