My mother suffered from transient ischemic storke (TIA). She was able to cover it up from her family and her GP for years. She lived alone and we only discovered her affliction after we hired a person to come in once a day to do the housekeeping and prepare her lunch. One day the helper called, frantic, to say that my mother was slumped over unconscious at the breakfast table. She came a round within a few minutes but clearly something was very wrong. I rushed over and mother confessed that she’d been having such episodes “for a few years.” Three weeks later she suffered a major stoke and went into a coma a couple of days later. She died in hospital two months after that.
Stoke continues to be a major killer of Canadians and it is on the rise. Together with heart disease, stroke accounts for on third of all deaths in Canada yet it receives scant public attention attention compared to other diseases such as breast and prostate cancer. Any responsible physician who suspects a patient is sucepible to stroke owes it to the patient to warn of the signs what actions should be taken.
A new study sheds yet more light on the causes of stroke. Hypertention continues to be the number one cause of ischaemic and intracerebral haemorrhagic stroke according to a Canadian study published in The Lancet last Friday, June 18, 2010. Of greater interest, the three year study, of 3000 patients and 3000 controls in 22 countries listed the chief causes which accounted for 90% of strokes. The participants were taken from middle and lower income groups. Contributing factors in order of their importance were:
hypertension
waist-to-hip ratio
diet risk score
diabetes mellitus
alcohol intake for more than 30 drinks per month or binge drinking;
psychosocial stress
depression
cardiac causes
Collectively, these risk factors accounted for 88·1% of stokes. When an alternate definition of hypertension was used (history of hypertension or blood pressure >160/90 mm Hg), for all stroke the percentage rose to 90.3%. The risk factors were all significant for ischaemic stroke. Hypertension, smoking, waist-to-hip ratio, diet, and alcohol intake were significant risk factors for intracerebral haemorrhagic stroke.
The conclusion, in keeping with current medical practice, suggested targeted interventions that reduce blood pressure and smoking, and promote physical activity and a healthy diet, could substantially reduce the burden of stroke.
The study, involved 22 clinicans and was funded by the Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, Canadian Stroke Network, Pfizer Cardiovascular Award, Merck, AstraZeneca, and Boehringer Ingelheim.
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