approaches that can be used to reduce the stroke prevalence and its side effects

approaches that can be used to reduce the stroke prevalence and its side effects

Introduction

Stroke is a leading health concern in the US and across the globe. Its prevalence is anticipated to increase owing to demographic changes, such as increased aging. A stroke is commonly known as a brain attack and takes place when blood supply to the brain is blocked, causing brain damage or death. A stroke can result in long-term disability, brain damage, and mortality. Demystifying stroke leads to a better understanding of the brain. The brain requires oxygen to perform its functions efficiently, including controlling body movements and functions and storing individuals’ memories. When the blood flow is blocked, the brain cells begin to die, leading to a stroke. Two types of stroke manifest differently (“About stroke,” 2019). First, an ischemic stroke takes place when blood clots and other particles block the blood vessels leading to the brain. Second, a hemorrhagic stroke is caused by a blood build-up that can be attributed to blood vessel burst in the brain. The effects of the disease are fatal, and this explains why the healthcare sector should work towards addressing the causes and risk factors.

Forthwith, the topic is interesting and requires comprehensive research to identify the approaches that can be used to reduce the stroke prevalence and its side effects. Cardiovascular diseases have been attributed to high mortality resulting in the loss of 17. 9 million lives annually (“Cardiovascular diseases,” 2019). Four out of five deaths that are attributed to cardiovascular diseases are due to strokes and heart attacks, and this makes it a captivating area of study. The occurrence of the disease makes it an interesting topic in the community and public health nursing.

Epidemiology

Epidemiological research leads to the identification of people and regions that are at a higher risk, an understanding of the history of stroke, and the establishment of the risk factors. Stroke has been identified to be one of the leading causes of adult disability and mortality in the US (Mukherjee & Patil, 2011).  It can be observed that the global impact of stroke is more prominent, but the prevalence differs widely. The stroke prevalence is estimated to be 3% in the adult population, an estimate of seven million individuals. Approximately 800, 000 first-time and recurrent strokes are reported in the US annually, with most of the cases being primary cases (Ovbiagele & Nguyen-Huynh, 2011). Global estimates show that first-time hemorrhages make up a high percentage of the reported incidents. Further, individuals of Latin American, African, and Asian origin have been found to have a higher incidence of first-time hemorrhage while compared to people of European descent. Stroke incidence increases significantly with age and doubles every decade after the age of fifty-five years (Ovbiagele & Nguyen-Huynh, 2011). The occurrence of the condition and the associated costs are expected to increase as the aging population grows. While stroke occurs among children, its commonness is comparatively lower. It follows that sickle cell is the leading cause of stroke among children. Stroke impacts people from different races and age groups.

Developed nations have experienced improved control of vascular risk factors in the past decades as there have been modest reductions in the occurrence of stroke. Hospital-based diagnoses reduced from 680,607 to 609,359 between 1997 and 2006 (Ovbiagele & Nguyen-Huynh, 2011). The average decline was found to be considerably higher in men while compared to women. These statistics can be used when coming up with strategies to address stroke.

Risk Factors

Stroke has been identified to be a treatable and preventable disease that remains one of the most worrying neurological disorders. It is a debilitating disorder that has a significant impact on individuals’ social, mental, and physical health.  Risk factors have also been classified as environmental, metabolic, and behavioral. There are modifiable that are influenced by counselling, training, and education and non-modifiable factors (Madsen et al., 2018). Over 90% of the stroke cases are linked to modifiable risk factors, while 75% of the cases are attributed to behavioral risk factors (Jones & Jones, 2017). Therefore, controlling metabolic and risk factors through lifestyle modifications can mitigate stroke up to 75%. People’s choices can significantly regulate stroke.

The first risk factor that contributes to hemorrhagic and ischemic stroke is hypertension that leads to 50% of all incidents. The most significant modifiable risk factor (Jones & Jones, 2017) Hypertension patients should be treated to sustain their blood pressure. Cigarette smoking is the second considerable risk factor, as it has been found to double the occurrence of ischemic stroke. People are advised against smoking as it decreases the risk of stroke among smokers.

Obesity can be associated with hypertension, unhealthy diet, and physical inactivity. Even though obesity has been identified to be a factor that is closely related to the onset of stroke, the evidence that shows that weight loss can prevent stroke independently. Physical activity can reduce the risk of stroke by 30% and reduce its mortality (Jones & Jones, 2017). Diet is equally instrumental in the reduction of the occurrence of stroke and other cardiovascular diseases. The risk factors have been found to vary across different parts of the world owing to the lifestyle, state of the healthcare system, and composition of the population.

