The escalating prevalence of strokes in locals has sounded alarms within the medical community and beyond. With this in mind, the Heart and Stroke Foundation South Africa has highlighted a distressing statistic: An average of 10 individuals are afflicted by strokes every hour within the nation, signalling an urgent call for awareness and action.
Dr Tristram Horton, a Neurovascular Surgeon at Mediclinic Newcastle, has emerged as a vocal advocate, illuminating the substantial impact of strokes not only as a leading cause of permanent disability but also as a major contributor to mortality rates.
Strokes, primarily ischemic in nature, are triggered by clot-induced obstructions in blood vessels leading to the brain, while hemorrhagic strokes result from the rupture of weakened blood vessels.
Beyond the commonly acknowledged risk factors such as smoking and excessive alcohol consumption, Dr Horton emphasised the significant, albeit indirect, role of psychological stress in stroke incidence
“Psychological stress is a known risk factor for many conditions, including strokes. It acts in indirect ways, such as elevating blood pressure, and high blood pressure is one of the most important risk factors for strokes. It is also in of itself just like stress, something you can partially control,” explained Dr Horton.
Expanding on this, the doctor emphasised the importance of managing high blood pressure, also known as hypertension, through appropriate medication. Stress, which can raise blood pressure, can be addressed either medically or non-medically, depending on the individual.
Moreover, drug abuse is a significant concern in Newcastle, with efforts underway to address the associated social problems.
Delving into the role drugs play in increasing a person’s risk of stroke, Dr Horton said, “Drug abuse is absolutely a recognised risk factor for patients of having a stroke of any type. If a young person has a stroke, it is one of the things we have to rule out and check to see if that may have been a factor.”
Furthermore, the doctor discussed the connection between drug abuse and strokes, noting that while ischemic strokes typically occur in older adults, aged 60 to 65, they are increasingly seen in younger individuals, some under 40. This trend has led medical professionals to investigate whether drug use could be a contributing factor in these younger patients.
An ischemic stroke, according to Dr Horton, is the most common type of stroke. He explained, “85% of what we call stroke is due to cerebral infarction. However, 15% of strokes are not actually an infarction, but they are opposite. They are caused by a haemorrhage in the brain. Those are commonly also due to high blood pressure, but can be due to other reasons. In both the ischemic infarction stroke and the less common one caused by bleeding or haemorrhage, one of the known risk factors in younger people is drug abuse. Specifically, drugs that are stimulant types of drugs such as amphetamines.”
Amphetamines include drugs such as cocaine, KAT and crystal meth.
According to Dr Horton, the reason these drugs can cause a stroke is due to them raising one’s blood pressure. These narcotics are also known to cause damage to blood vessels, including blood vessels of the heart and brain placing immense strain on an individual’s body.
However, regarding cannabis, Dr Horton mentioned that there is no scientifically backed evidence linking its use to stroke causation or treatment.
On another note, Dr Horton discussed the use of anabolic steroids among gym goers and local sports enthusiasts. He pointed out that steroids, common among bodybuilders and contact sports participants, heighten the risk of stroke as well as cardiovascular issues.
According to the research paper, Anabolic Steroid Use and Ischaemic Stroke in a Young Fitness Enthusiast by James Choulerton, Nishan Guha and Rebecca Squires, it was highlighted that the long term use of anabolic steroids could elevate serum homocysteine levels leading to increased risk of ischaemic stroke.
To read the full research paper, click here.
Highlighting the genetic and lifestyle predispositions among certain demographics, Dr Horton pointed to individuals of African descent and those with prevalent rates of hypertension and type 2 diabetes as being particularly vulnerable to strokes.
Building on the above foundation, it’s imperative to recognise obesity, physical inactivity, poor diet, and conditions such as atrial fibrillation (An irregular, often rapid heart rate that commonly causes poor blood flow) as additional stroke risk factors. Moreover, the role of environmental determinants like air pollution in the rising stroke incidence cannot be overlooked, pointing to a broader spectrum of risk beyond personal health choices.
As per the doctor, a comprehensive stroke prevention strategy encompasses a holistic approach: Regular physical activity, a balanced diet, moderated alcohol consumption, and abstention from tobacco and illicit drugs are foundational pillars.
Discussing treatments, especially for ischemic strokes, Dr Horton noted significant progress in intra-arterial direct treatments targeting the underlying issue: Clots forming in the arteries and obstructing blood flow to the brain.
This treatment involves using special catheters, stents, and other devices to remove the blockage and restore blood flow to the affected part of the brain, which holds a high success rate.
Given the potentially fatal or disabling consequences of a stroke, seeking medical help promptly is crucial. Therefore, Dr Horton outlined key signs to watch for, including:
- Sudden onset of severe headaches and/or neck pain.
- Sudden onset of specific neurological deficits, such as changes in speech, facial drooping, loss or decrease of function on one side of the body, or a decrease in consciousness level.
- Seizures.
Furthermore, Dr Horton’s discourse and the expanded insights into stroke prevention coalesce into a potent call to action. Understanding the diverse nature of stroke risk factors and the paramount importance of early detection empowers people to proactively engage in preventive measures and embrace treatment innovations.
In rallying together to cultivate a health-conscious society alert to the dangers of strokes, we can safeguard our collective well-being and ensure a healthier future for communities.
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