High temperatures and especially sudden weather changes that affect arterial pressure can increase the risk of stroke and heart attack. Chronic patients and elderly people should be especially cautious.
About 25,000 people experience a stroke every year in Serbia, one third of whom die, one third remain incapable of living independently, and only about 7-8,000 patients are able to return to their previous activities. Unfortunately, more than 20% of patients are younger than 45 years. The number of such patients is constantly on the rise, and ever younger people are suffering from it. How does a stroke occur?
„A stroke is damage to part of the brain tissue that occurs due to the blockage of a blood vessel in the brain by a clot, which is called an ischemic stroke, or due to the rupture of a blood vessel and blood spilling into the brain tissue or meninges, which is called a haemorrhagic stroke. Hypertension as a key risk factor in ¾ of the patients who experienced a stroke. That is why it is important to detect and treat high blood pressure in time. In addition, it is of great importance to reduce elevated cholesterol, excessive body weight, as well as to stop smoking and consume high quantities of alcohol”, warns dr Danijela Stanišić Srdić specialist of clinical pharmacology and director of Rx portfolio for the Western Balkans, Hemofarm.
And how much can these heat waves or sudden weather changes increase the risk of stroke?
„Staying outdoors during the hottest part of the day, when temperatures exceed 30 degrees Celsius, is not recommended even for healthy people, and especially not for chronic patients or the elderly. On hot days, it is extremely important to drink plenty of fluids. Otherwise, a loss of electrolytes can occur, which can be a trigger for arrhythmias and stroke. That high temperatures are associated with a higher risk of stroke was confirmed by the results of a recently published study of the clinic in Augsburg. During a period of 14 years (2006-2020), the data of stroke patients were analysed in the said hospital, and it was observed that for the majority of them, namely 11,037 patients, the stroke occurred precisely in the months of the highest temperatures, from May to mid-September”, says our interlocutor.
Studies suggest that there is a link between sudden weather changes and the risk of a stroke. The famous Mayo Clinic warns that exposure to a sudden drop in temperature increases the risk of stroke through changes in blood viscosity and variations in blood pressure.
„Blood pressure is generally higher in the winter and lower in the summer. Low temperatures cause temporary narrowing of blood vessels so more pressure is needed to move the blood through the narrowed blood vessels. Our blood vessels react to any sudden changes in the weather. Also, sudden temperature differences are dangerous when you enter heavily air-conditioned rooms during hot days, which is quite often in our country, so when you enter rooms cooled to 18 degrees from outdoor temperature of 35 degrees, such transitions can be very dangerous and cause first of all heart attack, but also stroke”, warns Dr Stanišić Srdić.
Key role of prevention
Stroke is the first cause of disability in the world and in our country and is the leading cause of dementia. In addition to high blood pressure, what are the most significant risk factors?
„Unregulated high blood pressure is responsible for the occurrence of more than 70% of strokes, and the existence of comorbidities, primarily diabetes, is certainly an important risk factor, due to known side effects on blood vessels. It is known that diabetics experience myocardial infarction, sudden death and stroke 5 times more often. Heart disease is also an important risk factor, as well as metabolic disorders, obesity, lipid status disorder, insufficient physical activity, stress. We can influence most of these factors, and this is where the importance of prevention is mostly demonstrated”, emphasizes our interlocutor and further demonstrates that primary prevention plays a key role in control of cerebrovascular diseases in patients with one or several risk factors.
Keeping high blood pressure or diabetes under control, attention in the case of heart rhythm disorders, control of the patency of the carotid arteries, are some elements of preventive protection against stroke. There is also the great importance of health education and the adoption of healthy lifestyles, and at the same time raising awareness of the importance of responsible patient behaviour, i.e. regularly taking therapy for chronic diseases, going to medical check-ups, following the doctor's advice. Therefore, we should do everything we can to prevent the occurrence of cerebrovascular diseases and their complications.
Treatment as in the highly-developed countries
The state-of-the-art therapeutic procedures are carried out in Serbia in the treatment of stroke, where acute stroke is treated according to the first degree of urgency, in which it is equated with trauma. The first stroke unit with a highly specialized team of doctors and nurses was opened in Serbia in 2005 at Department of Emergency Neurology of the UKCS Neurology Clinic, where patients are provided with the most modern diagnostic and therapeutic procedures, and which served as a model for the opening of other similar units in Serbia.
„Contemporary so-called new oral anticoagulant drugs (NOACs) such as rivaroxaban have a significant place in the prevention and treatment of thrombosis and thromboembolic complications. I am primarily referring to their use in patients undergoing orthopaedic hip or knee replacement surgery, as well as in patients with certain heart rhythm disorders such as atrial fibrillation, which carries a high risk of stroke. The advantage of these drugs is reflected in the fact that they show effectiveness with a much more acceptable way of use for the patient, because they are given in fixed doses and do not require routine monitoring of coagulation. Rivaroxaban is much safer compared to the old oral anticoagulant drug warfarin, because it much less often leads to intracranial bleeding as the side effect that we fear most when applying anticoagulant therapy”, says dr Danijela Stanišić Srdić from Hemofarm.
