Nov 22, 2016
While stroke is a major public health concern worldwide, the burden on India has been increasing at an alarming rate, writes Dr Amit Aslam Khan.
New Delhi: Stroke is the second most common cause of death after coronary artery diseases globally. It is also the most prevalent cause of chronic adult disability.
However, while stroke threatens mankind all across the globe, developing countries like India account for more than four-fifths of all strokes. The stroke incidence rate in India is much higher than in other developing countries with approximately 1.8 million Indians out of a population of 1.2 billion suffering from stroke every year.
Previous hospital-based data from India observed a high proportion of young stroke (first-ever stroke onset below 40 years of age), ranging between 15 and 30 percent. In a recent study at All India Institute of Medical Sciences (AIIMS), out of the 2,634 patients admitted for ischemic stroke, 440 (16.7%) were in the age range of 18-45 years. Stroke is not limited to the elderly only.
In India, common risk factors such as hypertension, diabetes, smoking, and dyslipidemia are prevalent and insufficiently controlled due to low awareness levels of the disease. Another major challenge is that treatment for stroke is still evolving in India. Until recently, physicians have been using intravenous tPA, a clot-busting drug to open blocked blood vessels, as the first line of defense. Five global clinical trials have shown that the addition of stent retriever therapy to IV-tPA improves functional disability in patients and is now recommended as a first-line treatment for acute ischemic strokes.
Many people affected by stroke are unable to access treatment and rehabilitation due to lack of awareness.People generally tend to ignore the symptoms of stroke. However, early detection is very crucial because in stroke, 32,000 brain cells are damaged every second the disease goes untreated.But ignorance about stroke symptoms, poor infrastructure, and hesitancy about hospital admission even when infrastructure and access are available often leads to delay.
Stroke is treatable and its impact can be significantly reduced. The addition of stent retriever technology has reduced disability, improved neurological outcomes and increased the rate of return to functional independence in patients suffering stroke.
While stroke is a major public health concern worldwide, the burden on India has been increasing at an alarming rate over the past few decades. The startling statistics show that there is an urgency with which the phenomenon of stroke needs to be addressed in India for reducing the huge stroke burden that the country is facing. Without more effective public education of all demographic groups, the full potential of acute prevention will not be realized.
Dr Amit Aslam Khan is an eminent neuro-vascular interventionist currently associated with Max Super Speciality Hospital, Shalimar Bagh, New Delhi.