It's plain as day the WSO has no intention of solving stroke to 100% recovery. They've reached for the bottom of the barrel in just raising awareness. They need to be destroyed and run by survivors.
You'll have to tell your children and grandchildren to never have a stroke since they are effectively untreatable(True treatment is 100% recovery, NOTHING LESS), contrary to this lie from World Stroke Day a few years ago.
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What a lying piece of shit. |
The global impact of stroke in 2022
Each year, the November issue of the International Journal of Stroke
(IJS) coincides with World Stroke Day, which this year is on Saturday
29 October. World Stroke Day is coordinated by the World Stroke
Organization (WSO) and is an opportunity for us all to highlight the
enormous global burden of stroke and to promote campaigns to reduce its
incidence and impact. In this month’s issue, to coincide with World
Stroke Day 2022, we publish the important Global Stroke Statistics 2022.1
This initiative regularly reviews stroke incidence, case-fatality, and
mortality across the world. It provides key data for health providers,
clinicians, and researchers. Once again, it demonstrates evidence of
major global disparities in stroke incidence and mortality, with a
particular burden in low- and middle-income countries (LMICs). A shorter
summary of key stroke facts is also is available in our 2022 global
stroke factsheet.2
In
view of the lack of high-quality epidemiological data from many regions
worldwide, as highlighted by the Global Stroke Statistics paper, we are
particularly pleased to also publish in this issue a population-based
study on stroke incidence from the Qom area in central Iran.3
This shows a high incidence of stroke, with an age of onset earlier
than the global average. Epidemiological data also provide the
opportunity to identify trends in stroke incidence in specific regions,
and in particular whether health interventions and better control of
risk factors are reducing incidence. A further paper in this month’s
issue analyzed the incidence and mortality of cerebrovascular disease in
Spain from 2001 to 2015.4
Reassuringly, it was found that stroke mortality reduced by half in
Spain over this period, consistent with many studies from other
high-income countries.5
These show that a combination of public health measures, and better
primary prevention, can reduce incidence of stroke and cardiovascular
disease and emphasises the importance of developing such approaches
globally, including in LMIC.
An important
step to improving care in LMIC is documenting the current state of
stroke services. This is addressed by a collaborative paper from authors
across Africa, also in this month’s issue.6
The authors highlight how stroke used to be viewed as a rare disease in
Africa, but that it is now considered one of the common noncommunicable
diseases with a reported annual incidence in some African countries
ranging from 250 to 316 per 100,000, and prevalence rates of 560 to 1460
per 100,000.6
Moreover, stroke has become one of the leading causes of morbidity and
mortality, with a 3-year fatality rate as high as 84%. Despite this
heavy burden, the results of the survey reveal an inadequacy of
well-structured primary stroke prevention and public awareness programs
in many African countries. Similarly, acute stroke management is
inadequate, with only five stroke units and two centers among the 17
studied countries, and a low percentage of recanalization therapy,
whether thrombolysis or thrombectomy, being provided in less than 5% of
all acute cases. In addition, thrombectomy is available only in 35% of
the participating countries.
A major emerging
factor in stroke risk worldwide is air pollution. Increasing studies
suggest air quality is an important determinant of cardiovascular
health, including both ischaemic heart disease and stroke.7–9 Further evidence of this association is provided in a paper by Ho et al. in this issue.10
They performed a nationwide population-based analysis of all ischaemic
stroke cases reported to the Singapore Stroke Registry between 2009 and
2018. Using this, they estimated the incidence rate ratio of ischaemic
stroke across different concentrations of different pollutants. Ozone
and carbon monoxide were positively associated with ischaemic stroke
incidence, and this increased risk persisted for 5 days after exposure.
Interestingly, individuals with atrial fibrillation were more
susceptible to exposure from pollutants. This, and other data,
emphasises the importance of public health measures to improve air
quality worldwide.
Cardiovascular risk
factors also play an important role in stroke risk. A study by Joundi et
al. using the Canadian Community Health Survey, looked at the
contribution of four common risk factors (diabetes, hypertension,
obesity, and diabetes) to stroke risk across different age ranges.11
Almost 500,000 people were included in an analysis, with 8865 stroke
events. Associations of diabetes, hypertension, and obesity with stroke
risk were stronger at younger age and progressively reduced with
increasing age. These data emphasise the importance of attending to
cardiovascular risk in early life, rather than waiting until middle or
late age. The authors suggest it also provides important information to
address stroke risk in the young which is not decreasing in high-income
countries in the same way in which we are seeing reductions in overall
stroke incidence.
One test we sometimes ask
for in cryptogenic stroke is syphilis. However, how important syphilis
really is in stroke risk, particularly with the more widespread use of
antibiotics, remains unclear. To to answer this question Chang et al.
from Taiwan conducted a long-term population-based study to determine
the risk of new ischaemic stroke after syphilis infection.12
In 1585 patients with syphilis, 3.8% developed new onset ischaemic
stroke, and compared to controls syphilis was associated with a higher
risk of ischaemic stroke with a hazard ratio of 1.35 (1.01–1.80).
We are delighted to include the latest Japanese Stroke Guidelines in this issue.13
These important guidelines are published in full in Japanese but a
summary of the important recommendations are presented in an English
version in this issue.
Finally release of
this issue is coinciding with the Word Stroke Congress, the WSO’s now
annual conference, between October 26th and 29th in Singapore. It’s a
very exciting program, and we hope to see many of you there. (https://worldstrokecongress.org). All delegates will have free access to this issue of the IJS.
Hugh S Markus
University of Cambridge
Email: hsm32@medschl.cam.ac.uk
University of Cambridge
Email: hsm32@medschl.cam.ac.uk
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