By Dr. Sujit Kumar, Director & Senior Consultant – Neurology, KIMS Hospitals, Bengaluru 

A stroke occurs when the blood supply to a part of the brain is suddenly cut off, either because a clot blocks a blood vessel or a blood vessel ruptures and bleeds into the brain. Within minutes of the blood flow stopping, brain cells start to die. Depending on the area of the brain involved the effects can include paralysis of one side of the body, loss of speech, difficulty swallowing, visual disturbance, memory loss and in the most severe cases, death.

Stroke is the second leading cause of death globally and one of the leading causes of long-term disability. What makes this particularly significant is that the majority of strokes are preventable. And the conditions that drive stroke risk are not rare or exotic. They are the everyday health problems that millions of people are living with, and in many cases, managing inadequately.

The Conditions That Raise Stroke Risk

●      High Blood Pressure is the single most important modifiable risk factor for stroke, responsible for the majority of cases across both the blocked and bleeding varieties.

●      Type 2 Diabetes causes progressive damage to blood vessels throughout the body, including the vessels that supply the brain. People living with diabetes are two to four times more likely to experience a stroke than those without the condition.

●      High Cholesterol contributes to the development of atherosclerosis, the buildup of fatty deposits inside artery walls that narrows them progressively and makes them increasingly prone to blockage. When this process affects the carotid arteries in the neck or the vessels feeding directly into the brain, the risk of ischaemic stroke rises considerably.

●      Atrial Fibrillation is an irregular heart rhythm in which the upper chambers of the heart beat chaotically rather than in a coordinated rhythm. This causes blood to pool and stagnate inside the heart, where it can form clots. Those clots can travel through the circulation to the brain, causing strokes that tend to be large, severe, and associated with poor recovery.

●      Obesity raises stroke risk both directly and through the web of associated conditions it tends to produce. High blood pressure, type 2 diabetes, high cholesterol, atrial fibrillation, and obstructive sleep apnoea are all significantly more common in people carrying excess weight, and each of these independently elevates stroke risk. The combination of several of them multiplies that risk considerably

●      Smoking is one of the most powerful modifiable stroke risk factors. It accelerates damage to blood vessel walls, raises blood pressure, reduces the oxygen-carrying capacity of blood, promotes inflammation, and creates conditions in which clots are far more likely to form.

●      Obstructive Sleep Apnoea causes repeated interruptions to breathing during sleep, each one producing a drop in blood oxygen levels and a surge in blood pressure. Over time, this pattern drives hypertension, promotes irregular heart rhythms, and is associated with a significantly elevated stroke risk.

Recognising a Stroke

The FAST acronym is the most important tool for recognising stroke and responding appropriately:

●      F — Face drooping or weakness on one side, or an uneven smile

●      A — Arm weakness or inability to raise both arms to the same height

●      S — Speech that is slurred, confused, absent, or very difficult to understand

●      T — Time to call emergency services immediately, without waiting to see if symptoms improve

What Reduces the Risk

●      Blood pressure measured regularly and kept consistently within a healthy range with medication where necessary

●      Blood sugar managed carefully in people with diabetes, with regular monitoring and medication review

●      Cholesterol treated with statins or other appropriate agents where lifestyle changes alone are not sufficient

●      Anticoagulation prescribed and taken consistently for patients with atrial fibrillation

●      Stopping smoking, which delivers meaningful risk reduction regardless of age or how long a person has smoked

●      Regular physical activity and sustained weight management

●      Assessment and treatment for obstructive sleep apnoea in people with relevant symptoms

Conclusion

Stroke is largely preventable. The conditions that cause it are common, well understood, and in most cases, manageable. Treating them seriously and consistently is one of the most significant contributions a person can make to their own long-term health.