In 2018, an estimated 387,000 Australians aged 15 and over (1.6% of the population) had
experienced a stroke at some point in their lives. In 2020, approximately 39,500 stroke events were reported in Australia, averaging more than 100 per day. Stroke remains the second leading cause of death and disability globally. It is a complex condition, not a singular disease, and can result from a variety of risk factors, disease processes, and mechanisms.
Defining Stroke
A stroke occurs when blood flow to the brain is interrupted or blocked, leading to potential
brain cell damage. There are two primary types of stroke:
Ischemic Stroke: This is the most prevalent type and occurs when a major brain
blood vessel is obstructed, typically by a blood clot or plaque—a buildup of fatty
deposits and cholesterol.
2. Hemorrhagic Stroke: This type happens when a blood vessel in the brain ruptures,
causing blood to spill into surrounding tissues. The resulting pressure increase in the
brain tissue exacerbates damage and irritation.
Risk Factors for Stroke
Strokes can occur at any age, though certain risk factors significantly increase the likelihood. These risk factors can be categorized as modifiable or non-modifiable.
Modifiable Risk Factors: These can be altered or managed to mitigate stroke risk.
High Blood Pressure: Blood pressure readings of 140/90 or higher can damage
arteries supplying the brain.
Heart Disease: A major risk factor for stroke, with overlapping risk factors between
heart disease and stroke.
Diabetes: Individuals with diabetes face a heightened risk of stroke.
Smoking: Smoking nearly doubles the risk of ischemic stroke.
Transient Ischemic Attacks (TIAs): Often referred to as mini-strokes, TIAs have
symptoms similar to strokes but are temporary. A history of TIAs significantly
elevates stroke risk.
High Red Blood Cell Count: An increased number of red blood cells thickens the
blood, raising clot risk.
High Cholesterol and Lipids: Elevated cholesterol can lead to atherosclerosis,
reducing blood flow to the brain and increasing stroke risk.
Lack of Exercise: Sedentary lifestyles are associated with higher stroke risk.
Obesity: Excess weight contributes to various stroke risk factors.
Excessive Alcohol Use: Consuming more than two drinks per day can elevate blood pressure and increase stroke risk. Binge drinking also poses a significant risk.
Abnormal Heart Rhythm: Irregular heartbeats, particularly atrial fibrillation, are a
significant and treatable risk factor.
Cardiac Structural Abnormalities: Conditions such as damaged heart valves can
contribute to stroke risk over time.
Non-Modifiable Risk Factors: These factors cannot be changed but are important to
acknowledge.
Age: Stroke risk increases with each decade past age 55.
Race: Certain racial groups may have a higher stroke risk.
Gender: Men are more likely to experience a stroke, though women face higher
mortality rates.
History of Prior Stroke: A previous stroke increases the risk of subsequent strokes.
Genetics: A family history of stroke can elevate individual risk.
Additional Risk Factors:
Temperature and Climate: Extreme temperatures can increase stroke risk.
Social and Economic Factors: Lower socioeconomic status is associated with higher stroke incidence, often due to poorer health literacy and access to care.
Recognizing Stroke Symptoms
Prompt recognition of stroke symptoms is critical. The acronym F.A.S.T. assists in
identifying key signs:
Face: Look for facial droop or uneven smile.
Arms: Check if one arm is weak or cannot be lifted.
Speech: Listen for slurred or unusual speech.
Time: Call emergency services (000) immediately if any symptoms are present.
Additional symptoms may include sudden weakness or numbness on one side of the body, trouble speaking or understanding, vision problems, dizziness, balance issues, severe
headaches, nausea, or changes in consciousness.
Role of Exercise in Stroke Prevention
Regular physical activity is crucial in reducing stroke risk by improving cardiovascular health
and managing several modifiable risk factors. The following guidelines are recommended for adults:
150 Minutes of Moderate-Intensity Aerobic Activity: Activities such as walking,
cycling, or swimming, distributed throughout the week. Alternatively, 75 Minutes of
Vigorous Aerobic Activity can be effective.
Strength Training: Engage in moderate- to high-intensity muscle-strengthening
exercises at least 2 days per week.
Reduce Sedentary Time: Even light-intensity activities can help mitigate the risks
associated with prolonged sitting.
Gradual Increase: Aim for up to 300 minutes (5 hours) of activity per week for
additional benefits, and increase exercise intensity and duration gradually.
These guidelines are also applicable to stroke survivors, who may benefit from personalized recommendations from an exercise physiologist to accommodate their specific needs and limitations.
Seeking Professional Guidance
For assistance in initiating an exercise program for stroke prevention or management, consult your GP or seek a referral to an Exercise Physiologist. These professionals are skilled in prescribing exercise regimens tailored to individual health conditions, helping you achieve personal health goals and improve overall quality of life while reducing stroke risk.
References
1. Billinger, S. A., Arena, R., Bernhardt, J., Eng, J. J., Franklin, B. A., Johnson, C. M., ... & Tang, A. (2014). Physical activity and exercise recommendations for stroke survivors: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 45(8), 2532-2553.
3. Prior, P. L., & Suskin, N. (2018). Exercise for stroke prevention. Stroke and Vascular
Neurology, 3(2).
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