Regular Exercise, Lifestyle changes could lower risk of Stroke –Report

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Recent studies have shown the interconnectedness between a sedentary lifestyle and the high level it portends of having a stroke.

Stroke, medically known as cerebrovascular accident, as defined by John Hopkins Medicine, occurs when blood flowing to the brain is stopped or disrupted. The research structure lists Ischemic stroke; the commonest type of stroke caused by blockage of a major blood vessel in the brain, and Hemorrhagic stroke; linked to a burst of a blood vessel in the brain, as the two types of stroke.

Sedentary lifestyle, age, high blood pressure, obesity, smoking, diabetes, previous history of stroke, race, and gender have been listed as risk factors for stroke.

The World Health Organisation stated that 60 to 85 per cent of people around the world lead sedentary lives. It is estimated that about two-thirds of children were insufficiently active and faced with the risk of serious future health complications.

Findings from a February 2022 research by American Heart Association, reported an 11 per cent increase in stroke cases among younger to middle-aged adults due to sedentary lifestyles.

The report, published in Daily Mail, stated that those who barely moved for 13 or more hours per day were 44 per cent more likely to suffer a stroke within seven years compared to those sedentary for 11 hours or less per day.

It stated, “Getting in three-and-a-half hours of light exercise per week was also shown to reduce the risk of a stroke by 26 per cent, compared to moving less than two hours per day. Light exercise could include doing housework or walking around the house.

“An even greater protective effect was recorded in people who did harder physical activity. Those who did 14 or more minutes of moderate or vigorous exercise – like going on a brisk walk, cycle or even gardening – saw their risk fall by 47 per cent, compared to people who did less than three minutes per day.”

In Africa, as compared globally, stroke has been reported to have the highest incidence and case fatality. In Nigeria, several medical researchers highlighted the prevalence of stroke to 1.14 per 1000 with a higher prevalence of 1.51 per 1000 in males and 0.69 per 1000 in females. Due to lack of funding, the fatality rate of stroke patients within 30 days is as high as 40 per cent.

Research by Uchenna Okonkwo, Favour Uzuh, et al, on “Awareness of the risk factors of stroke among the non-teaching staff of the Nnamdi Azikiwe University, Nnewi Campus, Anambra State, Nigeria,’’ stated that the primary medical cause of strokes was an underlying heart or blood vessel disease which includes hypertension.

Another recent study carried out by a team of researchers from the Chinese Academy of Medical Sciences and Peking Union Medical College showed that people who engaged in little physical activities or barely moved for more than 13 hours per day were at the highest risk of stroke.

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According to Daily Mail, the study which tracked 100,000 adults for over a decade, further revealed that those who were physically inactive and exercised for more than 12 hours weekly, reduced the risk of death to 17 per cent while those who exercised for less than two hours had a 50 per cent increased risk.

In his comment on the issue, a professor of Clinical Neurology and Internal Medicine, University of Nigeria, Nsukka, Ikenna Onwuekwe, stated that the burden of stroke in Africa was increasing and getting worse.

He attributed changes in lifestyle, diet and lack of exercise as some of the reasons for the increased cases.

Onwuekwe said, “Our ancestors did not have the extent of high blood cholesterol, hypertension, stroke, diabetes and heart attack as much as we hear currently. What has changed? A lot of research we have done has shown that factors that account for this include changes in lifestyle and diet. We have become westernised. We have left some of the traditional things we were known for and adopted the white man culture, food and way of life and so we have started having diseases and conditions we didn’t use to have before.’’

He added that the high risk of blood pressure, blood cholesterol and diabetes mellitus, which were the three commonest factors for stroke worldwide, accounted for the increase.

The neurologist further stated that a sedentary lifestyle was directly correlated with the increase in stroke cases as it was a known risk factor for high blood pressure and cardiovascular diseases such as heart disease and high blood pressure.

On measures to prevent the increase, the researcher on epilepsy and stroke said, “It is going to be a multidimensional approach. There are things we can do as individuals at personal levels, organisations, industries, public, and government regulations.

“When you get to the office, occasionally, maybe every two or three hours, get up and walk around. If you walk in an office that is a high rise, walk down the flight of stairs and exercise for about 10 minutes and do so periodically till the close of work.”

He urged those who have a family history of high blood pressure, stroke, diabetes, high blood cholesterol or obesity to have a personal lifestyle that encouraged a good lifestyle.

Onwuekwe added, “Walk briefly for about 30 minutes or one hour every week. Have a good diet, reduce foods that are known to increase weight, eat more fish, stop eating meat, moderate your level of alcohol, take more nuts and vegetables.”

He advised the government to ensure employers of labour created a working environment to enhance health and productivity.

He also urged them to subsidise available but costly medications that could reverse some of the features of stroke in persons who were brought in early to the hospital.

Also, a professor and consultant neurologist with the Lagos State University Teaching Hospital, Yomi Ogun, said that a sedentary lifestyle was among the risk factors for stroke.

Ogun stated that the main cause of the stroke was high blood pressure and a closer cause was diabetes mellitus and high cholesterol among other factors.

The consultant added, “Some of the ways to prevent all those diseases is to control your blood pressure, diabetes, and high cholesterol if you have it. There are other preventive measures. If you are obese, try and shed weight or do adequate exercise.

“If you have a sedentary job, which of course will predispose you more to being obese and not doing enough exercise, you have to make sure that you prevent and avoid all those. If your cholesterol is high, you should also try and control it as well.”

He added that the risk of blood clots in one’s vein was high for those with jobs making them sedentary.

Ogun also said, “If you have had a case of stroke, you must stick strictly to preventing a recurrence. In terms of prevention, we look at it at five levels. The first is primordial prevention, this cuts across everyone and you ensure you take a lot of green vegetables, and fish, adequate exercise, and weight and obesity control. Also, minimise alcohol and cigarette intake.

“Secondary prevention is for those who have had a stroke before to prevent a recurrence. Some of the drugs used for secondary prevention are blood thinners and statins. Tertiary prevention is for those who, when they have a stroke, must quickly be taken to the stroke unit where they can be given what they call clot busters for dry stroke. There is what we call a dry and wet stroke. For those who have a dry stroke, the pipe is blocked while a wet stroke meant the pipe is burst. So, those who have a dry stroke need to get a clot-buster or remove the clots by clot retrievers surgically. But this is possible if they present early enough. That way you improve the outcome and reduce the mortality.”

He added that early presentation of stroke cases in the hospital would prevent further complications.