Looking at Deepak Shinde, a 32-year-old security guard in Pune, one would not know that he had suffered a brain stroke a week ago. That’s because when he had a paralytic attack and collapsed while on duty, he was rushed to a hospital that had a stroke-ready drill in place. In other words, a CT scan, multi-disciplinary specialist interventions, clot dissolving medication and a catheter procedure to remove the blockage were done in a few hours. By Day 3, he had begun walking. “I did get headaches but I didn’t know that I was getting them because of my high blood pressure or that I had a BP problem.”
Silent risk factors for a stroke
High blood pressure is one of the commonest risk factors for a stroke, which occurs when a blood vessel in the brain ruptures and bleeds or when there’s a blockage in the blood supply to the brain. Dr Nasli R Ichaporia, Director of Neurology, Sahyadri Hospitals, Nagar Road, who treated Shinde, says, “Unchecked blood pressure can pose a real problem.” High BP, over time, damages the walls of arteries, making them thinner, stiffer and more likely to rupture. That’s how you get brain bleeds. It can cause a build-up of plaque in the arteries, which can lead to the formation of blood clots. If a clot travels to the brain, it can cause a stroke. High blood pressure can even damage tiny blood vessels deep inside the brain. The risk of stroke increases when blood pressure readings are consistently 140/90 millimetres of mercury (mm Hg) or higher.
“Even diabetes, when high blood sugar levels can either stiffen or damage blood vessels and lead to blood clots, and cholesterol, which encourages plaque formation, are all risk factors for the young,” says Dr Ichaporia.
Why are strokes increasing among the young?
Obesity, smoking, alcohol use, substance abuse and hypertension are making the young more risk-prone, according to Dr Ichaporia. “The burden of stroke in India is increasing due to lifestyle factors associated with urbanization such as poor diet, sedentary behavior and heightened stress,” he says.
According to a recent Lancet study, half of all the disability and the lives lost to stroke globally (81 million healthy years of life lost) in 2021 were the result of haemorrhagic strokes — the deadliest form, mainly due to high blood pressure — despite being around half as common as ischaemic strokes (4.1 million new haemorrhagic strokes vs 7.8 million new ischaemic strokes).
Prompt therapy protocol
Shinde had a CT scan within minutes of his arrival and got a thrombolytic (clot-busting) medication within 20 minutes. Then his clot was removed with a catheter. If there is excessive bleeding, then the surgeon decompresses the brain, which means a tiny hole is made in the skull to drain the blood.
How to prevent a stroke?
Apart from monitoring and managing blood pressure, cholesterol and diabetes, Dr Ichaporia says it is crucial to adopt a healthy diet low in saturated fats, trans-fats, and sodium and increase fruits, vegetables and whole grains. “For young urban professionals, high-stress levels, prolonged sedentary behaviour and exposure to urban pollution are known risk factors. Prioritize regular physical activity such as 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous activity each week. Regular health screenings are crucial from your 20s, as hypertension and diabetes can develop insidiously and significantly increase the risk of stroke if left unmanaged,” says Dr Ichaporia.