Stroke is a debilitating medical condition that affects millions of people worldwide, leading to long-term disability and, in many cases, death. In India, the burden of stroke is substantial, and increasing awareness about this condition is crucial to mitigate its impact. Dr Madhuparna Paul, a Consultant Neurologist at AMRI Hospital Mukundapur, provides valuable insights on the prevalence, risk factors, prevention, and treatment of stroke.

The exact prevalence of stroke can be challenging to determine accurately due to underreporting and limited access to healthcare in some regions but the available data is alarming, Dr Paul says. “Stroke is a leading cause of morbidity and mortality in India. It’s a significant public health concern, with a steadily rising incidence over the years. The latest trend is a rising number of cases among younger people, even in those below 40,” she adds. 

Recent studies indicate that the age-standardized stroke incidence rate in India is estimated to be around 145-150 per 100,000 people, with a higher incidence in urban areas. Dr Paul explains, “The prevalence of stroke varies across different states and regions, with higher rates reported in southern states like Kerala, Andhra Pradesh, and Tamil Nadu.”

Stroke is a complex medical condition with two main types, ischemic and hemorrhagic. Ischemic strokes occur when a blood clot blocks an artery, while hemorrhagic strokes result from the rupture of a blood vessel in the brain. Dr Paul stresses on the importance of understanding these distinctions, as they impact treatment decisions and outcomes.

One of the critical aspects of stroke awareness is recognizing the risk factors associated with the condition. Dr Paul highlights on some common risk factors in the Indian context: 

Hypertension: High blood pressure is a major risk factor for stroke. According to Dr Paul, "Uncontrolled hypertension is prevalent in India, and it significantly increases the likelihood of stroke."

Diabetes: India has witnessed a surge in diabetes cases in recent years. Dr Paul notes, "Diabetes can damage blood vessels, increasing the risk of stroke."

Smoking & Tobacco Use: Smoking and tobacco consumption are prevalent habits in India, and they are linked to an increased risk of stroke.

Unhealthy Diet: A diet high in saturated fats, salt, and processed foods can contribute to conditions like obesity and high cholesterol, increasing the risk of stroke.

Physical Inactivity: Sedentary lifestyles and a lack of regular physical activity are common in urban areas, further elevating the risk of stroke.

Family History: Dr Paul underscores the importance of knowing one's family medical history, as a family history of stroke can increase an individual's susceptibility.

Preventing stroke is crucial, and raising awareness about the risk factors and lifestyle modifications is an essential step. “Preventing stroke involves managing risk factors and making healthy lifestyle choices,” Dr Paul explains. She shares the following key preventive measures: 

Blood Pressure Control: Regular monitoring and management of blood pressure are vital in stroke prevention. Medication and lifestyle changes may be necessary for individuals with hypertension.

Diabetes Management: Diabetics should aim to maintain their blood sugar levels within a healthy range through diet, exercise, and medication as prescribed by healthcare professionals.

Smoking Cessation: Quitting smoking and avoiding exposure to secondhand smoke can significantly reduce the risk of stroke.

Healthy Diet: A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage weight and reduce the risk of stroke.

Regular Exercise: Physical activity not only helps maintain a healthy weight but also improves cardiovascular health. Dr Paul advises, "Engaging in at least 150 minutes of moderate-intensity exercise per week is recommended."

Medication Compliance: Patients prescribed medications for conditions like high blood pressure or cholesterol should take them as directed by their healthcare providers.

In addition to individual efforts, Dr Paul highlights the importance of community-based stroke awareness programs and initiatives by healthcare organizations. "Educational campaigns, workshops, and screening programs can play a significant role in increasing stroke awareness and prevention," she says. While progress has been made in stroke awareness and care in India, several challenges persist. Dr Paul highlights some of these challenges: 

Healthcare Infrastructure: Access to stroke care facilities, especially in rural areas, remains limited. “Timely access to specialized stroke units and neurologists is crucial for optimal outcomes,” says Dr Paul.

Awareness Disparities: Urban areas tend to have better access to healthcare resources and information compared to rural areas. Addressing this disparity is essential to ensure that stroke awareness reaches all segments of the population.

Lack of Rehabilitation Services: Post-stroke rehabilitation is a crucial aspect of recovery, but rehabilitation services are often underutilized in India.

Public Education: Dr Paul stresses the need for ongoing public education to dispel myths about stroke and promote early recognition of its symptoms.

Stroke awareness in India is a matter of utmost importance, given the rising incidence of this debilitating condition. Dr Paul points out that it is imperative that individuals, communities, and healthcare organizations work together to increase stroke awareness, implement preventive measures, and improve access to quality stroke care across the country. Through education, prevention, and timely intervention, we can reduce the burden of stroke and improve the quality of life for countless individuals in India.