It's a crisis because you BLITHERING IDIOTS haven't figured out that the solution to this is 100% recovery protocols! Yeah that's a BHAG(Big Hairy Audacious Goal)
but leaders solve those. We have NO leaders in stroke. And the result is 10 million disabled stroke survivors every year!
Explain to me in precise terms where I'm wrong; oc1dean@gmail.com, I'm stroke-addled you know, so simple-minded me needs you to be precise in your explanation.
Looking forward to your excuses!
Mounting Stroke Crisis in India: A Systematic Review
Published: March 27, 2024
DOI: 10.7759/cureus.57058
Cite this article as: Hedau V N, Patil T (March 27, 2024) Mounting Stroke Crisis in India: A Systematic Review. Cureus 16(3): e57058. doi:10.7759/cureus.57058
Abstract
Stroke, a neurological disorder, has emerged as a formidable health challenge in India, with its incidence on the rise. Increased risk factors, which also correlate with economic prosperity, are linked to this rise, including hypertension, diabetes, obesity, sedentary lifestyle, and alcohol intake. Particularly worrisome is the impact on young adults, a pivotal segment of India's workforce. Stroke encompasses various clinical subtypes and cerebrovascular disorders (CVDs), contributing to its multifaceted nature. Globally, stroke's escalating burden is concerning, affecting developing nations. To combat this trend effectively and advance prevention and treatment strategies, comprehensive and robust data on stroke prevalence and impact are urgently required. In India, these encompass individuals with elevated BMIs, and those afflicted by hypertension, diabetes, or a familial history of stroke. Disparities in stroke incidence and prevalence manifest across India, with differences in urban and rural settings, gender-based variations, and regional disparities. Early detection, dietary changes, effective risk factor management, and equitable access to stroke care are required to address this issue. Government initiatives, like the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) 2019, provide guidelines, but effective implementation and awareness campaigns are vital. Overcoming barriers to stroke care, especially in rural areas, calls for improved infrastructure, awareness campaigns, and support systems. Data standardization and comprehensive population studies are pivotal for informed public health policies.
Introduction & Background
Cerebrovascular disease (CVD) is a term used to describe all disorders that lead to stroke, which can be either ischemic or hemorrhagic. In low- and middle-income countries (LMICs), including India, the frequency of stroke increased by 100% between 1997 and 2008. This showed a 26% rise in stroke mortality worldwide during the previous 20 years [1]. Stroke continues to be the second most significant cause of death globally due to the increased mortality rate, according to the World Health Organization (WHO) 2020 [2]. Over the past four decades, there has been a statistically significant reduction in stroke incidence rates, with stroke incidence falling by 42% in high-income countries (HICs) and rising by more than 100% in LMICs [1]. Age, sex, low birth weight, ethnicity, and genetic variables are all irreversible risk factors for stroke [3]. A report of India's population-based stroke registries mentions that the majority of first-ever stroke cases reported hypertension (from Tirunelveli, 40.3%, to Cuttack, 75%), diabetes, and current tobacco use (from Varanasi, 19.3%, to Cuttack, 62.4%) [4]. Ischemic stroke (range 41.6% to 77.8%), hemorrhagic stroke (range 42.6% to 74%), and indeterminate stroke (range 2.0% to 35.9%) all had hypertension as their primary risk factor [4]. Young people's risk of stroke is considerably enhanced by smoking, drinking, having a higher BMI, having diabetes, and having high blood pressure [5,6]. A hospital-based multi-center prospective stroke registry in India to identify and recruit 10,000 acute stroke patients from 100 hospitals within the country conducted an interim analysis to determine aetiologies, clinical supervision, and outcomes with 5301 patients. According to the data, stroke patients had a number of highly hazardous factors, including heavy alcohol and cigarette use, diabetes, hypertension, and dyslipidemia [7].
The study found that stroke patients with higher frequencies of risk variables had higher short-term mortality [8]. Adopting coordinated care for stroke in LMICs is limited and insufficient, particularly in a nation like India, where the facilities available for rehabilitation are sparse [9]. The global burden of CVD has been rising, with stroke being the second most significant factor in fatalities worldwide, after ischemic heart disease in 1990 and the WHO 2020 factsheet [2,10]. A sizeable share of stroke deaths occur in LMICs, and these nations also experience more years of life lost to disability-adjusted life than high-income nations [11]. India has a greater cumulative incidence and crude prevalence of stroke than high-income nations [1]. This suggests that stroke is a significant health burden in India. Globally, there were around 25.7 million stroke survivors in 2013, along with 6.5 million stroke fatalities, 113 million years of life lost to disability, and 10.3 million new stroke cases [12]. Worldwide, the incidence of stroke is rising, mostly as a result of an older population and more risk factors such as type 2 diabetes and high blood pressure. Stroke occurrence among young people is increasing in LMICs [13]. There are regional, national, and ethnic differences in cardiovascular disease incidence, prevalence, and mortality. Due to their altered cardio-metabolic profiles and propensity for cardio-metabolic dysfunction, people from South Asian nations, especially India, have a disproportionately increased risk of cardiovascular disease [14]. To address the concerns of stroke prevention and treatment, reliable data on the burden of CVD in the Indian population is needed. To meet this demand, a comprehensive analysis of all community-based studies providing data on the mortality, prevalence, and incidence of stroke in rural, urban, and both population contexts is required. The present article aims to focus on the stroke crisis in India.
No comments:
Post a Comment