90% of strokes are preventable, by adopting the right “prevention” reflexes - Featured

2023-10-27 13:18:06

October 27, 2023

Every year, October 29 marks World Stroke Awareness Day. For the occasion, focus on prevention. Because contrary to what is still widely believed, strokes do not strike randomly.

A cerebrovascular accident (CVA) is the consequence of impaired blood circulation to the brain: either a blood vessel is blocked, it is then an ischemic accident (80% of strokes), or a blood vessel tears. It causes hemorrhage in or around the brain (this is a hemorrhagic stroke). Brain cells are thus deprived of oxygen and fuel (glucose), leading to neurological after-effects. This is why stroke is one of the leading causes of death worldwide, the leading cause of acquired disability in adults and the second leading cause of dementia in seniors.

1 stroke every 4 minutes in France

In France, there are nearly 140,000 new cases of stroke each year, or one every 4 minutes. Paralysis, weakness or numbness of part or half of the body, but also deformation of the mouth, difficulty speaking, loss of vision in one eye, problems with balance, coordination or walking or an extremely painful unusual headache should alert you. You must then call 15 without waiting.

More than half of strokes are preventable

Preventing the occurrence of a stroke relies on screening and treating eight risk factors. “ In an ideal world, with a healthy lifestyle, 90% of strokes could be avoided at the individual level by controlling all these risk factors. », assures Professor Sonia Alamowitch, president of the French Neurovascular Society (SFNV) and head of the Neurovascular Emergency department at the Pitié-Salpêtrière hospital (APHP, Paris). “ Which would mean preventing more than half of strokes each year ».

And to recall the fundamentals in terms of prevention: “ The first risk factor for stroke is high blood pressure: each 10 mmHg reduction in systolic blood pressure (the first of the two digits of blood pressure) reduces the risk of stroke by 20%. Although it is crucial to treat hypertension, because it drastically reduces the risk of stroke, even for people who are already hypertensive, it still needs to be screened for! However, 50% of people with hypertension do not know that they are hypertensive. »

Thinking about rhythm disorders

The second risk factor that can be corrected is a common heart rhythm disorder called atrial (or atrial) fibrillation. The heart beats chaotically, resulting in stagnation of blood in the heart chambers, promoting the formation of clots. When they break away, these clots end up in the cerebral circulation, with the risk of causing a stroke. “ Atrial fibrillation may be asymptomatic », Warns Professor Sonia Alamowitch. “ The diagnosis is often made during a heart exam. However, there are warning signs, such as palpitations that the patient may experience. People over 40 or 50 should also monitor their pulse regularly. A fast, irregular heartbeat may indicate atrial fibrillation. If this disorder is present, the best way to limit the risk of stroke, for patients at high risk of clots, is to follow anticoagulant treatment to thin the blood, thus preventing the formation of clots. This treatment reduces the risk of stroke by approximately 60%. »

Other risk factors are called metabolic: these are obesity, excess cholesterol and diabetes. “ It is therefore recommended to regularly measure these parameters (LDL-cholesterol, blood sugar) by carrying out blood tests. », advises the specialist. “This approach should be carried out at least once in young adults and then, in a personalized manner, from the age of 50. In general, by reducing these metabolic risk factors, we reduce the relative risk of stroke by around 15 to 20%. »

As for the risk factors linked to poor lifestyle, nothing could be simpler, in theory at least:

Stop smoking, because smoking doubles the risk of stroke;
consume alcohol in moderation;
consume several fruits and vegetables per day while limiting fat and sugar and reducing salt (at the table and avoiding industrial cold cuts, stock cubes, etc.);
finally, commit to physical activity. 30 minutes of walking a day is enough.

To know more :

Source : Interview with Professor Sonia Alamowitch, president of the French Neurovascular Society (SFNV) and head of the Neurovascular Emergency department at the Pitié-Salpêtrière hospital (APHP, Paris) –
Written by : Hélène Joubert – Edited by Emmanuel Ducreuzet