Strokes don’t just happen to older people – one-in-six of us will have a stroke at some point in our lives, and it can strike at any age, with a quarter of strokes occurring in individuals under 65. Andrea Cail, Director, the Stroke Association in Scotland, explores how this treatable and preventable disease requires urgent attention.

As a pharmacist, many members of your community will be at risk of, or affected by, stroke. You will know it strikes in an instant, without warning, and it can lead to devastating consequences – it’s a leading cause of disability.

In Scotland, approximately 4,000 deaths happen each year as a result of stroke, and there are over 124,000 people in the community living with the effects of stroke and many, many more at risk of the disease.

The good news is that up to 80 per cent of strokes in Scotland could be prevented.

Main Risk Factors for Stroke

The largest number of people who have strokes are aged over 55 and the risk increases with age. Lifestyle factors, too, play a significant role in increasing stroke risk.

Recognised advice is always to:

• Eat healthily – reduce salt and sugar intake

• Stop smoking

• Take regular exercise

• Reduce alcohol intake

Two of the major risk factors for stroke that can be managed are high blood pressure and atrial fibrillation – an irregular heartbeat. If diagnosed and treated promptly, thousands of strokes could be prevented every year.

High Blood Pressure

We need more people in communities across Scotland to understand the link between high blood pressure and stroke. High blood pressure is growing in Scotland.

High blood pressure puts a strain on all the blood vessels, including the ones leading to the brain.  High blood pressure often has no symptoms, so having it measured is the only way to tell if it is high. Normally, blood pressures will be taken by a GP or a community pharmacist and most people with high blood pressure will need to take medication to reduce it.

Changing lifestyle can also help to bring it down. The Stroke Association’s booklet, ‘How to Reduce Your Risk of a Stroke – Active Steps Everyone Can Take’, is available to read and download for more information.

Atrial Fibrillation

Atrial fibrillation (AF) is the most common type of irregular heartbeat and can increase the risk of stroke five-fold. Having AF means that the heart may not be pumping as well as it should. As a result, blood clots are more likely to form in the heart, increasing the risk of having a stroke.

AF-related strokes are often the most severe and cause significant complex disability.

Some common symptoms of AF include:

• Palpitations (being aware of your heart beating fast)

• Breathlessness

• Chest pain

• Fatigue
Some people don’t have any symptoms and AF is often only diagnosed during a general medical check-up or after a stroke or transient ischaemic attack.

If members of your community suspect their pulse is irregular, they can make an appointment with their GP who will test their pulse and refer their patient for further tests to confirm AF.

To find out more about AF and stroke risk, review or download the Stroke Association’s information leaflet on AF by visiting www.stroke.org.uk/finding support.

Treating Stroke as a Medical Emergency

Knowing the signs and symptoms of a stroke is vital to treat suspected stroke as a medical emergency. The FAST test helps people to recognise those signs:

Face: Can the person smile? Has their face fallen on one side?

Arms: Can the person raise both arms and keep them there?

Speech problems: Can the person speak clearly and understand what you say? Is their speech slurred?

Time: If you see any of these three signs, it’s time to call 999
The Stroke Association want people to understand that by getting to hospital fast and being diagnosed and treated quickly, their stroke outcome can be significantly better.

To order FAST leaflets, wallets or posters, go onto the Stroke Association’s website by visiting www.stroke.org.uk.

Taking Action to Help Prevent Stroke

As a member of the Cross-Party Group on Heart Disease and Stroke, we have been involved in some activities to improve diagnosis, treatment and care of AF and high blood pressure in Scotland. Both reports can be found at www.stroke.org.uk.

Two Inquiries in the Scottish Parliament

• Beating High Blood Pressure: Scotland’s Silent Killer

• A Focus on Atrial Fibrillation in Scotland

For more information about the Stroke Association, visit www.stroke.org.uk, email info@stroke.org.uk, or call the stroke helpline on 0303 3033 100. For further stroke information, visit www.nhsinform.scot.