Monday, August 05, 2013

Why Risk Of Stroke Declined In Singapore?

In Singapore, the risk of getting a stroke for all age groups has been reduced each year. According to The Ministry of Health (MOH), the rate of strokes per 100,000 people has lowered from 175 in 2007 to 158 in 2011. The number of deaths from stroke has also dropped from 39 in 2007 to 34 per 100,000 people in 2011. All the figures were after adjusting for an older population.

Stroke is, however, still the fourth leading cause of death that accounts for 9 percent of total mortality in Singapore. People who are most at risk are those are elderly, smokers, hypertensive (high blood pressure), and those who have high cholesterol and diabetes.

A study on 240 acute ischemic stroke patients at the National University Hospital (NUH), Singapore found that hypertension was the most prevalent risk factor (75 percent), followed by high cholesterol (57 percent), atrial fibrillation (35 percent), diabetes mellitus (29 percent) and smoking (26 percent). The findings can be found in March 2013’s issue of JAMA (The Journal Of The American Medical Association) Neurology.

Fortunately, besides the number of smoking, diabetes and obesity that have increased, the number of Singapore residents aged between 18 and 69 years old with hypertension and high cholesterol has declined since 1998.

32.5 percent of Singapore residents had hypertension and 28.2 percent had high cholesterol in 1998 but the 2010’s National Health Survey showed that only 23.5 percent had hypertension and 17.4 percent had high cholesterol.

Being the strongest risk factor for stroke, hypertension puts a person at about 4 times higher risk of developing a stroke than a non-hypertensive person. But if the condition can be well controlled with lifestyle modifications and medication, the risk of getting a stroke could be cut by 40 to 50 percent.

There are 2 types of stroke, namely ischemic and hemorrhagic. 80 percent of all strokes here belong to ischemic stroke, which occurs when a blood vessel to the brain is blocked, usually by a blood clot. A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, causing bleeding in or around the brain. This type of stroke, though fewer in number, results in more deaths than ischemic strokes.

The declining death rate in Singapore could be due to better hospital care and stroke treatment, and more importantly, people can take better care of themselves. Meanwhile, better preventive treatment with medications to reduce high cholesterol and hypertension do help lower the rate at which Singaporeans are getting strokes.

While primary prevention is very important, preventing further strokes cannot be overlooked too. The risk for a stroke patient to get another stroke is 10 percent in the first year following a stroke, with the risk highest in the first month.

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