Experts, in a study, say stroke occur earlier among individuals in Nigeria and other low-income and middle-income countries (LMICs) than in high-income countries, leading to a marked negative impact on socio-economic development, particularly because many individuals in LMICs are affected at the peak of their productive lives.
In a new health policy paper, the researchers stated that the currently available knowledge of evidence-based interventions for stroke prevention has not been translated into reduced stroke burden in LMICs due to barriers limiting implementation.
They declared that the growing burden of stroke across the globe strongly suggests that current primary stroke and cardiovascular disease prevention strategies are either not used widely enough or are insufficiently effective. It was in The Lancet Public Health.
The researchers had conducted a situational evaluation by collecting and analysing data on the state of stroke-related services and resources in LMICs compared with HICs. They added that there was a scarcity of funding for primary stroke prevention across all countries, particularly in LMICs.
According to them, culturally appropriate education about healthy lifestyles should be incorporated into standard education curricula and started early in life, with reinforcement across the lifespan as well as a nationwide and representative system for measuring and monitoring the effects of primary prevention activities.
They declared that prioritising health investment streams towards population-wide primary prevention across the lifespan is important since, for every US$1 spent on the prevention of stroke and cardiovascular disease, there is a more than $10 return on investment.
They added, “the preventive interventions that focus on risk factors are the most cost-effective options. Additionally, stroke primary prevention efforts are likely to yield large gains due to secondary effects of reducing the risk of heart disease, type 2 diabetes, dementia, and some types of cancer that share common risk factors, thus supporting achievements of a range of SDGs.
“A World Stroke Organization coordinated international survey on stroke showed that only about a third of the recommended activities for primary prevention are being done in the 82 countries that participated in the survey, and the use of these recommended activities was particularly poor in LICs.”
They also called for comprehensive reviews of primary and secondary prevention of stroke because previously, effort only focused on stroke was mostly on individual risk factors and measurements of the effectiveness of preventive interventions.
There are two main primary stroke and cardiovascular disease prevention strategies currently in use: population-wide cardiovascular disease strategies and strategies for individuals who have a high risk for cardiovascular disease.
Population-wide strategies for primary stroke and cardiovascular disease prevention are well established, including nationwide measures to reduce exposure to smoking and vaping; reduce intake of sugary drinks, salt, and alcohol; and promote adequate physical activity.
The majority of the burden of stroke (60–70%) across all countries in the world is associated with high blood pressure (the single most important risk factor for stroke) and unhealthy lifestyle risk factors, such as smoking, obesity, low physical activity, and poor diet (eg, excessive salt, sugar, and alcohol intake and low fruit and vegetable consumption).