These 7 Facts About Stroke Could Change Your Life
Are you at risk of stroke? Yes, you may be. Perhaps, this question may have crossed your mind but not much attention was given. But, what is stroke to begin with? Stroke indicates a sudden brain attack that can happen to anyone at any time. It occurs when the blood flow in brain is cut off, resulting in oxygen deprivation of brain cells. Eventually, an individual faces lost of abilities controlled by that area of brain, such as memory and muscle control.
The severity of stroke depends on how much the brain is damaged. Small stroke attack may only cause minor problems such as temporary weakness of an arm or leg. As for larger stroke, that one may become paralyzed permanently on one side of the body or lose the ability to speak. Some may recover completely from stroke; unfortunately, more than ⅔ of stroke survivors will have some type of disability for the rest of their lifetime.1
Stroke can be classified into two types: hemorrhagic stroke and ischemic stroke.
What You Should Know About Stroke?
1. It attacks without any prior symptoms
There is no symptom before a stroke attacks. The sudden onset is generally recognised by sudden numbness or weakness of the face, arm or leg (especially one side of the body); confusion, troubled speech or understanding speech; trouble eyesight on one or both eyes; difficulty in walking, dizziness, loss of balance or coordination; or sudden severe headache with no pertaining reason.
2. Early detection reduces the damage to brain
Every minute counts when stroke strikes! If stroke is left untreated for too long, the damage to the brain will worsen and be irreversible. Comparing with the normal rate of neuron loss in brain aging, the ischemic brain ages 3.6 years each hour without treatment.17 Do the FAST test if suspect of stroke.
At the hospital, the patient will be requested to undergo several assessments, including brain imaging scan (eg: CT scan, MRI), full neurological and cardiovascular assessment, and blood tests* to diagnose and rule out other disease with symptoms that could mimic stroke. Once stroke is diagnosed, supportive treatment will be given to stabilize the blood pressure and cardiac rhythm. For ischemic event, thrombolytic therapy** is given within the first 3 hours of onset. As for hemorrhagic event, the patient is often seen with rapid loss of consciousness, hence the medical team will maintain the patient’s airway and reduce the elevated intracranial pressure caused by bleeding in the brain.
*Low blood glucose level may cause symptoms similar to those of a stroke
**Prescription of drug to dissolve blood clots that caused blockage
3. Some people possess higher risk for stroke
High blood pressure is known to be the major risk factor for stroke.3,8,19 People with increasing age, high cholesterol, cardiovascular disease, family history of stroke, smokers (including second hand smokers) and alcohol use are found to be at higher risk.3,8 Stroke survivor also need to beware of another stroke attack. The cumulative risk of stroke recurrence is 3.1% at 30 days; 11.1% at 1 year; 26.4% at 5 years; and 39.2% at 10 years after the initial stroke attack.11
4. Stroke is growing to be common
Although stroke affect people of all ages, it is more commonly seen among elderly. Stroke is the second leading cause of death worldwide in 2010 (consists of 11.1% i.e. 5.8 millions death) and shows an increasing prevalence.4 In Malaysia, stroke is one of the top five leading causes of death, ranging from 6.6-8.4% of death in general hospitals since 2005, with the mean age between 54.5-62.6 years.29 Furthermore, in 2007, it has been reported that six new stroke cases occur in every hour.30 Stroke is Singapore’s fourth leading cause of death.31 The average number of stroke episodes from 2005 to 2013 was approximately 5,868 a year, with most of the cases occurred among age group 40 and above. 30
5. Stroke recovery is a lifelong process
Stroke recovery begins after the patient’s condition has stabilized (blood flow to brain is restored and elevated pressure in the surrounding area is reduced). The sooner the recovery begin, the higher chance one has to regain from their affected brain and body function. Stroke results in significant impairment towards one’s language, cognition, motor, and/or sensory skills, and may also causes complications such as impaired bladder and bowel control, difficulty in swallowing, and depression. Hence, stroke survivors need lengthy time for rehabilitation and chronic care in improving the impairments and managing the complications, which doesn’t just happens for the first few months after a stroke attack. It requires patience, hard work and commitment from both caregiver and patient, and may take years to recover (depending on the severity of stroke). Generally, the recovery involve high-intensity training, repetitive-task training and fitness training. It can take place at either rehabilitation units, skilled nursing homes or even your home, if you can get the specialist coming over to help.
