Winter and increased risk of Stroke

Bangalore is experiencing a chilling winter now and all are wrapped up in thermals and enjoying their morning sleep. However winter poses unique health risks which we need to be aware of. Certain neurological disorders like stroke, Bell’s palsy, neuropathy are known to increase during winter season, patients suffering from degenerative diseases like Parkinson’s disease and dementia are prone to infections and cold related medical issues.
The incidence of stroke is significantly increased in winter, especially when the temperature drops sharply in a cold period. Understanding this connection can help individuals take proactive measures to protect their health during the colder months. Mechanism of stroke in winter involves a cold-induced increase in blood pressure, increased blood viscosity causing hypercoagulation, and fibrinolysis. Patients are prone to develop heart attacks and there’s an increased risk of stroke during heart problems due to atrial fibrillation and clot formation in heart chambers.
Stroke is mainly of two types. Ischemic stroke occurs due to clot in the brain blood vessels causing death of neurons in the brain and accounts for 70-80% of stroke cases. Hemorrhagic stroke occurs due to rupture of one for the brain blood vessels causing bleeding into the brain parenchyma causing destruction of the neurons. . Ischemic stroke has been previously reported to be associated with low temperatures. Studies have shown that with every 1°C fall in temperature below the average daily temperature, there was a 3.9% increase in incidence of ischemic stroke. Exposure to low temperatures causes blood vessels to constrict, a process known as vasoconstriction. This can raise blood pressure, one of the most significant risk factors for stroke. For individuals with pre-existing conditions like hypertension, diabetes, or cardiovascular disease, the added strain on the heart and blood vessels during winter can be dangerous. Strokes happen in early morning hours or in the night causing delay in response by the family members.
Additionally, cold weather can increase blood viscosity, making it thicker and more prone to clot formation. Blood clots can block arteries in the brain, leading to ischemic strokes, the most common type. Moreover, physical inactivity during winter, as people stay indoors to avoid the cold, can exacerbate risk factors like obesity and high cholesterol. Food intake increases during winter leading to metabolic derangements. People tend to drink less water during winter as sweat rate is less adding to the disease burden.
Respiratory infections, such as flu, are also more prevalent in winter. Studies suggest that infections can trigger an inflammatory response, potentially destabilizing arterial plaques and leading to stroke.

How to recognize stroke symptoms?

Stroke and heart attacks together cause 30% of annual deaths in India. Stroke is the second leading cause of death globally and third in India. Identifying stroke symptoms and shifting patients to nearest stroke Ready hospital is crucial for patient’s recovery.
It’s crucial to recognize stroke symptoms promptly, as timely treatment can significantly improve outcomes. The acronym BEFAST is a helpful tool:
Balance: loss of balance
Eye signs: blurring of vision, loss of vision or double vision..
Face: Drooping on one side of the face
Arms: Inability to raise one or both arms
Speech: Slurred or incoherent speech
Time: Time to act fast and call emergency services
Treatment
If you identify stroke symptoms; please go to the nearest stroke Ready hospital in the golden hour. First four and half hours after onset of stroke symptoms is called as the golden hour during which time clot bursting medications can be administered. If large blood vessels are occluded, it can be removed by a procedure called mechanical thrombectomy. Surgery may be required if there’s a large bleed or swelling in the brain.

Measures to reduce stroke risk during winter:

Stay Warm: Dress in layers and keep your home adequately heated to avoid excessive cold exposure. Ensure that adequate ventilation is there in sleeping areas.
Monitor Health: Regularly check blood pressure and follow a healthy lifestyle, including a balanced diet and regular exercise.
Stay Active: Find indoor activities like yoga, stretching, or using gym equipment to maintain physical fitness. Minimise outdoor fitness activities during extremes of weather.
Boost Immunity: Get vaccinated against the flu and practice good hygiene to avoid infections. Take nutritious food
Manage Stress: Use techniques like meditation or breathing exercises to manage stress effectively.
Hydrate well during winter.
While winter brings many joys, it also demands vigilance regarding health. By understanding the heightened stroke risks associated with the season and taking proactive measures, Recognizing the signs of stroke and responding swiftly can save lives, making awareness and prevention essential parts of winter health care.
Dr. Prof. Suryanarayana Sharma, Senior Consultant Neurologist and Stroke Specialist, Apollo Hospitals Bannerghatta Road Bangalore, Founder Secretary, Karnataka Stroke Foundation Bangalore



_{Images are for reference only.Images and contents gathered automatic from google or 3rd party sources.All rights on the images and contents are with their legal original owners.}