Thursday, August 31, 2017

Tackling hypertension and improving stroke prevention awareness in South Africa

Hypertension prevalence in South Africa as recorded in the Study on Global Ageing and Adult Health (SAGE), conducted by the World Health Organisation, is the highest ever reported by a nationally representative survey of people aged 50 and over for any country.[1] 

The Heart and Stroke Foundation South Africa estimate that up to 1 in 3 adults have raised blood pressure levels; the most important risk factor for stroke. A high salt intake is an established risk factor for increased blood pressure. South Africans consume more than double the recommended amount of salt a day. In 2013 the Minister of Health signed legislation to make salt reduction in the food industry mandatory, making South Africa the first country globally to legislate salt levels to help reduce the amount of salt that the public takes in from processed foods.

Also in 2013, Salt Watch was established through a multi-sectorial coalition group to undertake a public awareness and education campaign to encourage South Africans to reduce their salt intake. The Heart and Stroke Foundation South Africa was nominated as the implementing body of the campaign, with the support of the National Department of Health. The campaign consists of a television and radio campaign and providing information and education materials. Salt Watch brochures are available free of charge, in five different languages ( ).

The Heart and Stroke Foundation, in a joint venture with Unilever, have also created a Salt Calculator to help people estimate their salt consumption. The salt calculator estimates salt intake based on the frequency by which common foods are consumed, and then provides feedback on current intake and tips on making better food choices. The tool was developed by using local research and statistics to guide the inclusion of food categories. Sodium content for more than 200 branded foods was collected online and in-store to provide a representative and reliable tool.[2]

Professor Pamela Naidoo, CEO of The Heart and Stroke Foundation says ‘my reason for wanting to prevent stroke is indeed because largely it can be prevented if you make positive life-style choices. Despite having a genetic vulnerability or a familial history for raised blood pressure, if you have good eating habits by choosing foods with low salt levels and refrain from adding salt to cooked food, and engage in physical activity which can also help to reduce stress levels, you can reduce your risk for a stroke. The effects of stroke can have a devastating impact on you, your family and your ability to lead a productive life.’

Another stroke support organization engaged in awareness raising and risk factor management is The Stroke Survivors Foundation South Africa. The Stroke Survivors Foundation provides post-discharge support for stroke survivors, their families and caregivers. This includes information on stroke and how to manage risk factors. Information is shared through social media, a website, print materials and at stroke support groups.

Having experienced the lack of statutory stroke support in the community after a stroke in his thirties, George Scola co-founded the Stroke Survivors Foundation in 2010. The sole purpose for creating the Stroke Survivors Foundation is to assist stroke survivors, their families and their caregivers, survive the trauma and give them the knowledge needed to endure the incident and their recovery.

George says ‘a stroke is a silent killer; this does not mean that we just have to accept it and fight it on our own. Having survived the stroke is the easy part. Recovering, adjusting and acknowledging the disability, patience for the survivor and the caregivers, staying motivated and staying positive… this is the difference between conquering and overcoming it, or taking it lying down’.

‘My reason for wanting to prevent a stroke is because I have personally experienced the destruction it can cause to a stroke survivor’s life, the turmoil and negative impact on their families, spouses, children and parents!
With the exception of medical reasons and in order to prevent this type of destruction from happening to others, it is important to look after ones health by not smoking, exercising regularly and following a healthy eating plan.’

For more information please visit:

[1] Lloyd-Sherlock et al (2014)
[2] Heart and Stroke Foundation South Africa

Tuesday, August 29, 2017

Fibrinolytic for Treatment of Intraventricular Haemorrhage

Fibrinolytic for Treatment of Intraventricular Haemorrhage

Fibrinolytic for Treatment of Intraventricular Hemorrhage: A Meta-Analysis and 
Systematic Review published in the International Journal of Stroke 

Intraventricular haemorrhage is a significant cause of mortality and morbidity worldwide. Treating it with intraventricular fibrinolytic therapy via a catheter is becoming an increasingly utilized intervention. But what is the role of this treatment in hypertensive intraventricular haemorrhage patients and what are the effect sizes for survival as well as level of function at differing time points?

interview with Alexandra Baker and Krissia Rivera Perla  from John Hopkins Hospital, Baltimore, Maryland

