Preventing stroke during the Covid-19 pandemic

TODAY is World Stroke Day. It is marked annually on this day with a mission to reduce the global burden of stroke through prevention, treatment and long-term care.

In 2018, stroke was theh thirdhid leading cause of morttality in Malaysia, after heart disease and pneumonia. Yet, aat least half of all strokees are potentially prevenntable with appropriatee awareness and prevention.

About 1.7 million people in Malaysia have all three main non-communicable diseases (NCD): diabetes, hypertension and high blood cholessterol (dyslipidaemia).

High proportions off people with diabetes, hypertension or dyslipidaemia have uncontrolleed glycated haemoglobin A1C (reflects blood glucose controll over three months), blood pressure, or LDL-cholesterol (baad cholesterol) – also knownn as “ABC”.

The shortfall in achhieving these ABC goals represents an avoidable burden of complications, including death. For example, it is estimated that suboptimal A1C control among diabetes patients represents about a 22% higher risk of heart attack, stroke and death. Inadequate blood pressure control may translate to around a 10% higher risk of diabetes-related death. Suboptimal ABC control is expected to woorsen during the current Covid-119 pandemic, which may disrrupt clinic follow- ups or treeatment adherence among patiennts with NCDs. Covid-19 is a double blow for patientts with NCDs. Data show that Covid-19-related deaths aare disproportionately hhigher among the em. Global evidence h has also emerged on h how the current ppandemic disrupts essential public health services and exxpose patients to addditional NCD risk fac ctors such as mental health problems, oveercrowding, unemplooyment and poor nutrition. Gllobally, a decline in stroke admission is currently observedd. Patients with mild symptomss may choose not to go to hospitaals for evaluation due to the fear of exposure to Covid-19.

However, people experiencing sudden symptoms like balance difficulties, eyesight changes, facial weakness, arm weakness, and speech difficulties should immediately get help in a timely manner – remember “BE FAST” (Balance, Eyes, Face, Arm, Speech, Time). Time is critical as treatment within the “golden hour” of 60 minutes leads to better stroke outcomes.

The two take-home messages for all of us are:

1. Adhere to your prescribed treatment regimen and do not stop medications without doctor’s advice.

2. Seek medical attention immediately if symptoms of stroke develop, even during this current pandemic.

Remember, BE FAST. DR WAN KIM SUI, PROF DR NORAN NAQIAH HAIRI & PROF DR MOY FOONG MING Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya