Stroke is a syndrome caused by a disruption in blood flow to a part of the brain. It occurs when the blood vessel either ruptures or becomes blocked. A stroke deprives the neurons and other brain cells of glucose and oxygen, which leads to cell death. The longer the brain is deprived of oxygen and nutrients, the higher the likelihood of permanent damage to the brain.
Stroke prevention, care, rehabilitation and reintegration: priorities
- Ontario’s population will grow by 34.4 per cent between 2010 and 2036.
- In 10 years, almost one in five Ontarians will be over 65, an increase of 37.5 per cent since 2005.
- Almost 80 per cent of Ontarians over 45 have a chronic condition.
- Diabetes and obesity are on the rise among younger Ontarians.
- More than 7% of Ontarians report having diabetes and 52.6 % report being overweight or obese and 17.6% report having high blood pressure … and all of these risk factors are on the rise (2010 Canadian Community Health Survey).
Stroke factors you cannot control6
- Age – Your chances of having a stroke go up as you get older. Two thirds of strokes occur among people over 65. After age 55, the risk of stroke doubles every 10 years.
- Gender – Men have a slightly higher stroke risk than women. However, more women than men die from strokes because they tend to live longer than men.
- Ethnic origin – Canadians of First Nations/Aboriginal peoples and Canadians of African, Hispanic and South Asian descent have higher rates of high blood pressure and diabetes, which are conditions that can lead to stroke.
- Family history – Your risk is higher if your immediate family members (grandparents, parents or siblings) had a stroke before they were 65.
- Prior stroke or mini-stroke (transient ischemic attack/TIA) – Up to a third of people who survive a first stroke or mini-stroke (TIA) have another stroke within 5 years. A stroke survivor has a 20 per cent chance of having another stroke within two years.
Stroke factors you can control6
- High blood pressure – accounts for 35-50% of stroke risk. Almost 20% of Canadians have high blood pressure.
- High blood cholesterol – The link between high cholesterol and stroke isn’t as clear as the link between high cholesterol and heart attacks. However, researchers believe that high blood cholesterol can play a part in blocking the arteries leading to the brain.
- Irregular heartbeat (Atrial Fibrillation/AF) – those with AF are 5 times more likely to have a stroke and about 15% of stroke patients have AF.
- Diabetes – patients with diabetes are 2 to 3 times more likely to develop stroke. Almost 20% of people who have a stroke are diabetic.
- Drug Abuse – The use of illicit drugs such as cocaine and crack cocaine can cause a stroke. These drugs can cause narrowing of blood vessels resulting in less blood flow to the brain. Cocaine also affects the heart, causing abnormal heart rhythm and rapid heart rate that can lead to the formation of blood clots. Strokes caused by drug abuse are often seen in a younger population.
- Overweight – particularly those who have “central obesity” where extra weight is carried around the hips. Men with waist circumference of 40 inches or more and women with waist circumference of 35 inches or higher are at particularly high risk of stroke.
- Physical inactivity – people who exercise 5 or more times per week have a reduced stroke risk.
- Alcohol consumption – the link to stroke is not entirely clear however, in some studies, excessive alcohol consumption has been negatively linked to stroke.
- Smoking – doubles the risk of stroke. Quitting will significantly reduce the risk within two years. Within five years, your risk will be the same as someone who never smoked.
- Diet – eating a heart-healthy diet can reduce your risk of heart disease or stroke by 80%.
- Sleep Apnea –People with sleep apnea are approximately 1.6-2.72 3 times more at risk to have a stroke. Several studies have shown a link between people with sleep apnea who go on to have a stroke and also those people who have had a stroke that show a higher incidence of sleep apnea after the stroke. There is also evidence that stroke patients with obstructive sleep apnea appear to have increased risk of death if the sleep apnea is untreated.
- Stress/Depression – There is a growing body of research showing a link between stress and stroke. Stress is linked with stroke risk factors including, high blood pressure, smoking and being overweight. Research is also showing that depression
The Impact of Stroke in Ontario
- Stroke is the third leading cause of death and the leading cause of adult disability.
- More women than men die from stroke.
- More women die of stroke than breast cancer.
- There are an estimated 25,500 new stroke events in Ontario 15,500 hospital inpatient admissions, every year.
- At least every 30 minutes, there is one new stroke victim in Ontario.
- More than 5,500 (22%) of Ontarians die within one year of their stroke.
- The annual cost of stroke for new patients admitted to inpatients is > $1.1 billion annually7.
- One in five residents in long-term care has had a stroke.
The Impact of Stroke in Canada
- Stroke is the leading cause of adult disability in Canada and the third leading cause of death. Every year, nearly 14,000 Canadians die from stroke.
- Every year in Canada, there are over 50,000 new strokes—that’s one stroke every 10 minutes.
- About 426,000 Canadians are living with the effects of stroke.
- Canadians spend a total of three million days in hospital because of stroke every year.
- Stroke costs the Canadian economy more than $3.6 billion a year in physician services, hospital costs, lost wages, and decrease productivity.
- For every minute delay in treating a stroke, the average patient loses 1.9 million brain cells, 13.8 billion synapses, and 12 km of axonal fibres2.
- Each hour in which treatment does not occur, the brain loses as many neurons as it does in almost 3.6 years of normal aging (Saver, 2006)2.
- Stroke costs the Canadian economy $3.6 billion a year in physician services, hospital costs, lost wages, and decreased productivity (2000 statistic)3.
- Every year, patients with stroke spend more than 639,000 days in acute care in Canadian hospitals and 4.5 million days in residential care facilities4,5.
|Estimated Prevalence of Stroke Survivors Living with Disability in Canada By Region in 20131
Including residents of Homes for the Aged and Children ages 0‐11
||Prevalence of Stroke Survivors Living with Disability
||Prevalence of Stroke Survivors Living with Disability
(Age‐Adjusted to the 2013 Canadian Population)
||Estimated Number of Stroke Survivors Living with Disability
Of every 100 people who have a stroke:
Moderate to Severe Impairment (40%)
Severely Disabled (10%)
Minor Impairment or Disability (25%)
Recover Completely (10%)
1 Estimated Prevalence of Stroke Survivors with Disability in Canada February 25, 2015, H. Krueger & Associates, Inc.
2 Saver JL. Time is brain – Quantified. Stroke , 2006;37:263-66.
3 Public Health Agency of Canada. (2009). Tracking Heart Disease and Stroke in Canada, 2009. Retrieved from: http://www.phac-aspc.gc.ca/publicat/2009/cvd-avc/pdf/cvd-avs-2009-eng.pdf
4 Canadian Stroke Network. (2011). A family guide to pediatric stroke 2011.
5 Canadian Stroke Network. (2011). Quality of Stroke Care in Canada 2011. Retrieved from: http://www.canadianstrokenetwork.ca/wp-content/uploads/2011/06/QoSC-EN1.pdf
7 Conservative estimate based on ischemic stroke costs, does not include non-admitted ED pts. Can J Neurol Sci. 2012; 39: 793-800