Recurrent stroke in Nigeria, Ghana linked to salt, alcohol intake — Experts

Experts, in a new study, said aside from factors such as hypertension, abnormally high cholesterol or fat, diabetes mellitus, family history of heart diseases, being older than 50 years, or Yoruba or Hausa ethnicity, practices such as table-added salt and alcohol intake are associated with a recurrent stroke in Nigeria and Ghana.

Researchers, in a study to assess the prevalence, risk factor profile, stroke types and mortality from recurrent strokes in Ghana and Nigeria, said those with recurrent stroke were significantly older than index stroke cases.

They analysed data from 3553 stroke cases involved in the Stroke Investigative Research and Educational Networks (SIREN) study for the proportion of recurrent strokes.  They cross-examined risk factors of recurrent stroke. It was in the August edition of the Journal of Neurological Sciences.

According to them, among stroke cases, 9.4% had recurrent strokes, of which 79.9% were ischemic (caused by blockage of an artery) and 20.1% haemorrhagic (caused by bleeding). The topmost risk factors associated with recurrent stroke were hypertension, abnormally high cholesterol or fat, diabetes mellitus, and a family history of heart diseases.

In addition, the relative risk factors associated with recurrent stroke were being older than 50 years, Hausa ethnicity, Yoruba ethnicity, table- added salt and current alcohol intake.

They said mortality from recurrent stroke is 20.5% and several modifiable lifestyle-related factors may warrant additional emphasis as targets for reducing the burden of recurrent stroke in sub-Saharan Africa.

According to SIREN’s study principal investigator, Professor Mayowa Owolabi, in a study that analysed 30 potential risk factors for stroke in Ghana and Nigeria, found that hypertension and abnormally high cholesterol or fat in the blood top the list of 11 contributors but modifiable factors for stroke to occur.

In descending order, these were hypertension, high cholesterol or fat level (dyslipidaemia), regular meat consumption, pot belly (high waist-to-hip ratio), diabetes, low green leafy vegetable consumption, stress, added salt at the table, heart disease, physical inactivity, and current cigarette smoking.

While obesity, physical inactivity, regular meat intake, salt intake, and cardiac diseases were associated with ischaemic strokes, tobacco was associated with haemorrhagic strokes.

Hypertension, dyslipidaemia, diabetes, stress, and low consumption of green leafy vegetables were associated with stroke regardless of age.

Heart diseases were significantly more associated with stroke in people younger than 50 years, whereas current cigarette smoking, added table salt, and regular meat consumption were significantly associated with stroke in those 50 years and older.

Professor Owolabi declared that dietary and socioeconomic factors seem to play more important roles in predisposition to stroke among Africans than previously appreciated.

Stroke remains a leading cause of long-term disability and the second most common cause of death worldwide. It is particularly pertinent in sub-Saharan Africa (SSA) where nearly 80 per cent of all global stroke mortalities occur, and the stroke burden is projected to increase in the coming decades.