India is currently facing the challenge of a high stroke incidence. Cardiovascular disease including stroke, which comprised 19% of death in India in 2001-2003, is estimated to rise to 36% by 2030. Stroke is one of the leading causes of death in India. The rates are especially higher among women, perhaps because women exhibit higher prevalence of uncontrolled hypertension than men.
What is stroke?
The common mode of expression of stroke is a sudden occurrence of a focal neurologic deficit. Strokes are broadly categorized as ischemic or hemorrhagic.
A) Ischemic stroke is due to occlusion of a cerebral blood vessel and causes cerebral infarction.
Common causes are: (i) atherosclerosis with superimposed thrombosis affecting large cerebral or extra cerebral blood vessels, (ii) cerebral embolism, and (iii) occlusion of small cerebral vessels within the parenchyma of the brain.
B) Haemorrhagic stroke: Haemorrhage, which occurs either within the substance of the brain or contained within the subarachnoid spaces and ventricular system.
Common risk factors for stroke are:
Modifiable risk factors:
Non modifiable risk factors:
Early age at menarche (< 10 years)
Early age at menopause (< 45 years)
Post menopausal hormonal therapy: oral estrogens,
Combined oral contraceptives
Hypertension in pregnancy
Gestational diabetes mellitus