In Kerala, according to the data of the Trivandrum Stroke Registry at the SCTIMST, the annual incidence of stroke is between 120-140 per 1 lakh population. The mortality rate is approximately 25%. About 40-50% of patients will have moderate to severe disability for life.
The India State-level Disease Burden Initiative, a joint initiative of the Ministry of Health, Indian Council of Medical Research (ICMR), Public Health Foundation of India (PHFI), and various stakeholders, recently published a comprehensive analysis of NCDs for every State, as part of the Global Burden of Disease Study 1990-2016. The results were published as a series in The Lancet Global Health.
In India, the estimated incidence is about 119-145/100,000 population. The study shows that between 1990 and 2016, there has been an increase by 2-3 times in stroke prevalence in the country, from 2.8 million in 1990 to 6.5 million in 2016. Stroke contributed to 7.1% of total deaths in 2016.
Stroke prevalence
The study put the crude prevalence of stroke in Kerala at >625 per one lakh population. Kerala, Goa and West Bengal are the States with the highest stroke prevalence in India.
High systolic pressure accounted for 54.6 % of the risk factors that contributed to Disability-adjusted Life Year (DALYs) due to cardiovascular diseases in India in 2016.
Again, amongst all States of India, Kerala was at the top when it came to high prevalence of systolic blood pressure and high total cholesterol amongst adults aged 30 plus years in 2016. According to the data from the Indo-US Collaborative Stroke Project, a multi-centric study conducted in five high-volume tertiary care centres in India, including the SCTIMST, published last year, over 30% of ischemic stroke cases in India are caused by atherosclerosis of the arteries supplying blood to the brain
Vascular risk factors
The study drew attention to the urgent need to address modifiable vascular risk factors in India, particularly smoking and hypertension .
The study reported that the mean age of stroke incidence in India is 58 years, which is much lower than that in the West. The percentage of women with stroke — 33% — is also lower than that in the West. Disability for life after stroke was 44%. Major risk factors were hypertension (61%), diabetes (36%) and tobacco use (32%)