As the World Stroke Day is marked globally, experts have said that with the country grappling with 50 per cent prevalence of hypertension and poor socio-economic issues, Nigeria may experience a surge in stroke incidents.
They, therefore, said that there must be collective efforts to drive a campaign by stakeholders especially the government to educate Nigerians on how to prevent stroke and manage the risk factors, especially hypertension and diabetics.
The expert maintained that almost all stroke cases are preventable, but noted that the dilemma is that recovering fully from stroke with the brain fully intact is slim.
They also pointed out that Nigeria does not have the infrastructure and support system to manage stroke patients.
Similarly, the World Stroke Organisation (WSO), in a message to mark this year’s World Stroke Day said: “One in four of us are at risk of stroke in our lifetime. And 90 per cent of those strokes could be prevented by addressing a small number of risk factors including high blood pressure (hypertension), irregular heartbeat (atrial fibrillation), smoking, diet and exercise.”
The WSO stated that the theme for this year’s celebration is ‘Greater Than Stroke’, because with better awareness and collaborative efforts, the incidents of stroke and people dying from it can be halted.
Speaking with The Guardian on the theme, a Consultant Neurologist at Royal Cross Medical Centre, Dr. Seyi Roberts, said: “Once a stroke occurs, there is very little that medical science can actually do in most cases. It is only in a very small and narrow situation that intervention can actually do something of reversing the stroke effect or mitigating it completely.
“In most cases, it does not, because stroke is damage to the brain and once an injury has occurred, it is all over. You have to wait for the injury to heal for repair and the brain does not repair very well. Damaged brain cells are damaged forever. So, it is something you do not want to happen.”
Roberts maintained that cases were quite prevalent in Nigeria right now, stating that it is actually almost the second cause of death in Nigeria and a major leading cause of disability in the country.
“One in four of every human being would get a stroke in their lifetime. That is 25 per cent of the population. It is that common and prevalent, reason we need to do something about it. Like I do tell patients, students of medicine, families, the best treatment for a stroke is actually prevention,” he said.
He added that every time a stroke occurs, it is because there has been a failure in the system, either from the patients, family, doctors, lack of education and information or medical infrastructure are not adequate.
“Of course, if you go back to the underlying cause of stroke, in this environment, like in other parts of the world, it is hypertension, that is the number one risk factor of stroke and hypertension is the disease with no symptoms.
“So, if you are working around, you can be hypertensive and not know. The thing is to be able to identify people who are hypertensive, treat them before they get a stroke so that you can prevent a stroke. There are other risk factors like diabetes, obesity, smoking, lifestyle, underlying heart diseases that could lead to stroke.
“But the number one cause of stroke is hypertension, followed by diabetes. Diabetes may not be preventable in most cases, but it is something that can be treated and controlled and that would reduce the risk of developing a stroke.”
Roberts advised Nigerians to regularly check their blood pressure as well as blood and urine sugar to know if they are diabetic, in addition to adopting a change in lifestyle so that they become more active and do not smoke or abuse alcohol or other illicit substances.
“These are the things that may lead to stroke. And the prevalence of hypertension in adults is almost 50 per cent; it is that common. Of course, with the socio-economic crisis, people are less likely to deal with hypertension if they are poor. If you are diagnosed with hypertension and told to take medication, with the skyrocketing cost of medication, many patients will not be able to continue with medication.
“It is not a medication that you take for two weeks or six months; hypertensive medications are for life. It is not something you say let me borrow money and treat this thing and after that I will be okay. Once you get on the bandwagon; that is it
Associate Professor, College of Health Science, University of Abuja, Gerald Onwuegbuzie, also said that stroke is the most prevalent neurological disorder and a leading cause of morbidity and mortality worldwide, pointing out that stroke is the second leading cause of death and third leading cause of death and disability worldwide, according to the World Stroke Organisation (WSO) 2022 estimates.
“The WSO also puts the incidence of stroke worldwide at 84.69 per 100,000. Although globally the incidence of stroke appears to be on the decline, the opposite is the case in low and middle-income countries like Nigeria. This has been attributed to the growing cardiovascular risk profile amongst the population due to changing trends in lifestyle and longevity.
“According to the WSO, there are 12.2 million new strokes and is estimated that one in four people over the age of 25 will have a stroke in their lifetime. About 47 per cent of strokes occur in men, while 53 per cent occur in women. The WSO also estimates that over 101 million people are living with stroke worldwide and 22 per cent of this figure is in people between the ages of 15 and 49 years of age. The WSO also states that six and half million people die every year from stroke and up to 86 per cent of this is in Africa and other low income countries.”
Onwuegbuzie said that the prevalence of stroke in Nigeria is 1.14/1000 although some estimate that this may be higher in some rural communities where values up to 8.51 per 1000 were estimated.
He also said that the risk factors for stroke include hypertension (high blood pressure), diabetes mellitus (increased blood sugar), smoking, dyslipidemia (cholesterol abnormality), physical inactivity and irregular heart rate.