In conversation with Professor Pankaj Sharma on PHE Stroke Awareness Campaign

Gee from Punjab2000 talks to Professor Pankaj Sharma. Professor Sharma is the Director of the Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL).

Professor Sharma.

Thank you for taking the time out to discuss major health issues surrounding Strokes, this will bring great awareness within our Asian Communities, In fact this will be something educational for each and everyone one of us and hopefully enable us to have a  greater understanding surrounding Strokes.

Firstly what exactly is a stroke?

A stroke is a brain injury caused by a blockage or bleed in the brain. Since the brain controls and directs the rest of the body, the damage caused by a stroke can affect many of its functions, also the way we think, our ability to learn and how we feel and communicate. Despite being a treatable condition, stroke continues to be the third leading cause of death in England and the largest cause of adult disability. It does not need to be this way. Can this happen to anyone at any age any time? Strokes can affect anyone at any age but the incidence is higher in people aged over 55. In particular those with certain medical conditions such as high blood pressure and diabetes are at a higher risk.

What happens during a stroke – how?

Strokes happen when a blood clot blocks the flow of blood to your brain.

How do you know a person is suffering  a stroke – is there a difference of  symptoms for minor stroke  apposed to a major stoke?

The symptoms of a mini stroke (TIA or transient ischaemic attack) are temporary; they last for a short amount of time, no longer than 24 hours compared to a full stroke. This is because the blockage in your artery is temporary – it either dissolves on its own or moves, so that the blood supply returns to normal and your symptoms disappear. Although the symptoms may not last long, a TIA is still very serious. It is a sign that there is a problem and you are at risk of going on to have a full stroke that could cause you considerable harm. Because of this it is often called a ‘warning stroke’. So don’t ignore it. Get it treated urgently.

What are the typical symptoms of a Stoke & how can they be identified?

FAST is a simple test to help people to recognise the signs of a stroke and mini stroke and understand the importance of acting FAST. FAST shows people what to look out for in themselves and others: • Facial weakness – can you/the person smile? Has your/their mouth or eye drooped? • Arm weakness – can you/the person raise both arms? • Speech problems – can you/the person speaks clearly and understands what you say? • Time to call 999 you should not hesitate to call 999 if you notice stroke symptoms in yourself or others.

Should one consult a GP, or perhaps go to the nearest Walk in centre or  immediately call for emergency on 999 or 111 ?

The campaign highlights the people should call 999 if they recognise any of the symptoms even if the symptoms only last a short time, this may be a mini stroke, a common precursor to a full stroke. Time is of the essence, the faster you act the better chance you have of saving the person for long term disability or having a full stroke.

Is there any reason someone may find it difficult to identify stroke symptoms?

The FAST test is very simple to ensure that it’s easy enough for most people to understand. We hope to reach family members and carers with this campaign who may be able to help people identify the symptoms.

What should be done if you are suspicious of someone experiencing  a stroke  If you think you or anyone else is having a stroke call 999 immediately. Time is of the essence.

Why is there a need to act fast during a stroke? Strokes can leave people with severe disabilities; the faster the person is treated the less damage the stroke can have.

What are the major risk factors for stroke? A person’s risk of having a stroke is affected by age, family and medical history. There is a prevalence of diabetes and high blood pressure in South Asian communities, which are risk factors for stroke. So if there is a history of these conditions in your family, your chance of having a stroke is also higher. Additionally, lifestyle factors such as smoking, excessive drinking of alcohol, high salt intake, a diet high in fat, lack of exercise and being overweight or obese also play a big part. Is there a certain recovery period and healing process for people whom have been subject to a stroke? Stroke affects everybody differently, and it is difficult to say how much of a recovery is possible. Many stroke survivors experience the most dramatic recovery during their stay in hospital in the weeks following their stroke. However, many stroke survivors continue to improve over a much longer time, sometimes over a number of years. Their recovery is in fact a long period of rehabilitation, as they learn to deal with the effects the stroke has had on them. Rehabilitation is about getting back to normal life and living as independent a life as possible. It involves taking an active approach to ensuring that life goes on for people who have had a stroke. This can mean helping them to acquire new skills or relearn old ones. It may involve helping them adapt to the limitations caused by stroke. Or it can mean helping them find social, emotional and practical support.

Are there any major treatments to prevent  major or minor stroke re -occurring? There are many treatments available to stop the recurrence of a stroke or a mini stroke. Survivors of strokes cause by blood clots can be prescribed medication to prevent their blood from forming new clots easily as well injections to dissolve existing blood clots. Stroke survivors are also prescribed medication to help lower their blood pressure and cholesterol to help prevent the recurrence of a stroke. In extreme cases, surgery may be recommended to unblock narrow arteries.

What can you do to reduce your risk of stroke? You can get a health check to screen for any of the medical conditions that can increase the risk of stroke such as high blood pressure, diabetes, high cholesterol, and heart disease. There are many things that you can do to improve your health and help reduce your risk of stroke. These include lifestyle changes such as giving up smoking, eating a diet low in fat and salt, taking regular exercise and cutting back on alcohol. However, in the event you or your loved one does experience a stroke, remember the FAST test.

How do we raise more awareness within our Asian community? Speak about the issue, with friends and family. Know the heightened risk in South Asians and learn to spot the signs of a stroke, that knowledge could save lives.

Where can we seek further support or advice for perhaps  family or friends who have suffered a stroke and  is there any support groups available or contact help lines?

If you or a family member has suffered a stroke there are many services available to you for support. Your GP is always a good port of call for any concerns. There are also charities such as Stroke Association who do great work to raise awareness of stroke and provide support to stroke survivors. Go to www.nhs.uk/actfast or www.stroke.org.uk for more information.

Thank you Professor Sharma , it’s been a delight and honour engaging with you and certainly, Great to have such an insight into the  risk factors associated with Strokes.

Professor Pankaj Sharma is Director of the Institute of Cardiovascular Research, Royal Holloway University of London (ICR2UL). He was formally head of Imperial College Cerebrovascular Research Unit (ICCRU) at Imperial College London. He holds doctorates from both the Universities of Cambridge and London.

He is Editor-in-Chief of the Journal of the Royal Society of Medicine Cardiovascular Disease, Hon. Medical Director of Different Strokes, a UK national charity which seeks to support young stroke victims, Chair of the London Cardiovascular Society and founding Trustee & Treasurer of the South Asian Health Foundation, a charity which serves to reduce the incidence of cardiovascular disease in South Asians living in the UK.

A former Dept of Health Senior Fellow, British Heart Foundation Clinician Scientist at Cambridge University and Fulbright Scholar at Harvard Medical School, he has a long standing interest in the genetics of hypertension, cardio- and cerebrovascular disease. He has published extensively in the field and is an internationally recognized authority on the genetic basis of stroke.