According to the World Stroke Organization, stroke now accounts for almost 6 million deaths each year and ranks second only to heart disease as the world’s leading cause of death. If basic preventive measures are not taken, the number of people predicted to die from stroke will rise by another million over the next six years.
Unhealthy diets, smoking, and physical inactivity are all unequivocally identified as fuel for a growing epidemic of hypertension, high cholesterol, obesity and diabetes, all associated with a raised risk of both heart disease and stroke. Atrial fibrillation, the most common disorder of heart rhythm, has also been clearly associated with an increased risk of stroke.
Studies have shown that:
- High blood pressure is the most important risk factor for stroke; in the Framingham Heart Study stroke risk in people with measurements within the normal range was half that of those with hypertension.
- Smoking roughly doubles the risk of stroke (after adjustment for other risk factors.
- Atrial fibrillation increases the risk of stroke by around five times.
European Society of Cardiology Guidelines on Cardiovascular Disease (CVD) Prevention, which were updated in 2007, list stroke alongside coronary artery disease, heart failure and peripheral artery disease as cardiovascular diseases within the scope of prevention initiatives. The Guidelines distinguish between hemorrhagic stroke (around 15% of cases) and ischemic stroke, but add that the cause of many strokes remains undetermined.
The Guidelines note that treating high blood pressure reduces risk of both ischemic and hemorrhagic stroke, and that stroke prevention is still the most important effect of antihypertensive treatment. The Guidelines stress that smoking should be discouraged, and exercise encouraged.
Professor Ian Graham, Chairperson of the Fourth Joint Task Force of the ESC and Other Societies on CVD Prevention in Clinical Practice, added salt to the risks above, saying: “In addition, restriction of salt intake can help to reduce the burden of high blood pressure and consequent stroke.”
References:
1. According to WHO estimates, the number of stroke events in Europe is likely to increase from 1.1 million per year in 2000 to more than 1.5 million per year in 2025 solely because of demographic changes.
2. Wang TJ, Massaro JM, Levy D, et al. A risk score for predicting stroke or death in individuals with new-onset atrial fibrillation in the community: the Framingham Heart Study. JAMA 2003; 290: 1049-1056.
3. Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB. Probability of stroke: a risk profile from the Framingham Study. Stroke 1991; 22: 312-318.
4. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991; 22: 983-988.
5. Noda H, Iso H, Toyoshima H, Date C, et al. Walking and sports participation and mortality from coronary heart disease and stroke. J Am Coll Cardiol 2005; 46: 1761-1767.
6. Hu G, Sarti C, Jousilahti P, et al. Leisure time, occupational, and commuting physical activity and the risk of stroke. Stroke 2005; 36: 1994-1999.
