An estimated 400 people die of stroke every day in Pakistan, and around the world, more than four-fifths of deaths from this disease occur in low-and middle-income countries.
These were some of the alarming figures that came under discussion at a seminar held on Saturday at the Aga Khan University (AKU) to mark the World Stroke Day. “Stroke is a global epidemic, but 87 percent of the total losses due to stroke in terms of disability-adjusted life years worldwide also occur in these same low- and middle-income countries,” said Dr Mohammad Wasay, consultant neurologist at the Aga Khan University Hospital (AKUH), while speaking on the occasion.
“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 said that this information is pivotal for effective health care planning and resources allocation, especially in a resource limited country such as Pakistan.
“It is evident from regional data that the percentage of people suffering strokes and other neurological diseases is increasing in South Asia.” He also said that a number of factors increase the chances of having a stroke and some of them 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 at the 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 percent 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,” he said.
“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 of the Neurology Section at the AKUH, spoke about stroke treatment at the 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,” he said.
“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 at the AKUH, stressed the need for 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,” he said.
“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.”
