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Photos: B. Jothi Ramalingam and M. Vedhan

Prevention better than cure Maintain ideal body weight and avoid oily foods

A CT scan at the hospital confirmed he had developed an ischemic stroke (block to the circulation which deprives areas of the brain of blood). His BP, sugar and cholesterol levels were found to be high. He was administered drugs to improve circulation to the brain, control BP, sugar levels and cholesterol. He was given intensive physiotherapy besides speech and occupational therapy. He was lucky to improve reasonably well and return to work after about three months. Only then did he realise how wrong his lifestyle had been.

The threat of a recurrence made him change dramatically. He lost weight, ate in moderation, gave up alcohol and smoking, spent more time with family and friends, and remarked at a follow-up that he was only now enjoying life and work after rearranging his priorities. All stroke victims may not be as fortunate.

So, are more young people succumbing to strokes? The answer is thankfully, no. Thanks to all the modern treatment, many lives have been saved (doctors estimate that about 20 per cent to 50 per cent of people who have suffered strokes go back to work and their original status, depending on how quickly they have received treatment). But if we do not watch out and take preventive measures we might be heading in the wrong direction.

Sounding warning bells of a possible stroke epidemic, Dr. V. Shankar, Senior Consultant Neurologist, Sri Ramachandra Medical Centre and Sundaram Medical Foundation, says, “About 15 to 20 per cent of strokes occur in people aged below 40. In developing countries like India, the average age of patients with stroke is about 15 years younger than in developed countries. It is definitely a major problem in India as we have a sizeable workforce of young people with risk factors — especially diabetes and hypertension — who do not follow the prescribed treatment. If this continues, they will go on to develop strokes. This is the basis for predicting a stroke epidemic.”

Dr. R. Pazhani, Senior Consultant Neurologist, Apollo Hospitals, says, “Common risk factors for strokes — ischaemic and haemorrhagic (rupturing of blood vessel in the brain) — are high blood pressure, diabetes and high cholesterol. The incidence of stroke in the young is increasing because of the risk factors they are exposed to, many of which are modifiable and lifestyle-related. Often, people think only the elderly get hypertension. There is also a wrong idea that hypertension should produce some symptoms. But the truth is most of the time it is asymptomatic (without symptoms) and affects young people too. By screening, diagnosing and treating asymptomatic hypertension, strokes can be prevented. Access to food cooked for taste, not for health, which makes youngsters overweight, in addition to other risk factors such as constant stress, frequently changing targets, lack of exercise, smoking and alcohol consumption further increase the chances of suffering a stroke.”

Agrees Dr. Deepak Arjundas, Head of the Stroke Unit at Vijaya Health Centre and Mercury Nursing home. “Hypertension by itself or along with diabetes and/or heart disease is the cause in 72 per cent of cases. Since salt intake in excess is an important cause of hypertension in those with genetic predisposition, junk foods contribute to early onset, increase in severity and reduction of control by treatment of hypertension. Atherosclerosis underlies all strokes and this will also increase with fatty, junk foods. Besides, inactivity at work spot (such as call centres and the IT industry) increased income and lifestyles that encourage smoking and alcohol compound the problem. So I predict there will be two peaks of stroke incidence in the next decade, one between 40 and 50 years and the other between 60 and 70 years — when age catches up.”

So what can be done to avoid strokes in younger people? Says Dr. V. Shankar: “Lifestyle modifications (see box) can have a dramatic effect on reducing the risk of strokes. The Oxford Vascular Study showed a decrease in stroke incidence over a 20-year period in Oxfordshire, UK which may be attributed to recognition and treatment of high blood pressure and abnormal cholesterol levels and use of blood thinners in appropriate patients. These data show that stroke is preventable.”

Drawing attention to the connect between diseases such as strokes and heart attacks, Dr. Ajit S Mullasari, Director, Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, says, “As strokes and heart attacks are cardio vascular diseases, they represent a similar subset. Hence diseases which affect the brain will also affect the heart. We are also finding increasing incidence of young people having heart attacks because of similar reasons.”

Avoid junk foods, especially those high on salt

Restrict salt intake to 5-6 grams per day

Eat sensibly — stay away from saturated animal fats and remember no more than 30 per cent of calories from fats

Include fruits and vegetables in your diet

Maintain ideal body weight and watch out against abdominal obesity

Learn to handle stress the right way

Engage in regular physical activity

Remember smoking and drinking increase your risk

Take medication for high BP and diabetes regularly

Get a good night’s sleep

Make time to monitor your health

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