Charmaine Gauci

Strokes are sudden and have an immediate effect. They are a leading cause of long term disability in adults. In 2010, strokes accounted for 8.7% of total deaths in Malta. In addition there were six hundred and fifteen discharged cases of stroke in Malta and Gozo in the year 2011. Stroke is also the second leading cause of death in the Western world after ischaemic heart disease, with an exponential increase in its occurrence with increasing age.

Some risk factors cannot be modified by medical treatment or lifestyle changes:

• Age

• Gender

• Family History

• Ethnicity/race

However other risk factors can be modified. These can be split into:

Medical risk factors

Lifestyle risk factors

• Hypertension

• Smoking

• Hypercholesterolaemia

• High alcohol consumption

• Diabetes

• Physical inactivity/obesity

• Heart disease

• Unhealthy diet

The Health Promotion and Disease Prevention Directorate is embarking on an initiative to reduce the risks of stroke.

1. A balanced diet

A diet low in saturated fats and cholesterol and high in dietary fibre:

• Include plenty of fresh vegetables and fruits

• Avoid adding salt to food during its preparation or at table

• Avoid processed foods that are high n salt

• Read food labels to help you choose foods that are low in salt, fat and sugar

2. Be active

Thirty minutes for at least five days per week of moderate intensity activity (such as brisk walking or riding a bike at ground level) is recommended. Some physical activity is better than none. Any amount of physical activity gives health benefits. Physically active men/ women generally have a 25-30% lower risk of stroke or death than the least active people.

3. Tobacco

Smoking doubles the risk for stroke. Smoking cessation is also associated with a rapid reduction in risk of stroke to a level that approaches but does not reach that of those who never smoked.

4. Alcohol

Heavy drinking multiplies the risk of having a stroke by more than three times. One gram of alcohol is equivalent to seven calories and therefore may lead to weight gain. General practitioners have an important role in making people aware of stroke and the possible consequences. Regular measurement of blood pressure, cholesterol levels, blood glucose levels, weight ,waist circumference and Body Mass Index (BMI) can help identify risk factors and take measures to limit their impact.

A stroke can cause temporary or permanent disabilities which include:

• Paralysis

• Dysarthria, aphasia

• Memory loss or thinking difficulties

• Emotional problems

• Central pain syndrome

• Changes in behaviour and self-care

The rates of reported medical complications of stroke are high with 50% of deaths after stroke being attributed to medical complications. An autopsy series found that the most common cause of death after ischemic and hemorrhagic stroke was cerebrovascular disease in the first week, pulmonary embolism in the second through fourth weeks, bronchopneumonia in the second and third months, and cardiac disease after three months.

Early treatment when stroke happens is essential. Hence it is important to understand stroke warning signs and get the patient to hospital fast.

The FAST test helps recognise the signs:

Face: Does one side of the face droop? Ask the person to smile

Arms: Ask the person to raise both arms. Does one arm drift downwards?

Speech: Is the speech slurred? Ask the person to repeat simple sentences

Time: Act Fast. Dial 112 immediately

For more information on the campaign contact the Directorate on 23266000.