In Pakistan, an estimated 400 people die of stroke every day and around the world more than four-fifths of deaths from this disease occur in in low and middle income countries. These were some of the alarming figures which came under discussion at a seminar held to mark World Stroke Day at Aga Khan University.
Stroke is a global epidemic said Dr Mohammad Wasay, Consultant Neurologist, Aga Khan University Hospital (AKUH) but 87 per cent of total losses due to stroke in terms of disability-adjusted life years (DALYs) worldwide also occur in these same low and middle income countries.
Many stroke survivors are left with some degree of physical impairment but the economic cost of caring for stroke patients and the loss of life years from stroke-related disability in Pakistan is not known. He stressed that this information is pivotal for effective health care planning and resources allocation, especially in a resource limited country such as Pakistan. Dr Wasay underscored that it is evident from regional data that the percentage of people suffering strokes and other neurological diseases is increasing in South Asia.
A number of factors increase the chances of having a stroke and some of these are unique to Pakistan and have not been studied so far. These include smoking a hookah, chewing tobacco, and a diet that includes the use of ghee, clarified butter, and hydrogenated oils.
Talking about stroke prevention strategies, Dr Sarwar Siddiqui, Consultant Neurologist, AKUH described primary and secondary prevention measures – the former, the steps taken to prevent a first stroke and the latter, the measures taken to prevent subsequent strokes after the first one has already occurred. Singling out high blood pressure as the main risk factor for stroke, Dr Siddiqui pointed out that about 30 per cent of the Pakistani population above the age of 45 years suffers from high blood pressure.
In primary prevention a healthy lifestyle, a low fat diet, weight reduction measures and regular exercise all help in stroke prevention; while secondary preventive measures include tight control of blood glucose in diabetics, blood thinning medications under a specialist supervision, lowering blood cholesterol levels and surgical correction of carotid artery narrowing.
It is estimated that scaling up of these interventions will avert more than 10 million deaths in the next eight to 10 years.
Dr Saad Shafqat Consultant Neurologist and Head Section of Neurology, AKUH spoke about stroke treatment at AKU, defining vascular dementia as a chronic and incapacitating illness similar to Alzheimer’s disease. Caused by insufficient blood supply to the brain, either due to repeated strokes or through poor blood flow that slowly damages brain cells, the condition results in loss of memory, independence, insight, and judgment, leaving patients unable to care for themselves or interact with loved ones.
While no effective treatment is available at present, active research efforts are underway all over the world. The best way to prevent vascular dementia, he suggested, is to adopt a healthy lifestyle, which includes a proper diet, exercise, and avoiding the use of alcohol and tobacco.
Highlighting the importance of long-term stroke care at home, Dr Mughis Sheerani, Consultant Neurologist, AKUH, stressed on the important role the family and caregivers play when dealing with stroke patients who have been discharged from hospital. Patients are usually discharged from the hospital when they are stable as prolonged hospital stays can lead to hospital acquired infections. It takes about three months to a year for stroke patients to return back to their normal routine and during that time they require support from family members and therapists. Even when stroke symptoms gradually improve, patients will need help in daily activities both at home and in work place, which can easily be provided by occupational and/or physiotherapists.
Hassaan Akhter, Media Executive, Department of Public Affairs, Aga Khan University, Stadium Road, Karachi, on +92 021 3486 2927 or email@example.com