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perspective

How to protect against a stroke’s blow 


Its billions of neurons form a uniquely complex network that controls reason, thought and our every move. 

But when the brain is deprived of blood, or when bleeding causes it to swell, the result can be loss of sight, seizures, fatigue, speech loss, memory loss and paralysis. Known as a stroke, such episodes can also cause death. 
It’s surprising, then, that so many of us know little about this affliction – and especially given that each of us has the capacity to prevent and detect it. 
Over 11 million strokes occur every year in low-and middle-income countries, which includes those of Southeast Asia. The result is more than 4 million deaths annually, with 30 per cent of survivors seriously disabled. For the 70 per cent who recover, the likelihood of suffering further strokes is greatly increased – recurrent stroke accounts for around one in four episodes of the life-threatening condition.
Risks for stroke include high blood pressure, high cholesterol, heart disease, diabetes and high blood-sugar level. Other indicators include obesity, smoking, drinking alcohol in large quantity and physical inactivity. The risk of stroke also increases with age, while men are more likely to suffer an episode than women. 
To significantly reduce lifestyle-related risks, those who smoke should quit, and those who drink heavily should cut down. Second, you can adopt a diet high in vegetables and fruit and low in salt, which will decrease fatty deposits in arteries that can cause blockages, as well lower the risk of burst vessels that high blood pressure brings. Third, regular exercise should be undertaken – at least 30 minutes of moderate-intensity aerobic activity five times a week. And fourth, blood pressure, blood-sugar and cholesterol levels should be checked regularly, with associated conditions managed by a medic. 
It’s also important to be able to identify the early warning signs of a stroke: Is the face drooping on one side? Is there weakness in one arm? Is the speech slurred? If the answer is yes to one or all of the above signs, seek medical help fast.
Meanwhile, healthcare systems must be in a position to act decisively to prevent stroke-related disability or death. Emergency facilities should be well-honed and efficient, and staff should be given the skills to treat attacks.
Importantly, as a means of diminishing the likelihood of a stroke occurring in the first place, treatment and counselling to manage stroke-related conditions such as diabetes and hypertension should be available at the primary healthcare level. 
After the recent adoption of the Colombo Declaration, which calls for a region-wide primary healthcare approach to tackling noncommunicable diseases, commitment across Southeast Asia is encouraging.    
Through avoiding tobacco and alcohol, consuming a nutritious diet, getting regular exercise, and managing underlying conditions, most brain strokes can be prevented. And through knowing the symptoms, seeking immediate care, and having a well-prepared health system, most complications can be averted. To ensure this is the case, individuals and the health systems they rely on must adapt accordingly. 

Dr Poonam Khetrapal Singh is the World Health Organisation regional director for Southeast Asia. World Stroke Day is tomorrow.

Published : October 27, 2016

By : Poonam Khetrapal Singh Special to The Nation