Research is formalized curiosity. It is poking and prying with a purpose - Zora Neale Hurston


image by: Stroke Research & Education Foundation

A massive global study of nearly 27,000 people has narrowed down the 10 biggest risk factors accounting for 90% of strokes worldwide. The good news is the factors are all potentially modifiable. The bad news is that the biggest risk factor is a silent killer many people don’t realize they have.

The study, published in the Lancet, builds on findings from the INTERSTROKE study that included participants from 32 countries in Europe, Asia, Africa, Australia and the Americas. While a few of the risk factors varied from region to region, the most consistent factor across all regions was hypertension.

According to Dr. Martin O’Donnell, lead study author from the Population Health Research Institute at McMaster University , “The wider reach [of the study] confirms the ten modifiable risk factors associated with 90% of stroke cases in all regions. 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."

Other major risk factors included lack of physical activity, poor diet, obesity, smoking, diabetes, alcohol intake, stress and cholesterol levels. Many of the risk factors are often linked in diagnoses of cardiovascular disease, but hypertension is different in that it can present in people who are otherwise healthy. Obesity and physical inactivity, for example, can contribute to hypertension, but many active people of healthy weight are genetically predisposed to the condition. It's an unusual threat that can exist apart from factors associated with an unhealthy lifestyle.

The variations in risk factors from region to region were interesting. For example, alcohol intake was a relatively low risk factor in Western Europe, North America and Australia, but was significant in Africa and South Asia. Physical inactivity was a significant factor in many regions but most significant in China.

The bottom line for most people in most countries: changing behavior to reduce the risk factors, especially hypertension, can dramatically reduce incidence of stroke. The researchers cited “better health education, more affordable healthy food, avoidance of tobacco and more affordable medication for hypertension” as targets for improvement around the world.

For us in the U.S., the study findings reinforce the message that evaluation and treatment for hypertension is critical. According to the Centers for Disease Control and Prevention, about 1 of 3 U.S. adults—or about 70 million people—has high blood pressure, but only about half have their condition under control. Roughly 1,000 people die every day in this country with high blood pressure as a primary or contributing cause. It's the lurking, silent killer that unfortunately deserves its notorious reputation.

The study was published in the Lancet.

Source: David DiSalvo, The Main Cause Of Stroke Worldwide Is The One You're Probably Ignoring. Forbes, July 29, 2016.

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Last Updated : Friday, May 31, 2019