Strokes are the fourth biggest killer in the UK after heart disease, cancer and respiratory disease, and recent statistics don’t make for happy reading.
A report from Queen Mary University of London and the London School of Economics estimates that strokes will claim 187,000 lives a year by 2035, an increase of almost two-thirds on today’s numbers.
But experts say around 114,000 of those deaths could be prevented through greater awareness of the risks, along with better treatment of the two main triggers – high blood pressure and atrial fibrillation (irregular heartbeat).
Dominic Brand, director of marketing and external affairs at the Stroke Association , which commissioned the report, says: “The reasons for the increase are driven mainly by the fact we have an ageing population and the risk of stroke is higher over the age of 45.
“As we age, arteries become harder and are more likely to get blocked.
“But research has also shown many strokes are preventable. We know that if you’re overweight, drink too much alcohol, smoke, don’t get enough exercise and have an unhealthy diet, your risk increases, so it’s important to address those issues.”
Tackle high blood pressure
High blood pressure accounts for at least half of strokes in England, Wales and Northern Ireland.
And while 9.5 million people have been diagnosed and receive treatment, a further 5.5 million people in England alone are thought to have the condition without knowing, leaving them at the highest risk of stroke.
So the message is: be proactive and get it checked, which you can do at pharmacies, as well as your GP’s surgery.
“If your blood pressure is high, lowering it is the single most important thing you can do to prevent both types of stroke: ischaemic [where a blockage such as a clot cuts off blood supply to the brain] and haemorrhagic [a bleed in or around the brain],” explains Peter Rothwell, Professor of Neurology at Oxford University.
“If you have a family history of high blood pressure, then it’s worth measuring it in your 30s and 40s to make sure it’s not following the same path as your parents or siblings.
“Blood pressure changes naturally with age but, generally speaking, it should be less than 130 over 80.
“One of the problems is that it’s so variable and the variability itself predicts strokes. One day you might catch it at a low, but it’ll be high at other times.
“The easiest thing is to buy a monitor and check it at home from time to time to get multiple measurements, which you can discuss with your doctor.
“If the average reading is always on the low side, that’s fine.
“Some blood pressure monitors cost less than £20, which is a small investment if it makes a big difference to your risk of suffering a heart attack or stroke.”
Get an irregular pulse checked
A type of irregular heartbeat called atrial fibrillation (AF) makes you five times more likely to suffer a stroke, as a clot can form in the heart and make its way to the brain where it can block an artery.
“If you have a stroke as a result of AF, it usually leads to greater disability and higher incidence of death,” says Dominic Brand.
“So if you notice repeated episodes of palpitations and other symptoms such as fatigue, breathlessness and chest pain, then see your GP who can check your pulse and refer you for more tests if necessary.”
Professor Rothwell adds: “Anticoagulant (blood thinning) drugs are very effective for AF, so it’s a treatable condition.
Manage your lifestyle
Tackling the lifestyle issues that lead to high blood pressure will bring down your stroke risk
- Quit cigarettes Smoking damages arteries and makes blood more likely to clot, as well as raising blood pressure. Says Professor Rothwell: “If you have a cigarette, it causes your blood pressure to rise over the next 10 minutes.” Stopping, no matter how old you are or how long you’ve smoked, will reduce your risk of stroke. Call the NHS Smokefree helpline on 0800 022 4332 for help with quitting.
- Cut back on booze Drinking too much alcohol raises blood pressure, and binge drinking is particularly dangerous as it causes blood pressure to rise very quickly. As a general rule, the Department of Health recommends not drinking more than 14 units of alcohol a week and to avoid drinking a lot in a single session. One unit is equivalent to a single measure of spirits, while an average pint of lager and a medium glass of wine (175ml) contain two units.
- Embrace the Mediterranean way This will help to lower blood pressure, manage your weight and control diabetes. Professor Rothwell says: “A Mediterranean diet with lots of fruit and veg, and not an excessive amount of red meat, seems to be a good thing in terms of cancer, heart disease and stroke prevention.” Cut back on salt as high intakes have been shown to raise blood pressure. Don’t have more than a teaspoon a day and be mindful there’s lots of salt in processed foods. Cut down on saturated fat, too, as this raises cholesterol levels, causing fatty deposits to build up in your arteries.