6. A mini-stroke should be treated as medical emergency
Mini stroke, which known as transient ischemic attack (TIA), is a temporary stroke symptom that last less than 24 hours. However, it is a major warning signs prior to actual stroke, with the recurrence rate of 10-20% within 90 days.10 Thus, individual who have experienced TIA needs immediate medical assessment and diagnosis. As proposed by its name, most cases of TIA involves ischemic events.
7. Stroke is preventable
Yes! Up to 80% of stroke cases can actually be prevented1 through managing the controllable risk factor (eg: high blood pressure, high cholesterol). Besides, practicing a healthy lifestyle is always the best preventive method:
- Exercise regularly – physical activity helps in managing the risk factors of stroke, especially in improving blood pressure and cholesterol levels; and this has been supported by various studies reporting that moderately active individuals had 20% lower risk and highly active individuals had 27% lower risk of stroke incidence or mortality than the low-active individuals.7
- Eat healthy and a balanced diet – an overall healthy eating pattern which involves consumption of a variety of fruits and vegetables; reduced intake of saturated fats, cholesterol, trans fat by substituting with fish, legumes and nuts; limit salt intake to less than 6 g/day by reducing intake of high salt-content food such as processed food, canned food; and reduce usage of salt in cooking (high salt intake is associated with significantly increased risk of stroke).20
- Consume natural supplement with premium quality and scientifically proven health benefit(s) –
a) Hoganbo PGB: helps by managing cholesterol levels (one of the risk factors for stroke) with its main ingredient – Policosanol, an extraction from Cuba sugar cane wax.21-23 Furthermore, it also contain extraction of Ginkgo leaves and Banaba leaves which helps in improving blood circulation, strengthening the weakened blood vessels,24 and enhances memory.25
b) Hoganbo Bongsam: containing 100% 6 years old Korea Red Ginseng which improves blood circulation by its antithrombotic effect (i.e. reduce formation of blood clot), hence reducing the risk for ischemic stroke. Besides, it can also helps to reduce fatigue, improve metabolism, enhance immunity and memory.26-28
A frequently used phrase in stroke incidence is “time is brain” which emphasizes on human nervous tissue that is rapidly at lost as stroke progresses, thus requiring emergent evaluation and therapy.17 We should recognise the signs of stroke so that we can take immediate action to reduce its damage to the brain. However, as prevention is always better than cure, active preventive actions should be taken before stroke gets you.
- National Stroke Association. 2017. What is stroke? Retrieved on 06 April 2017.
- Lindley RI. 2017. Stroke, 2nd Edition. United Kingdom: Oxford University Press. Retrieved on 06 April 2017.
- Lim SS et al. 2012. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. Vol 380 (9859): pp. 2224-2260.
- Lozano R et al. 2012. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. Vol 380: pp. 2095-2128.
- American Heart Association. 2016. Five Fast Things You Should Know About Stroke. Retrieved on 06 April 2017.
- National Institutes of Health, US. What You Need To Know About Stroke. Retrieved on 06 April 2017.
- Chong DL et al. 2003. Physical Activity and Stroke Risk: A Meta-Analysis. Stroke. Vol 34 (10): pp. 2475-2481.
- O’Donnell MJ et al. 2010. Risk Factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. The Lancet. Vol 376 (9735): pp. 112-123.
- Rathore SS et al. 2002. Characterization of Incident Stroke Signs and Symptoms: Findings From the Atherosclerosis Risk in Communities Study. Stroke. Vol 33 (11): pp. 2718 – 2721.
