Saed News: Stroke is considered one of the leading causes of death worldwide. Not only does it claim the lives of some of its victims, but it also leaves many others with disabilities that stay with them for the rest of their lives.
According to the Science and Technology Service of Saed News, citing ISNA, Dr. Ehsan Sharifipour, Secretary of the Iranian Stroke Association, spoke with ISNA on World Stroke Day, stating that two major studies on stroke incidence in Iran have been conducted. He emphasized that stroke incidence should be assessed based on large-scale studies. Two population-based studies on stroke incidence were conducted in Khorasan, Qom, and central regions of Iran in 2010 and 2020.
Dr. Sharifipour, a faculty member at Shahid Beheshti University of Medical Sciences, highlighted that the results of these studies show similar stroke incidence rates in Iran, despite the ten-year gap between them. The findings indicate that the stroke incidence rate in Iran is approximately 150 per 100,000 people annually, which is about 1.5 times higher than the global average.
He explained that the average age of stroke onset in Iran is about 10 years lower than the global average, which is a concerning issue requiring urgent attention from healthcare professionals. While the global average age for stroke occurrence is around 75–80 years, in Iran, it is approximately 65–70 years.
The neurology specialist stressed that given Iran's high stroke incidence and younger onset age, risk factors must be a priority for prevention. Addressing these factors requires national efforts and coordination between various organizations.
Dr. Sharifipour noted that stroke risk doubles every decade after age 50, making it a condition predominantly affecting older adults. However, stroke can affect individuals as young as 18 up to over 100 years old. Comparing peak stroke ages worldwide and in Iran is crucial; globally, strokes peak at 75–80 years, whereas in Iran, the peak is at 65–70 years.
Regarding stroke-related mortality, he stated that extensive studies confirm stroke as the second to fifth leading cause of death in different countries. In Iran, according to national mortality statistics, stroke is the second leading cause of death after heart disease.
Additionally, within the first month after a stroke, 20–30% of patients die, meaning that one in five stroke patients does not survive.
Dr. Sharifipour emphasized the importance of the "golden hour" in stroke treatment. If risk factors are identified and controlled, stroke can be prevented, and if a patient reaches medical facilities during the golden hour, stroke can be effectively treated. The golden hour refers to the critical time when medical intervention has the highest chance of success.
He explained that there are two primary treatments for stroke. One involves the use of thrombolytic drugs to dissolve blood clots, and the other is endovascular treatment using angiography techniques to remove clots from brain vessels. These treatments are most effective if the brain tissue is still viable, emphasizing the importance of the golden hour.
According to Dr. Sharifipour, there is a high chance of preserving brain tissue if treatment is administered within 4.5 hours after a stroke. Faster access to medical services significantly increases the chances of saving brain cells, potentially rescuing up to 2 million neurons per minute.
For endovascular treatments, the golden window extends up to six hours, and with advances in imaging and treatment methods, some patients may still benefit up to 24 hours after a stroke.
Before 2016, Iran lacked a comprehensive stroke treatment program using thrombolytic drugs, leading to high mortality rates. However, since 2016, the "724 Program" has been implemented nationwide. This initiative, recognized by the World Health Organization and the World Stroke Organization, has positioned Iran among the leading countries in stroke care.
Endovascular treatment is an advanced method requiring specialized angiography equipment and expert teams. Unfortunately, Iran has only five active centers offering this treatment, which is insufficient for an 85-million population. Investments in stroke treatment infrastructure, similar to the 724 Program, could significantly improve outcomes and save more lives.
Dr. Sharifipour explained that stroke risk factors fall into two categories: modifiable and non-modifiable.
Non-modifiable factors include age, gender, and family history. Stroke risk increases with age, and men are generally more affected than women. Individuals with a family history of stroke are also at higher risk.
Modifiable factors include high blood pressure, diabetes, obesity, smoking, sleep disorders, and stress. Addressing these factors can significantly reduce stroke risk.
He emphasized that high blood pressure is a silent killer, as many people are unaware of their condition. Regular blood pressure monitoring and timely treatment can lower stroke risk. Additionally, diabetes, obesity, physical inactivity, smoking, stress, and poor sleep habits increase the likelihood of stroke. People with a healthy lifestyle, including regular exercise and a proper diet, are less prone to stroke.
Dr. Sharifipour described stroke as a condition that involves three key phases: prevention, treatment, and rehabilitation.
Prevention focuses on controlling risk factors to reduce stroke occurrence.
Treatment aims to provide patients with timely and effective care during the golden hour.
Rehabilitation helps stroke survivors regain functionality through physical, psychological, speech, occupational, and medical therapies. A comprehensive rehabilitation approach improves the chances of recovery.
He highlighted the importance of Stroke Care Units (SCUs), which play a crucial role in managing stroke patients. Since 2016, Iran has established 155 stroke care units, significantly improving stroke management. However, further expansion is necessary.
Dr. Sharifipour praised the Iranian emergency medical system (EMS) for its role in stroke management. The EMS has integrated the "724 Program" and introduced the "SAMA Code" (Iran Stroke Code), ensuring that emergency personnel are trained to recognize stroke symptoms. If a patient exhibits sudden facial drooping, arm weakness, or speech difficulties, EMS teams quickly transport them to the nearest specialized hospital.
Despite the EMS's success, public awareness remains crucial. More efforts are needed to ensure that emergency services can reach patients in remote areas via air ambulances and other methods.
Dr. Sharifipour concluded by stressing that stroke is preventable, treatable, and manageable. However, recognizing its warning signs, seeking timely treatment, and prioritizing rehabilitation are essential. He also pointed out that health insurance policies need to provide better coverage for rehabilitation services, as many patients struggle with access to necessary therapies.