- Give yourself a 30-minute active makeover You don’t have to start running marathons. Research shows regular, moderate exercise can reduce your risk of stroke by 27%. Aim for 30 minutes of activity at least five times a week and choose any form of exercise, as long as it increases your heart rate and makes you feel warm and out of breath.
- Lose weight if you need to Being overweight puts you at risk of high blood pressure, heart disease and Type 2 diabetes, all of which raise your risk of stroke. If you carry weight around your middle you’re more likely to develop high blood pressure and diabetes. You should aim to lose weight if you’re a woman with a waist measurement of 80cm (31.5in) or more, or a man with a measurement of 94cm (37in) or more.
- Find ways to de-stress Studies show long-term stress is associated with a higher risk of stroke and heart disease. “There is a link,” agrees Professor Rothwell. “One of the possibilities is that it causes peaks in blood pressure, plus if we’re going through a period of stress, we tend to drink more alcohol, eat badly and we might smoke.
- “It’s also been shown that the biochemistry of the body changes when you’re under stress and inflammatory markers go up, making blood slightly more sticky.”
Is it a stroke?
Receiving treatment quickly is vital for improving the chances of a good recovery. Use the FAST test to spot signs of stroke:
Face : Can the person smile? Has their face fallen on one side?
Arms : Can the person raise both arms and keep them there?
Speech problems : Can the person speak clearly and understand what you say? Is their speech slurred?
Time : If you see any of these signs, it’s time to call 999.
Within minutes I could use my arm and leg again
Former teacher Karen Craven, 60, is married with two grown-up sons and lives in Wilford, Nottingham. She made a full recovery after a stroke thanks to ground-breaking treatment…
On the morning of my stroke in September 2015, I was getting ready for work when I felt an excruciating pain above my right temple, which lasted about a minute before subsiding.
My eldest son Sam, 28, was downstairs – he’d come back from the gym instead of going straight to work as he’d forgotten his clean shirt.
I went down to speak to him and he asked if I’d been drinking because I sounded slurred. “Chance would be a fine thing,” I joked, and headed upstairs to finish getting ready.
I dropped my hairbrush and, as I went to pick it up, I couldn’t grasp it with my left hand and that’s all I remember.
Sam came upstairs and found me on my knees with my left cheek flat on the floor.
When he lifted me up, he realised I might be having a stroke, so called 999 and a paramedic was at the house within minutes.
I couldn’t lift up my arms and the sight had gone in my left eye, along with the use of my left side.
When I got to hospital I was assessed in a specialist stroke unit and a CT scan revealed two blood clots in my brain.
The consultant referred me for a cutting-edge treatment called a thrombectomy – currently available in just a few UK hospitals – where a wire is inserted into an artery in the groin and travels up to the brain to pull out the clots.
I was awake during the procedure and there was a little pain when the surgeon grabbed the clots, but within minutes I had 100% blood flow in my brain, my sight was restored and I could lift my arm and leg. It was miraculous.
At teatime I was back on the stroke ward and able to get out of the wheelchair and walk towards my consultant to hug her and say thank you. I was home 48 hours later after passing all the physio and memory tests.
I had risk factors for stroke, but I wasn’t aware of them. I’d been diagnosed with AF at A&E in 2009 after feeling unwell and experiencing an irregular and rapid heartbeat.
I was given a beta-blocker to slow my heart and told to take aspirin and, for six years, I had no distressing symptoms and my medication never changed.
I didn’t know that aspirin is no longer considered sufficient to thin the blood of someone with AF.
Now I take beta-blockers, as well as blood pressure medication, a blood thinner and a statin.
I’m trying to manage my weight with a healthier diet and smaller portions and, rather than comfort eating to manage stress, I use mindfulness techniques.
I’m more active, too. I recently cycled 150 miles along the coast-to-coast trail from Workington to Sunderland to raise money for the Stroke Association.
I’m proof that early intervention saves lives.