Stroke is expected to cause 9.7 million deaths in 2050 – 10/10/2023 – Health

Deaths from cerebrovascular accidents (CVA), the second leading cause of mortality in the world, are expected to increase by 47%, according to a study published this Monday (9) in the journal The Lancet Neurology. In 2020, the disease took the lives of 6.6 million people worldwide. It is estimated that, by 2050, this number will rise to 9.7 million.

To give you an idea, in the same period the world population is expected to grow by 24%.

According to the projection made in the work, the disease should mainly victimize residents of low- and middle-income countries, reinforcing the need for investment in surveillance, prevention, treatment and rehabilitation in these places, since stroke and its recurrence can be avoided.

In all the poorest nations, including Brazil, the number of deaths should increase from 5.7 million in 2020 to 8.8 million in 2050. Rich countries should register a small reduction, but maintain around 900 thousand deaths per year.

The researchers also estimated the economic impact of the disease. In 2017, the cost was US$891 billion, considering direct expenses (hospitalizations and medical expenses) and indirect expenses (loss of productivity). This amount is expected to jump to US$2.3 trillion in 2050.

In contrast, an information campaign capable of reducing stroke deaths by 10% would cost just US$1 per person in the poorest countries.

The publication presents a review of public health guidelines for stroke, based on recent research and interviews with 12 experts, half of whom are from developed countries and the other from developing nations.

Sheila Martins, professor at the Federal University of Rio Grande do Sul (UFRGS) and president of the World Stroke Organization, says that inequalities in treatment between countries are profound. “We need a drastic improvement now, not in ten years.”

12 recommendations were structured. Among the main ones are establishing low-cost monitoring systems; promote campaigns on the importance of improving lifestyle; priority in planning acute cases with technical training and appropriate equipment; adaptation to regional contexts and establishment of local, national and regional ecosystems.

The work also highlights the need to control hypertension, the main risk factor for stroke.

Changing habits

Retired Ricardo Henrique Olivetti, 68, suffered a stroke at the age of 53. He was hospitalized for three months in serious condition and needed a long period of physiotherapy.

“I thought I might not recover,” he says. “After that, I started eating more fruit, drinking more water and, most importantly, walking a lot, as exercise is very important.”

The retiree also has check-ups every six months and tries to keep his hypertension under control. “Maybe if I had done all this before, I wouldn’t have had the stroke.”

João Brainer Clares de Andrade, member of the Board of Directors of the Brazilian Stroke Society and associate professor at the Federal University of São Paulo (Unifesp), states that, in addition to the increase in life expectancy and the risk associated with aging, the population is also experiencing a nutritional and lifestyle factors that favor the incidence of stroke.

“Habits related to the use of illicit drugs, increased sodium consumption and obesity and metabolic syndrome have a direct impact on the increased incidence of cerebrovascular diseases and increased severity of the disease, especially ischemic stroke”, says the neurologist.

He reinforces that misinformation is an important enemy in Brazil, especially in the 30 to 45 age group. “The incidence of stroke has increased, especially in young patients, so there is an increased need for training to identify these conditions, as well as qualification of the entire care network. The big challenge is to show this younger population that they can actually have a stroke.”

Cristoforo Scavone, professor in the Department of Pharmacology at the Institute of Biomedical Sciences at USP, says that the recommendation is to keep up with physical exercise, as this increases resilience and reduces anxiety and stress in the body, and a more balanced diet.

“It’s not about not drinking or stopping eating sweets, but avoiding excess. Furthermore, opting more for fruits, vegetables, greens, which have components that challenge our body to develop protective adaptive responses in both the peripheral and central nervous systems.”

Stroke and dementia

The study also draws attention to the fact that stroke is a cause of depression and dementia.

Stroke affects the so-called “strategic zones” of the brain, which are extremely sensitive and responsible for processing information such as memory, attention and concentration.

“Vascular dementia is a ‘cousin’ dementia of Alzheimer’s, but it does not have the same physiological mechanism. We call it a ‘strategic infarction’, because part of the brain died”, says neurologist João Brainer Clares de Andrade.

According to Cristoforo Scavone, vascular conditions in the nervous system can trigger other diseases through changes in microcirculation and neurological inflammation.

“The mediators of inflammation in the nervous system are a little different from inflammation in the peripheral system. Changes in this inflammatory profile can impact the system and initiate neurodegenerative diseases. They are involved [ainda] in neuropsychiatric diseases, such as depression and schizophrenia”, says the professor.