According to the Heart and Stroke Foundation South Africa (HSFSA), stroke is the third cause of death and is a leading cause of disability in South Africa. Additionally, 11 people in South Africa will suffer a stroke every hour.
However, the vast majority of strokes are actually preventable, reports a recent study. The INTERSTROKE study, which was published in The Lancet in July 2016, found that 10 modifiable risk factors were associated with 90% of strokes. Of these modifiable risk factors, high blood pressure (hypertension) is the most important controllable risk factor, reported the researchers.
Hypertension is South Africa’s most commonly diagnosed, non-infective condition, says the HFSA. Unfortunately you probably won’t feel it if you have high blood pressure, as its symptoms don’t exist in most cases, which is why the disease is dubbed a ‘silent killer’. It’s vital that adults have regular blood pressure screenings and make key lifestyle changes to prevent it and the danger of a stroke.
High blood pressure is the biggest threat
"The wider research confirms the 10 modifiable risk factors associated with 90% of stroke cases in all regions, young and older, and in men and women,” reported Dr Martin O'Donnell, the leader of the study which included 27 000 participants from every continent in the world and research collaborators from 32 countries. “The study confirms that hypertension is the most important modifiable risk factor in all regions, and the key target in reducing the burden of stroke globally."
The researchers investigated the proportion of strokes caused by particular risk factors in order to work out the extent to which eliminating each risk would reduce the impact of stroke. Eliminating hypertension was estimated to reduce the risk of a stroke by nearly 48%, they reported.
The other modifiable risk factors included (with reduction in risk if factor eliminated):
- Physical inactivity (36%)
- Poor diet (23%)
- Obesity (19%)
- Smoking (12%)
- Cardiac causes (9%)
- Diabetes (4%)
- Alcohol intake (6%)
- Stress (6%)
- Apolipoproteins (blood cholesterol levels) (27%)
Differences by region
While hypertension was the most important risk factor across all regions, there were also differences by region.
"In the African subgroup of this study, the greatest risk factors were hypertension, blood cholesterol levels and abdominal obesity," explains Gabriel Eksteen, a dietitian and exercise physiologist at the Heart and Stroke Foundation South Africa. "Blood pressure alone accounted for more than 50% of the population's risk, and having high blood pressure increased an individual's risk of a stroke fourfold. This is in line with other research in sub-Saharan Africa which shows that high blood pressure is underdiagnosed and poorly controlled."
Why prevention is always better than cure
Ideally, risk factors such as high blood pressure and diabetes need to be prevented before they develop, says Eksteen. “Unfortunately though, roughly half of people with high blood pressure are unaware of their condition and therefore remain untreated. Once diagnosed, a person needs to make appropriate lifestyle changes, may need to start and also adhere to treatment such as antihypertensive medication, and needs to be monitored so that treatment can be adjusted as needed.”
Greater public awareness, improved medical care and follow-up, better patient counselling, and addressing environmental obstacles such as the available food supply is also needed in the battle against strokes, adds Eksteen.
If you’d like to ensure you don’t develop high blood pressure and increase your risk of a stroke, the key lifestyle changes that will have a positive impact on your blood pressure include:
- Getting your weight within a healthy range by eating a healthy, balanced diet and exercising regularly
- Eating less salt (the HSFSA recommends no more than 5g in total a day)
- Quitting smoking
- Limiting your alcohol intake
Read here for more on hypertension and stroke
How Clicks Clinics can help you
Clicks Clinics will help you identify and manage hypertension with their wide range of screening tests. These include:
- Blood Pressure (BP) Test
- Cholesterol Testing and Consultation
- Lipogram Blood Test (to determine different types of cholesterol)
- Clicks Full Basic Screening (BP, Body Mass Index or BMI, meal guide and exercise plan)
- Clicks Screening Measurements only (BP and BMI)
- Clicks Comprehensive Screening (BP, BMI, Glucose and Cholesterol screening, plus meal and exercise plan).
To make an appointment at a Clicks Clinic, call 0860 254 257 or visit Clicks Clinics online.
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