Subhash Kaul.
Stroke in India: are we different from the world?.
Pak J Neurological Sci Jan ;2(3):158-64.

The last few decades have seen a rise in the incidence and prevalence of st roke in India, attributable to increasing life span, urbanization, and better survival, and the rates are now matching western figures. Hypertension, diabetes and smoking are the three major risk factors for stroke in India, as elsewhere. Low hemoglobin and low HDL cholesterol have also been identified as risk factors. Stroke in the young constitutes a higher proportion of stroke patients in India than in other countries, possibly due to the age structure of the population, and also perhaps from a preponderance of risk factors including infections, rheumatic heart disease, and cerebral venous sinus thrombosis. Ischemic heart disease is emerging as a major cardiac risk factor for ischemic stroke in India, while rheumatic heart disease continues to be a significant risk factor. As in most parts of the world, ischemic strokes predominate over intracerebral hemorrhage in India. Among ischemic strokes, intracranial atherosclerosis is the major stroke mechanism, although all other stroke mechanisms also contribute to stroke. Stroke is expected to assume epidemic proportions in India in the coming years and will strain its already limited health care infrastructure. Public education and strict control of risk factors at a primary care level is the most appropriate strategy for India to meet the growing challenge of stroke. This is a review article.

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