Stroke Week: Spotting South Africa’s ‘silent killer’ and signs to look out for

According to statistics, one in four adults over the age of 25 will suffer a stroke in their lifetime. File picture

According to statistics, one in four adults over the age of 25 will suffer a stroke in their lifetime. File picture

Published Oct 25, 2022


Cape Town - Heart disease and strokes are among the leading causes of death globally, and as South Africa observes World Stroke Awareness Week we share some valuable information you should know and look out for.

According to the World Health Organization (WHO), 17.9 million people die each year from cardiovascular disease (CVD), with 75% of the deaths occurring in low- and middle-income countries.

A leading vascular surgeon in South Africa, Dr Vinesh Padayachy highlights the need for South Africans to monitor their stress levels and alcohol and tobacco consumption as these are considered to be major risk factors for a stroke.

A stroke is when blood flow to the brain is interrupted causing starvation of oxygen, brain damage and loss of mobility in arms and legs on the side of the body where the stroke occurred.

A stroke, also commonly known as the “silent killer”, has reached epidemic levels.

According to statistics, one in four adults over the age of 25 will suffer a stroke in their lifetime.

Globally, more than 100 million people have suffered a stroke.

Information led by the Heart and Stroke Foundation states that 225 people die from CVD in South Africa every day.

Padayachy said a person who suffered a stroke often damages their brain tissue and if it’s a significant stroke, with time, their mental function can deteriorate.

“Often if a person has had a stroke, especially if it is an embolic stroke, meaning if a blood clot has gone up into the brain, then it can be a sign that there may be further strokes to happen in the future, almost like a tremor before the earthquake. So, if you have a mild stroke it’s important to seek help because it may be followed by a significant stroke thereafter,” he said.

Padayachy advises people that to avoid a stroke one should pay close attention to your blood pressure and arteries as high blood pressure and arterial disease are key risk factors.

“If you have risk factors for strokes including cholesterol, diabetes or high blood pressure, make sure these are controlled. Take your aspirin or Ecotrin, and obviously if you are a smoker you need to stop smoking.

“The onset of the Covid-19 pandemic and subsequent lockdown restrictions placed an extraordinary amount of stress on people. Already under pressure to perform at work, meet targets or pay off debt, people now found themselves forced into a new normal of wearing masks, constantly sanitising and experiencing death at abnormal rates,” he said.

Factors that increase the risk of suffering a stroke include:

  • unhealthy weight
  • excessive alcohol intake
  • drug abuse
  • unhealthy eating habits
  • smoking
  • lack of exercise.

Other factors that can also lead to a stroke include:

  • uncontrolled diabetes
  • cholesterol pre-eclampsia
  • sleep apnoea
  • atrial fibrillation.

Hypertension or high blood pressure is the number one risk factor for a stroke.

Padayachy has urged people with hypertension to remain diligent in monitoring their levels and to remain on track with their medication.

“Depending on the extent of the stroke, one may recover fully from it or one may be left permanently impaired by the stroke.

“Often improvement happens over time and can be up to six months for full recovery to happen. If one does not recover fully from a stroke, that is if there is extensive damage, then one may have permanent loss or weakness in the limb, impaired intellect, impaired cognition, impaired speech, swallowing difficulties. And all these symptoms may persist for the patient’s lifespan,” he said.

Padayachy has urged people to opt for a healthier, more active lifestyle where they are able to keep stress levels lowered.

He said at least 80% of premature stroke and heart disease can be prevented.

Symptoms to look out for that are easy to remember as FAST:

  • F – facial weakness
  • A – arm weakness
  • S – slurred speech
  • T – time

Seeing these symptoms, a patient should be rushed to the hospital immediately.

Other signs to look out for include:

  • difficulty walking
  • loss of balance
  • confusion
  • blurred vision
  • numbness in one or more limbs
  • severe headaches

Types of strokes

Ischemic stroke – a blockage or clot in a blood vessel in the brain. This blockage can be caused by a build-up of plaque inside an artery.

Haemorrhagic stroke – an interruption of blood flow to the brain caused by a broken artery in the brain. This is often a result of high blood pressure that places a strain on arteries, weakening them over time.

Transient ischemic attack (TIA) – also called a mini-stroke, this is from a small clot and briefly blocks an artery. It usually lasts less than one hour. TIAs are also a pre-warning that a more serious stroke could occur.

“If a patient’s face is drooping, they cannot raise both arms or have slurred or jumbled speech, then they require urgent medical attention. The same applies if they are experiencing numbness on one side of their body or have a severe headache and problems balancing,” Padayachy said.

He said the negative impact of strokes can be minimised when patients are cared for, supported to adhere to treatment, and attend rehabilitation.

Families are advised to seek help in how to care for patients and help them physically, mentally, emotionally and psychologically through the healing process.

Padayachy said it is most important that if you suspect a loved one is having a stroke, to get them to the hospital within three to six hours.

“Depending on the type of stroke, often the symptoms can be reversed completely. If the patient is taken to hospital immediately, they can be given medication which can dissolve the clot which may reverse the effects of the stroke even if the patient has full paralysis on one side.

“In terms of long-term help, these patients often require extensive help at home, physiotherapy assistance in mobilising, eating and just overall understanding that they have had a stroke and understanding and patience from their family,” Padayachy said.

He explains how a vascular surgeon fits in when a patient has had a stroke as a result of a build-up of plaque in their blood vessels that supply the brain in the carotid arteries.

“If this build-up is significant and is the cause of the stroke, then as a vascular surgeon I can go in and remove that plaque or insert a stent to tack that plaque down and prevent further bits from breaking off and travelling into the brain. Carotid artery stenosis is one of the causes of patients having a stroke,” Padayachy added.

[email protected]