World Stroke Week commemorated between the 28th October to 3rd November is marked around the world and is one of the Heart and Stroke Foundation South Africa’s annual flagship health campaigns. World Stroke Day is observed annually on 29 October during World Stroke Week. Every year a different aspect of stroke prevention and medical care is highlighted, although broadly the primary aim is to raise awareness about the symptoms of a stroke, to reduce the incidence of stroke, and ultimately, to prevent stroke.
The focus of the 2022 campaign is on the importance of getting the person suspected of having a stroke urgent medical intervention in the quickest time possible. Consequently, the theme is: “Minutes Can Save Lives” based on the fact that the longer it takes for the person suffering a stroke to get medical attention, the more brain cells die. Given the seriousness of stroke, the Foundation’s campaign pillars will comprise: educating the public at large that every second that goes by is crucial when you suspect a stroke as the negative impact on brain functioning is extensive if a stroke is not treated timeously by medical professionals. Brain tissues, millions of neurons and billions of synapses begin to fade during a stroke. The #Precioustime campaign, driven by the World Stroke Organization (WSO) and its members of which the Heart and Stroke Foundation, South Africa (HSFSA) forms a part, aims to raise awareness of stroke signs and the benefits of timely access to emergency medical care.
According to the WSO, on a global level, 1 in 4 adults over the age of 25 years will have a stroke in their lifetime. Just over 12 million people will have their first stroke this year and 6.5 million will die as a consequence. More than 110 million have experienced stroke. Stroke is a cerebrovascular disease and falls within the cluster of non-communicable diseases (NCDs). NCDs cause over 60% of the world’s deaths, 80% of which occur in low and middle income countries. South Africa is classified as a middle-income country. It is anticipated that by 2030 NCDs will overtake all other causes of death in Africa. Every hour, 10 people suffer from a stroke in South Africa.
A stroke can be best understood as a “brain attack.” It occurs when the blood supply to the brain is disrupted which results in oxygen starvation, brain damage and loss of function. In most cases, a clot in an artery supplying blood to the brain is what causes it. Strokes can also be caused by haemorrhage when a burst vessel causes blood to leak into the brain. Permanent damage, including partial paralysis and impairment in speech, comprehension and memory can be expected following a stroke. The type and severity of disability is dependent on the part of the brain affected as well as the length of time the blood supply has been stopped. The incidence of stroke increases greatly with age, however over 60% of strokes happen to people under the age of 70 years and 16% happen to those under the age of 50 years.
The warning signs of a stroke are sudden. The knowledge of how to recognise these signs is an important first step in help. An efficient way of identifying a stroke is to apply the acronym F.A.S.T. to the individual suspected of experiencing a stroke. F stands for Face where the individual is asked to smile and the assessor identifies whether one side of the face of the individual is drooping. A stands for Arms where the individual is asked to raise both their arms and the assessor identifies whether one arm is leaning lower than the other. S stands for Speech where the individual is asked to say something and the assessor identifies whether the speech is slurry. T stands for Time and this is when the assessor notes the time and calls for immediate help should any of the mentioned signs be present in the individual being assessed. Identifying a stroke in time can save a life and potentially prevent permanent brain damage from happening.
At the HSFSA, our work focuses on stroke prevention as it is important to address the controllable and uncontrollable risk factors for stroke. Some risk factors are out of your control but can still increase one’s risk of heart disease and strokes, making them important to be aware of.
The well-known unmodifiable risk factors include:
Age: strokes are more likely among older persons
Sex: – There is a higher risk for menopausal and post-menopausal women
Genetic pre-disposition: inherited high cholesterol, blood pressure, abnormal heart rhythm or clotting disorders can increase the risk of strokes.
Family history: – if close blood relatives have suffered a stroke, this increases an individuals’ risk of stroke
The modifiable risk factors increase the risk of stroke that an individual have the power to change as it is often due to unhealthy behaviours. These include smoking, poor physical activity, unhealthy diet, stress, overweight and obesity and heavy consumption of alcohol.
Up to 80% of strokes can be prevented by your life choices and habits such as eating a healthy diet, exercising regularly, not smoking, and managing stress effectively. Not only are lifestyle changes important to prevent the first stroke, but can also greatly reduce the risk of another stroke in stroke survivors. The best treatment for stroke is prevention and minimising risk factors for not only stroke but for heart attacks and peripheral vascular disease (PVD). By positively managing risk factors, following a healthy lifestyle and adhering to any medications prescribed by the doctor, one can also reduce the chance of having another stroke.
Professor Pamela Naidoo, CEO of the HSFSA, highlights the fact that stroke is a medical emergency. She states that “Every day, up to 360 South Africans are affected by stroke. About a third of those who suffer a stroke will die, and a quarter will be left with a life-changing disability”. Although a stroke is a complex medical incident, there are ways to significantly reduce its impact. Recognising the signs of a stroke early, treating it as a medical emergency and having access to the best professional care, can substantially improve outcomes.We do this through the provision of information, tools and support to build healthy communities. We advocate at all levels to minimise South Africans’ risk of developing heart disease and stroke.
As part of our mission, the HSFSA works towards halting the rise of premature deaths through cardiovascular disease (CVD) and cerebrovascular disease in South Africa promoting the adoption of healthy behaviours. Through our health promotion activities, we reach out to vulnerable communities to educate them about the condition. Health promotion activities include conducting health risk assessments of blood pressure, blood cholesterol, blood glucose, body mass index and waist circumference. Should any of these assessments be out of the normal range, the individual under assessment is given a referral letter to be followed up by their closest clinic. Further to this, information tables with pamphlets as well as health talks are conducted to educate the public on the risk factors of stroke, how to manage them and as well as to identify a stroke.
The HSFSA is proud of its Heart Mark (HM) endorsement programme which assists consumers to identify foods good for their heart and brain, addressing the influence diet may have as a risk factor for stroke. HM works with food manufacturers to improve food formulation. It is managed in accordance with the food regulatory framework and operates with the approval of the National Department of Health. It is not a diet but rather, a guaranteed way to buy food lower in salt, sugar and saturated fats, and higher in fibre.
We advocate at all levels to minimise South Africans’ risk of developing heart disease and stroke. Examples of these policies include the Sugar Sweetened Beverage Tax, Tobacco Sin Tax as well as the salt legislation. The Foundation is proud to have been at the centre of these initiatives and continues to play an important role along with other Non-Governmental Organisations (NGOs), Health Care Practitioners (HCP’s) and associated stakeholders.
A relatively new, innovative and exciting campaign in which the HSFSA is involved in is the FAST heroes campaign. This campaign leverages children’s amazing enthusiasm for learning and sharing, encouraging the spread of knowledge to the rest of their family, particularly to their grandparents. It is an award-winning educational initiative, aimed at raising awareness of stroke symptoms and the need for speedy action. The Fast Heroes campaign was developed by the Department of Education and Social Policy at the University of Macedonia, in Europe, and has been made possible from the support of the Angels Initiative through Boehringer Ingelheim. The HSFSA is the selected partner by Boehringer Ingelheim in South Africa. The HSFSA is also the financial partner for the FAST Heroes campaign in South Africa.
It is through campaigns such as WSW that the HSFSA hopes to achieve its mission of halting the rise of premature deaths through CVD and cerebrovascular disease in South Africa and to promote the adoption of healthy lifestyles.