8th Annual Congress of the Philippines Stroke Society

The 18th Annual Congress of the Philippines Stroke Society was held from August 17-19, 2017 in Dumaguerte, Philippines. At this occasion, the WSO/PSS joint education project "Cardinal Principles of Stroke Care and Management" was held.  Prof. Michael Brainin (WSO),  Dr. Epiphania Collantes (President, Philippines Stroke Society), and  Prof. Rhomy Esagunde (President, Philippine Neurological Society) hand over 200 diplomas, among them one to a resident of St. Lukes Medical Center (picture) and to eight residents from Dumaguerte Medical Center (picture), totalling 200 distributed during this event. With all actoivities since the inception of this program last year more than 1100 have completed this program which is scheduled to be continued another three years.

Thursday, August 24, 2017

Raising the profile of stroke secondary prevention - International Network of Stroke secondary Prevention Researchers

 INSsPiRE (International Network of Stroke secondary Prevention Researchers)
is a collaborative multi-disciplinary network of people with an interest in stroke secondary prevention research. It comprises representatives of the multi-professional stroke rehabilitation team, with academics, researchers and clinicians from across the world.

The long- term aim is to raise the scientific profile of secondary prevention as a key element of long-term stroke rehabilitation and living life with the consequences of stroke.  We need to learn more about how to help stroke survivors to initiate and maintain changes to their lifestyle to minimise risk of another stroke.  The network intends to share relevant information and resources and to facilitate international collaboration e.g. multi centre studies, thereby building a body of evidence to inform person-centred and/or family-centered healthcare services.

The INSsPiRE network is led by Dr Maggie Lawrence, a senior research fellow at Glasgow Caledonian University who has conducted systematic reviews to assess the effectiveness of behavioural secondary prevention interventions to prevent recurrent stroke: stroke survivor and family member perspectives of stroke interventions, and the effectiveness of structured, group-based self-management programmes with the potential to help people with long term conditions cope better with physical, psychological or emotional distress.

One of the first tasks for the group is to define Stroke Secondary Prevention, i.e. what are the essential elements of a stroke secondary prevention programme?  The network hopes to achieve a collective expert consensus on this using Delphi methodology, and members of the group made a start to this following a recent seminar hosted by Glasgow Caledonian University. The seminar consisted of presentations by various members of INSsPiRE to a varied audience consisting of academics and clinical practitioners, representing a range of professions including nurses, dieticians and psychologists, as well as representatives from third sector agencies.  This audience contributed to lively discussion following the presentations.

Highlights of the day included a review of reviews ‘Sign posting the way forwards: mapping the evidence for complex interventions addressing lifestyle risk factors after stroke’ led by Dr Olive Lennon.  This ground- breaking work will inform the future direction of the network.

Dr Eric Asaba and Dr Gunilla Eriksson presented on ‘Healthcare journeys, technologies, and prevention: Lessons learned from qualitative studies’.   In contrast, Dr James Faulkner talked about the benefits of physical activity as a means of secondary prevention care for patients with cardiovascular and/or cerebrovascular disease. 

A thought provoking discussion on interventions involving ‘Mindfulness for well-being after stroke’ then followed from Dr Birgitta Johansson.  The session finished with Dr Maggie Lawrence who talked about an Evaluation of Keeping Well ( an online resource for self-management of stroke risk reduction.

Following the morning’s programme, members of INSsPiRE met to engage in Delphi expert consensus work to try and agree on a definition for what is meant by ‘stroke secondary prevention’ and its constituent elements. This work continues remotely and will be discussed in a future blog.

You can find out more about the day and watch some of the presentations at

If you would like to join INSsPIRE please give us a ‘like’ on Facebook or email Maggie Lawrence (

Dr Jennie Jackson and Dr Maggie Lawrence from the  School of Health and Life Sciences, 
Glasgow Caledonian University, Glasgow 
on behalf of the  International Network of Stroke Secondary Prevention Researchers (INSsPiRE)

Dr Jennie Jackson is also from the Department of Life Sciences, 
School of Health and Life Sciences, Glasgow Caledonian University,

Friday, August 18, 2017

Long-term Predictors of Stroke in Healthy Middle-aged Men - Erik Prestgaard

Long-term Predictors of Stroke in Healthy Middle-aged Men - Erik Prestgaard

As you can imagine a longitudinal study of 2014 Norwegian men who were recruited from 1972-1975, and then followed up until 1997, is an amazing source of data. Researchers from the Institute of Clinical Medicine, and the Department of Informatics at the University of Oslo,
and from the Department of Cardiology, Oslo University Hospital, UllevÄl, Norway investigated the long term predictive impact on stroke risk of baseline variables including haemodynamic variables measured at rest and during exercise in these same middle-aged, healthy men.

