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Strokes affecting young people like never before

Stroke is the second most common cause of death after HIV/Aids in South Africa. Picture: Supplied

Stroke is the second most common cause of death after HIV/Aids in South Africa. Picture: Supplied

Published Nov 14, 2023


Stroke is the second most common cause of death after HIV/Aids in South Africa, and it is a significant cause of morbidity, with an estimated 150 000 people experiencing a stroke each year.

This contributes to more than 560 000 stroke-related disability-adjusted years, said health cover provider Affinity Health. They also said there has been a noticeable rise in strokes in young adults.

“When we think of strokes, we often associate them with older adults. However, strokes can happen at any age, and they're not as rare in young adults as you might think,” says CEO Murray Hewlett.

“A staggering 15% of strokes occur in those aged 18–50,” he added, explaining that a stroke was like a traffic jam in the brain, which occurs when something blocks or bursts a blood vessel that carries oxygen and nutrients to the brain cells.

“When that road gets blocked, your brain doesn't get what it needs, and its cells can start to die. Just like when a roadblock causes cars to pile up, a stroke can make your body stop working correctly,” he added.

Strokes can lead to severe consequences, including paralysis, difficulty speaking, memory problems, and death.

As the world looks at raising awareness around strokes this week, the World Health Organisation (WHO) says 15 million people suffer a stroke annually across the world.

The World Stroke Organisation said over 12 million people will have their first stroke this year, while 6.5 million will die from one.

Analysts say the incidence of a stroke increases significantly with age, with 60% of strokes happening to people under the age of 70, and 16% to those under 50.

The Heart and Stroke Foundation said there were uncontrollable risk factors, including age, sex, family history, inherited high cholesterol, blood pressure, abnormal heart rhythm and clotting disorders.

They noted a trend in the prevalence of strokes in young people, saying strokes are often disabling and they, therefore, pose a threat to socio-economic stability, particularly in developing countries.

“In young patients with an absence of conventional vascular risk factors and negative preliminary stroke work-up, clinicians need to take into consideration less common causes of stroke in this population,” says Hewlett.

“Recognising the surprising causes of strokes in young adults is crucial for prevention and early intervention.

“One of the biggest culprits is stress; prolonged stress can lead to high blood pressure, a major risk factor for strokes, and can also contribute to the formation of blood clots, which can block blood vessels in the brain, causing a stroke.”

Substance abuse was another cause. Certain drugs can lead to elevated blood pressure, irregular heart rhythms and even arterial dissection – a tearing of the blood vessel walls – all of which can precipitate a stroke.

Similarly, alcohol abuse can raise blood pressure and lead to an increased risk of atrial fibrillation, a heart rhythm disorder known to cause strokes, while smoking damages blood vessels and increases the risk of clot formation.

Hewlett says, “A lesser-known contributor to strokes in the young is undiagnosed medical conditions. Conditions like sleep apnoea, which disrupts breathing during sleep and lowers oxygen levels in the blood, can lead to hypertension and increase the likelihood of a stroke.

“Autoimmune disorders like lupus or even infections like Covid-19 have been linked to strokes in younger individuals.

These conditions can cause inflammation and blood vessel damage, making the arteries more susceptible to blockages.”

Poorly managed diabetes, being overweight or obese, and high cholesterol can also increase stroke risks.

Pretoria News