Global Efforts

Stroke is a leading health problem that calls for attention from citizens, public health specialists, clinicians, international agencies, policymakers, and governments. Prevention, thus, is the best solution for the problem (Feigin et al., 2016).  Countries should consider differences in epidemiology when coming up with strategies to address stroke. The population-wide approach has been included in the management of leading cardiovascular diseases, but no country has implemented it at the national level. The population-wide approach is beneficial as it targets all groups, not only those that are at high-risk. Health promotion becomes relatively easy across the board.

High-risk strategies remain pivotal in the prevention of stroke across the globe. Concerning this, the strategies that are utilized in the inhibition of primary stroke are grounded but underutilized. Health systems have failed to provide information that offers individuals with information on medications and to make the necessary lifestyle changes. The high-risk prevention approach calls for the calculation of cardiovascular diseases absolute risk in the next five to ten years (Feignin et al., 2016). These considerations should be made while applying the method. The UN has identified a combined approach as one of the best strategies that are applied in the primary prevention of stroke and other NCDs. The method should be applied for stroke prevention in the US.

Stroke prevention strategies must focus on the high-risk populations, such as individuals with sickle cell disease or atrial fibrillation. Such communities should target environmental, behavioral, and lifestyle strategies. Some government organizations influence change environmental, lifestyle, and socioeconomic factors (Feigin et al., 2016). The cross-sectoral, integrative, and behavioral methods have been identified to be instrumental in the prevention of stroke.

Implications for Nursing

The information provided in the discussion can be used in the service improvement to those that have been affected by stroke. Primary, secondary, and tertiary efforts have been launched in the US to promote the prevention and management of the disease. Nurses play a critical role in these efforts. The current guidelines that have been recommended for stroke management prove that nurses should educate patients on health-related and lifestyle behaviors (Jones & Jones, 2017). Nurses are seen to be part of the multi-disciplinary team in secondary and primary care and are strategically placed to offer patients with information that they need. This is in light of the discovery made by studies that information on health promotion for patients that are at risk is limited and inadequate. Nurses have been found to experience difficulties in comprehending the secondary lifestyle approaches that can be applied in stroke management in various areas, including alcohol consumption and diet. Improve training is valuable in helping patients make healthy lifestyle decisions.

The nursing practice has been forced to invest more towards training nurses on the prevention approaches that are applied in the management of stroke and other cardiovascular diseases. Nurses should be educated about primary prevention techniques such as teaching the general population about the lifestyle and behavioral changes they should make to prevent the occurrence (Jones & Jones, 2017). Moreover, they should also be trained on the secondary prevention efforts to help patients address the impacts of the disease as well as tertiary prevention to manage the lasting effects that the illness may have on individuals. As a result, nurses, policymakers, and healthcare institutions should invest in making the changes that are required to combat the increased stroke prevalence.

Conclusion

Stroke remains one of the most devastating health conditions in the US and across the globe. However, progress has been made in the identification and mitigation of the risk factors. Nurses should be at the center of the introduction of the strategies applied in the management of the disease. The stakeholders should play a leading role in managing the challenges that are associated with the prevention and management of stroke.

References

About stroke. (2019). CDC. Retrieved from https://www.cdc.gov/stroke/about.htm

Feigin, V. L., Norrving, B., George, M. G., Foltz, J. L., Roth, G. A., & Mensah, G. A. (2016).      Prevention of stroke: a strategic global imperative. Nature Reviews Neurology, 12(9),       501. Retrieved from https://www.cdc.gov/stroke/docs/prevention-of-stroke-strategic-     global-imperative.pdf

Jones P. & Jones D. (2017) Stroke 2: primary and secondary prevention strategies. Nursing           Times. 113(12) 42-46. Retrieved from https://www.nursingtimes.net/clinical-    archive/neurology/stroke-2-primary-and-secondary-prevention-strategies-13-11-2017/

Madsen, T. E., Howard, V. J., Jiménez, M., Rexrode, K. M., Acelajado, M. C., Kleindorfer, D.,   & Chaturvedi, S. (2018). Impact of conventional stroke risk factors on stroke in women:       an update. Stroke, 49(3), 536-542. Retrieved from            https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.018418

Mukherjee, D., & Patil, C. G. (2011). Epidemiology and the global burden of stroke. World          Neurosurgery, 76(6), S85-S90. Retrieved from         https://www.sciencedirect.com/science/article/abs/pii/S1878875011009259

Ovbiagele, B., & Nguyen-Huynh, M. N. (2011). Stroke epidemiology: advancing our understanding of disease mechanism and therapy. Neurotherapeutics, 8(3), p. 319.      Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250269/

Cardiovascular diseases. (2019). WHO. Retrieved from https://www.who.int/health-          topics/cardiovascular-diseases/#tab=tab_1