Stroke is a common and frequent disease that threatens the health of middle-aged and elderly people. There are two types of strokes: ischemic strokes and hemorrhagic strokes. Ischemic stroke is cerebral thrombosis or cerebral infarction, and hemorrhagic stroke is cerebral hemorrhage. Recently, the survey data of the Stroke Prevention and Control Committee of the Ministry of Health showed that 83% of patients in China have ischemic stroke.
The symptoms of ischemic stroke are related to the site of the occluded blood vessel. The occlusion of blood vessels in the cerebral hemispheres can be characterized by sudden weakness or paralysis of the lateral limbs, numbness of half of the limbs, difficulty in seeing, or inability to speak or speak clearly; the occlusion of blood vessels in the brainstem and cerebellum can be characterized by spinning, numbness and weakness of bilateral limbs, tinnitus and choking on water, and in severe cases, nausea, vomiting, or even unconsciousness. What’s more, once a stroke occurs, 75% of the patients are left with sequelae, which brings a heavy burden to the patients themselves and their families. Therefore, the prevention and control of stroke is very important!
I. The current situation of stroke incidence in China
With the aging of the population, China has become a country with a high incidence of stroke. Every year, there are about 2.5 million new cases of stroke, and on average, one stroke occurs every 12 seconds. The latest survey of the World Health Organization shows that the incidence of stroke in China is increasing at a rate of 8.7% per year. The third survey of causes of death in China shows that more than 1.65 million people die of stroke each year, and stroke has risen to become the first cause of death. Currently, there are about 7 million surviving stroke patients in China, 2/3 of whom are permanently disabled.
Stroke brings a heavy emotional and economic burden to families, society and the country. The lack of health care awareness and the lack of attention to stroke risk factors and control of underlying diseases are the main reasons for the high incidence of stroke in China. According to the 2004 Health and Nutrition Survey of China’s urban and rural residents by the Ministry of Health, there are 160 million hypertensive patients, 90 million diabetic patients, 160 million dyslipidemic patients, 330 million smokers and 900 million passive smokers in China. The rate of attainment of the above basic disease control is less than 15%. These alarming figures remind us that targeted screening for stroke, especially for high-risk groups, and early intervention are urgent!
What is stroke screening?
In June 2009, the Ministry of Health Stroke Screening and Prevention Project was launched, which is a major national health intervention project in China.
One of the most important features of the “Ministry of Health Stroke Screening and Prevention Project” is the refinement of the cerebrovascular examination results, which are divided into 5 levels, and the standardized measures and treatment for each level.
1. Level 1: There is no problem with cerebrovascular and no risk factors for stroke or the number of risk factors is less than 2 points, which is normal – regular self-examination.
2. Level 2: No problem with cerebrovascular but the number of risk factors for stroke is 3, which is a low risk group – control the primary disease.
3, Level 3: Cerebrovascular problems, such as relatively stable atherosclerosis, belong to the intermediate risk group – adhere to long-term standardized medication to prevent progression; and receive regular vascular imaging examinations.
4.Grade 4: cerebrovascular mild to moderate stenosis, belonging to the high-risk group – must take long-term medication to control, and regular imaging examinations to observe the changes of the degree of stenosis.
5.Grade 5: Severe stenosis of cerebral blood vessels, which is a very high-risk group – it is recommended to choose surgical treatment according to the condition.
C. Where can hospitals do stroke screening?
After a rigorous selection process, the Brain Prevention Committee of the Ministry of Health has awarded 99 tertiary hospitals with high medical level and influence as “Stroke Screening and Prevention Base Hospitals of the Ministry of Health”, initially building a national stroke prevention and treatment network system. These hospitals will screen people with high risk of stroke, such as hypertension, diabetes, coronary heart disease, hyperlipidemia and smoking, and establish health management files to guide patients to prevent and treat stroke.
Currently, Beijing has launched a free stroke screening program, which will screen 20,000 city residents over 45 years of age in 55 primary care institutions in 16 districts and counties for stroke and carotid artery stenosis free of charge. Eligible citizens can bring their ID cards or hukou books to the designated community health service center or street office near their place of residence to make an appointment for registration, and those who are verified to be eligible will receive physical examination, questionnaire and ultrasound screening.
IV. What are the risk factors for stroke?
1. Major risk factors
(1) Hypertension (including patients who are taking antihypertensive drugs)
(2) Hypercholesterolemia (including patients who are taking lipid-lowering drugs).
(3) Diabetes mellitus.
(4) Age over 50 years.
2. General risk factors
(1) Atrial fibrillation (AF) or have other heart disease.
(2) Having whistling sleep apnea (snoring).
(3) History of stroke or heart disease in the immediate family (parents, siblings, children).
(4) Smoking.
(5) heavy alcohol consumption.
(6) Lack of physical activity.
(7) Diets containing too much saturated fatty acids or fats.
(8) Significant overweight or obesity.
(9) Male.
(10) Frequent bleeding, swelling and pain of the gums, recession, loosening and loss of teeth.
(11) Ischemic eye disease.
(12) Sudden deafness.
Stroke screening is recommended for those with 2 of the above major risk factors, or 1 major risk factor and 2 or more general risk factors (including 2), or a previous history of stroke/transient ischemic attack (TIA).