Nearly All Strokes Globally Have Avoidable Element

Guargantuan Fucking Whoopee.

It means that your stroke doctors , stroke hospitals and stroke associations can continue to do nothing, as they have since forever, to solve all of the problems in stroke. Blame the victim and do conscience laundering. Fucking lazy assholes.

 Nearly All Strokes Globally Have Avoidable Element

Behaviors, metabolic factors, and air pollution found key contributors

• by Gloria Rothenberg
  MedPage Today Intern

• This article is a collaboration between MedPage Today® and:
  

Action Points

• Globally, stroke is almost entirely caused by modifiable risk factors, with air pollution emerging as a significant contributor.
• Note that almost 30% of the burden of stroke was attributed to air pollution.

Globally, stroke is almost entirely caused by modifiable risk factors, with air pollution emerging as a significant contributor, a systematic analysis showed.
Modifiable risk factors were determined responsible for 90.5% (95% uncertainty interval 88.5-92.2) of the global stroke burden, as measured using disability-adjusted life years, Valery Feigin MD, PhD, of New Zealand's Aukland University of Technology, and colleagues reported online in Lancet Neurology.
Potentially modifiable behaviors -- smoking, poor diet, and physical inactivity -- contributed to 74.2% of strokes (95% UI 70.7-76.7). Metabolic factors -- high systolic blood pressure, high body mass index (BMI), high fasting plasma glucose, high total cholesterol, and low glomerular filtration rate -- were attributable for 72.4% (95% UI 70.2-73.5).
The researchers also called attention to the "unexpectedly high" 29.2% (95% UI 28.2-29.6) of the burden of stroke attributed to air pollution.
This factor had a strong association with stroke burden in Central, Eastern, and Western sub-Saharan Africa, and South Asia, but a lower association with stroke burden in North America, most areas of Europe, Australasia, and Asia Pacific. This exemplified the variations in low- and middle- income countries and high-income countries.
"Air pollution has emerged as a significant contributor to global stroke burden, especially in low-income and middle-income countries, and therefore reducing exposure to air pollution should be one of the main priorities to reduce stroke burden in these countries," they wrote.
In an accompanying editorial, Vladimir Hachinski MD, of the University of Western Ontario in London, and Mahmoud Reza Azarpazhooh, MD, of Iran's Mashhad University of Medical Sciences, agreed, calling the percentage of strokes attributable to air pollution "alarming."
Their Global Burden of Disease Study 2013 included data from 188 countries from 1990 through 2013. Theoretical Minimum Risk Exposure Levels were used to assess levels of relevant exposures to a population for the 17 risk factors identified. Finally, the population-attributable fraction was calculated in order to determine the theoretical effect of mitigating each risk factor.
In addition to individual risk factors, clusters of risk factors were also assessed. These clusters of factors included behavioural, dietary, environmental and occupational, and metabolic categories of risk.
Notably, 71.7% of the disability-adjusted life years that were lost to stroke were in patients under 70 years of age.
The five risk factors associated with the strongest impact on disability-adjusted life years in developed countries were high systolic blood pressure, high BMI, diet low in fruits, diet low in vegetables, and smoking. The five risk factors with the strongest impact on disability-adjusted life years in developing countries were high systolic blood pressure, diet low in fruits, high BMI, diet high in sodium, and smoking.
Whereas most risk factors showed a downward trend in their contribution to stroke in high-income countries, a diet high in sugar-sweetened beverages was the exception. Over the course of the study, there was an almost 84% increase in stroke-related disability-adjusted life years from sugary drinks in high-income countries, compared with a 64% increase in its contribution globally.
Overall, the burden of risk was higher in developing countries than it was in developed countries, and almost all of the risk factors had a stronger effect on disability-adjusted life years in the low- and middle- income countries.
One limitation of the study was that atrial fibrillation, substance abuse, and some other risk factors were not assessed due to lack of data. One perplexing paradox indicated that in developing countries there was a decrease in second-hand smoke, yet an increase in tobacco smoking.
The editorial also noted that the cross-sectional, as opposed to longitudinal, study design likely led to underestimation of the global prevalence of stroke and its associated risk factors. However, it called the "monumental task" of pulling together the attributable risk data a success that "provides a firm basis for policy makers to implement preventative measures."