Wednesday, August 16, 2017

Acha Memorial Foundation delivers stroke prevention awareness in Nigeria

Acha was established as a stroke support organization (SSO) in 2015 by brothers Timothy and MacDonald Oguike, after the death of their father following a stroke. The Oguike family found it very difficult to find the right information about stroke facts, treatment and rehabilitation and the brothers believe this contributed to their father’s death. Through its MasterStroke project, Acha aims to address the burden of stroke in Nigeria through: community stroke awareness and education campaigns; guidance on how to access the right stroke treatment and long term support; and advocacy to decision makers for improved government stroke awareness and risk management services.

Stroke prevention advocacy
MacDonald won the World Stroke Campaign Award 2015 for outstanding individual achievement for his leadership of Acha's MasterStroke program that used an impressive combination of media, social media and mobile technology to raise awareness and understanding of stroke throughout Nigeria.

Tuesday, August 15, 2017

Where to now? AVERT answered an important question, but raised many more

Where to now? AVERT answered an important question, but raised many more

The AVERT trial was a Phase 3 randomised trial with over 2100 subjects designed to end the
controversy about the early mobilisation of stroke patients. It’s sounds intuitive doesn’t it, if a patient has a stroke get them up and moving as soon as possible get the blood flowing and consequently the patient healing faster.

Tuesday, August 8, 2017

Preventing stroke would allow me to be the mother; wife; daughter and professional person that I want to be without constraints or restrictions

Stroke survivor Hilary Wehby from Jamaica shares her experience of a life changing stroke and what stroke prevention means to her.

Before the stroke did you have any idea that you were at any risk of stroke? 
Before I had my stroke, I knew very little about strokes and considered myself "a healthy horse" I was usually the last in my family to catch any viruses going around and had 3 children via natural child birth. In fact I had no known medical issue and thought strokes primarily affected elderly persons. 

Monday, August 7, 2017

Stroke while driving: finding the risk factors

Stroke while driving: frequency and association with automobile accidents

Driving while having a stroke is potentially life threatening, imagine driving down a dark road at night, or a busy peak hour city street and suffering a stroke? A group of researchers in Japan, have looked at stroke while driving and they may be on the way to pinpointing the risk factors that may potentially be modified to make driving safer for those at risk of stroke. 

Carmen Lahiff-Jenkins, Managing Editor of the International Journal of Stroke spoke to Dr Joji Inamasu from Saiseikai Utsunomiya Byoin, Department of Neurosurgery in Tochigi, Japan.

Thursday, August 3, 2017

Why stroke prevention is essential for Europe

This blog was contributed by Jelena Misita, Communication Manager for the Stroke Alliance for Europe. SAFE is a member of the World Stroke Organisation and supports the World Stroke Campaign.

Stroke is a humanitarian catastrophe happening in Europe as we speak. A combination of otherwise welcome factors - people are living longer and with better access to healthcare - has led to more people having and surviving stroke and more people being left with disabilities. The result is that the overall burden of stroke in Europe is set to rise dramatically over the next 20 years. This is why it essential that we understand and take action to prevent stroke from happening in the first place.

Wednesday, August 2, 2017

Dr Liu Yang and the importance of education in stroke prevention

Dr Liu Yang, a stroke neurologist from South west China started a 4 -month clinical placement this week at Guy’s and St Thomas NHS Foundation Trust. Invited by Professor Tony Rudd, Dr Yang’s training will take in the hyper-acute stroke unit, stroke rehabilitation, community support for stroke survivors and how stroke services are regulated and inspected.

What does stroke support look like in your country?
Stroke support in the community is really inadequate in South West of China. Given the fact that stroke is a leading cause of disability in China and there are millions of stroke survivors, we need to look to establishing stroke support services in the community, which can lead to greater awareness, better management of risk factors and improved quality of life for stroke survivors. 

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