- Ois A et al. 2008. Factors Associated with a high risk of recurrence in patients with transient ischemic attack or minor stroke. Stroke. Vol 39: pp. 1717-1721.
- Mohan KM et al. 2011. Risk and Cumulative Risk of Stroke Recurrence. Stroke. Vol 42: pp. 1-6.
- Delgado A. 2016. Stroke Recovery: What to Expect. Retrieved on 06 April 2017.
- Dobkin BH. 2004. Strategies for Stroke Rehabilitation. Lancet Neurology. Vol 3 (9): pp. 528-536.
- Langhorne P et al. 2011. Stroke rehabilitation. (abstract). The Lancet. Vol 377 (9778): pp. 1693-1702. Retrieved on 06 April 2017.
- Frizzell JP. 2005. Acute Stroke: Pathophysiology, Diagnosis and Treatment. AACN Clinical Issues Advanced Practice in Acute Critical Care. Vol 16 (4): pp. 421-440.
- Walter Silke et al. 2012. Diagnosis and treatment of patients with stroke in a mobile stroke unit versus in hospital: a randomised controlled trial. Lancet Neurology. Vol 11: pp. 397-404.
- Saver JL. 2006. Time is Brain-Quantified. Stroke. Vol 37: pp. 263-266.
- Andersen KK et al. 2009. Hemorrhagic and Ischemic Strokes Compared: Stroke Severity, Mortality and Risk Factors. Stroke. Vol 40 (6): pp. 2068-2072.
- Pearson TA et al. 2002. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: 2002 Update-Consensus Panel Guide to Comprehensive Risk Reduction for Adult Patients Without Coronary or Other Atherosclerotic Vascular Diseases. Circulation. Vol 106 (3): pp. 388-391.
- Strazzullo P et al. 2009. Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. British Medical Journal. Vol 339: pp. 1-9.
- Berthold G&Berthold HK. 2002. Policosanol: clinical pharmacology and therapeutic significance of a new lipid-lowering agent. American Heart Journal. Vol 143 (2): pp. 356 – 365.
- Castano G et al. 1999. Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients. International Journal of Clinical Pharmacology Research. Vol 19 (4): pp. 105 – 116.
- Canetti M et al. 1995. A two-year study on the efficacy and tolerability of policosanol in patients with type II hyperlipoproteinaemia. International Journal of Clinical Pharmacology Research. Vol 15 (4): pp. 159 – 165.
- Cass H. & English J. 2002. User’s Guide to Ginkgo Biloba. USA: Basic Health Publications.
- Diamond BJ et al. 2000. Ginkgo biloba extract: Mechanisms and Clinical indications. Physical Medicine and Rehabilitation. Vol 81 (5): pp. 668-678.
- Kim HG et al. 2013. Antifatigue Effects of Panax ginseng C.A. Meyer: A Randomised, Double-blind, Placebo-Controlled Trial. PloS ONE. Vol 8 (4): e61271.
- Kang SW & Min HY. 2012. Ginseng, the ‘Immunity Boost’: The Effects of Panax ginseng on Immune System. Journal of Ginseng Research. Vol 36 (4): pp. 354-368.
- Inhee MJ et al. 2001. Ginsenoside Rb1 and Rg1 improve spatial learning and increase hippocampal synaptophysin level in mice. (abstract only). Journal of Neuroscience Research. Vol 63 (6): pp. 509 – 515.
- Loo KW and Gan SH. 2012. Burden of Stroke in Malaysia. International Journal of Stroke. Vol 7 (2): pp. 165-167.
- Krishnamoorthy M. 2007. Killer Stroke: Six Malaysians Hit Every Hour. The Star Online. Retrieved on 10 April 2017.
- Venketasubramanian N & Chen CLH. 2008. Burden of Stroke in Singapore. (abstract) Journal of Stroke. Vol 3 (1): pp. 51-54. Retrieved on 11 April 2017.
- Ministry of Health Singapore. 2015. Singapore Stroke Registry Report No. 4: Trends in Stroke in Singapore 2005-2013. Retrieved on 11 April 2017.