Leaving aside possible risks can lead us to the worst scenario for our health. And in the field of vascular diseases, our lifestyle and the reaction time before the first signs of the event will gauge the severity of its consequences. Julio Agredano, 53 years old and president of the Fundación Freno al ICTUS, was very aware of this when he suffered a stroke, a cerebrovascular disease that affects the blood vessels that supply blood to the brain and that affects around 120,000 people in Spain every year. causing death or disability in 50%, according to data from the Spanish Society of Neurology (SEN).
The stroke can be ischemic or hemorrhagic. The first, which occurs in 85% of cases, is caused by a significant decrease in blood flow to a part of the brain. Currently, stroke is the first cause of acquired disability in adults and the second cause of mortality, being the first in the case of women.
When recounting his experience, Julio usually says that he had bought all the cards to suffer a stroke: he weighed 103 kilos, had high LDL cholesterol - the so-called 'bad' cholesterol -, hypertension and a fatty liver, and he led a sedentary life. Furthermore, his job as a director of a technology company was an inexhaustible source of stress. “All this tells us that something is going to happen,” he says, anticipating the story. And that something happened.
That day that Julio will never be able to erase from his mind, he was in Gijón sightseeing with his family and, late in the afternoon, he began to feel weak and see double. “Unfortunately I put it down to tiredness and went to bed. That was the big mistake because, when I wanted to act, it was already too late,” he confesses. At that time he was 39 years old and thought that older people suffered from strokes. Although most patients are over 60 years old and age is a risk factor, stroke can appear at any age, experts say.
In the last 20 years, mortality and disability due to stroke has decreased, thanks to improvements in the early detection of symptoms, the control of the main risk factors and the introduction of new therapeutic measures, but its incidence continues to increase. , they point out from the SEN. The World Health Organization (WHO) estimates that over the next 25 years this will increase by 27%, a figure that could be reduced. In fact, 90% of strokes can be avoided with adequate prevention and treatment, points out the SEN. “There are controllable risk factors that are very easy to identify such as LDL (bad) cholesterol, hypertension, diabetes and smoking, in addition to a sedentary lifestyle and obesity,” lists Dr. Pere Cardona, director of the Stroke and Stroke Unit. of the Neurovascular Program of the Bellvitge University Hospital.
Within this group of risk factors, the neurologist delves into the role of LDL cholesterol, the so-called 'bad' cholesterol. “By controlling their levels we can reduce the risk of having a stroke, and also any type of cardiovascular disease,” says Dr. Cardona, who advocates carrying out analytical studies in health centers, especially in 40-year-old people with obesity and with a family history of vascular diseases. “Society has to understand that high LDL cholesterol affects both myocardial infarction and stroke,” says Julio, whose lifestyle habits and health indicators led him to suffer, sooner or later, a cardiovascular pathology.
A few weeks before the stroke, Julio underwent a medical check-up at work and the results of the tests alerted him. “The doctor recommended that I change my lifestyle to avoid cardiovascular diseases, and what did I do? Nothing, which is what most people usually do,” Julio admits. “The more LDL cholesterol and the more hypertension you have, the less active and more sedentary you are, and the more time you spend thinking only about your work, the greater the risk of suffering a stroke,” he lists forcefully. “I was very young and I didn't put up barriers to improve the situation,” he acknowledges.
The key to effective stroke treatment is speed since it is a time-dependent disease. This means that the more hours that pass, the less likely the patient will be to survive or not suffer sequelae. Experts recommend that, if you have any suspicion, you call 112 to activate the Stroke Code. The objective of this medical protocol is to prioritize the care and immediate transfer of the patient to a hospital that has a stroke unit.
“The ‘best’ stroke is the one we catch in time. You have to try to enter that chain of survival, which is what will help you overcome the disease,” says Julio, with the lesson more than learned. “The most important thing is that you don't go to the hospital; They take you to the hospital and the emergency services do it,” he insists. In fact, specialists emphasize that in the event of a stroke, patients should never travel to the hospital or health center by their own means.
The symptoms generally occur suddenly and unexpectedly and the main ones are alteration in language - with difficulties speaking or understanding what is being asked -, loss of strength or sensitivity in a part of the body - especially the face. or in the extremities—alteration of vision, lack of balance and coordination, or a very intense headache that is different from any you have had until now. Although most patients present several symptoms, experiencing just one of them is cause for alarm.
If patients who suffer a stroke are taken to the hospital immediately and the appropriate treatments are applied, they may not even have any sequelae. “But most of the time, when the patient arrives at the hospital, there is already brain damage,” warns Dr. Cardona. This damage means that in the first days after the stroke, those affected have problems with language or the inability to speak, when moving arms and legs, vision problems and difficulty walking. They may even suffer small strokes that would cause cognitive alterations that impair attention, concentration and memory.
Although he feels lucky to have survived the disease, the stroke meant a year of recovery for him, dedicating four hours a day to his rehabilitation in a private clinic. The first months are very important to recover and reduce the resulting disability. “You must start rehabilitating from day one,” he says. The change in his life was total. Julio, who took a year to walk, warns that the stroke is not only suffered by the affected person, but also by his family environment. He was discharged from the hospital with moderate physical consequences and, once he was able to regain mobility, he became interested in mountain biking and devoted himself to outreach.
After an event like this, for Julio, the only way is to start over. “A stroke sufferer, the day he has finished his rehabilitation in a regulated center, has to face his return to activity. Unfortunately, we are not prepared for emotional rehabilitation,” he comments, adding a revealing fact: 80% of people who suffer a stroke in the first two years need psychological support. “The positive attitude was very important in my recovery. Furthermore, having a vital purpose gives you something to fight for,” he says.
Julio will always be a stroke patient. Along with visits to the neurologist, all those affected must be monitored by their family doctor and follow very strict control of vascular risk factors. For example, your LDL cholesterol should be below 55 mg/dl to avoid the risk of suffering a stroke again. “Treatment is not just about administering drugs and taking them well. I always tell patients that this is 50%. The other half is controlling your lifestyle,” says Dr. Cardona.
In a hospital admission the patient is in the middle of cotton, but the problem arises when he returns to his routine. “More than half of people who have suffered heart attacks or strokes abandon treatment and continue smoking. If something like this happens to you and you continue smoking, it will happen again,” Julio laments. For him, everyone affected must accept their condition as a vascular patient and never forget that, in most cases, they can move forward because “stroke is highly preventable and treatable.”
