Stroke in the headlines - this means you!
Forget 'Love is All Around Us' - judging by this month's headlines, it's more a case of 'Stroke is All Around Us.'
On 2 May we heard that Ruth Rendell, the famous crime writer, had died as a result of a stroke she suffered earlier this year at the age of 85. Then yesterday came the news that Jimmy Greaves had also had a stroke. This footballing legend - 4th on the list of England's top all-time list of scorers in international matches - suffered a severe stroke on 10 May, but he had previously had a less serious stroke in 2012, at the age of 72. If a patient of mine dies from a stroke at the age of 85, I often hear their families murmur about them having had 'a good innings'. With the average age of stroke being 75, Jimmy Greaves' case is sad but perhaps not shocking.
Personal stories of stroke are always tragic, but perhaps even more worrying for the population as a whole is today's news. We tend to think of stroke as an old person's condition - I've been taught that the risk of stroke doubles every decade from the age of 55, and one in five women and one in six men will have a stroke by the age of 75 (1).
But new statistics from the Stroke Association shows a rise of over 45% in stroke admissions in England over the last 14 years for men aged 40-54 - up from 4,260 in 2000 to 6,221 in 2014. Figures for women of the same age were slightly less horrendous, but still increased by almost a third from 3,529 to 4,604. They concede that improved treatments for stroke in recent years may have meant patients being more likely to be admitted to hospital for treatment with minor strokes which would have been treated at home in the past - due to the Department of Health's 'Act FAST' campaign, but they warn that this is not enough to account for the whole rise. They also warn that if we keep going the way we are, we could wipe out the advances in stroke rates achieved by cutting smoking rates across the UK from 45% in 1974 to under 20% today.
The Stroke Association describe the increase as a 'sad indictment' of the nation's health, and place the blame squarely at the door of our lifestyle habits. Although high blood pressure is the single biggest risk factor for stroke, obesity is the risk factor which has been changing most rapidly in the UK - and not for the better. More than one in four UK adults are now obese, and excess weight is a common link for many of the stroke risk factors - high blood pressure, raised cholesterol, type 2 diabetes.
About one in six strokes in the UK is due to atrial fibrillation, or AF, the commonest abnormal heart rhythm in the UK, which affects over a million people. AF also gets more common with age, but can affect younger people, and it's largely related to the same risk factors as other forms of stroke.
Of course there are lies, damned lies and statistics, and this dramatic 50% increase only translates to an extra 2,000 men a year. But imagine being cut off in your prime, reduced overnight from a worker and family breadwinner to being completely dependent on others for the simplest acts of daily life. Do I get bored with endlessly reminding my patients - and my readers - of the importance of healthy lifestyle changes? Not when the stakes are this high.