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Reducing your risk of stroke: information for
South Asian people
Stroke can happen to anyone at any time, but if you are South
Asian (someone of Bangladeshi, Indian, Sri Lankan or Pakistani
origin) you may have a higher risk of stroke than other people in
the UK. This factsheet explains the factors that can make you
more at risk of a stroke and what you can do about them.
What is a stroke?
A stroke is a brain attack. It happens when the blood supply to
part of your brain is cut off. It can be caused by a blockage in
one of the blood vessels leading to the brain or by a bleed in
the brain.
Blood carries essential nutrients and oxygen to your brain.
Without blood your brain cells can be damaged or die.
Strokes affect people in different ways depending on the part of
the brain that is affected, how widespread the damage is and
how healthy you were before the stroke.
A stroke can affect the way your body functions as well as
your thought processes and how you feel and communicate.
The FAST test (below) can help you to recognise the symptoms
of a stroke. These symptoms usually come on suddenly. Other
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
1
symptoms include sudden weakness or numbness on one side
of the body, sudden confusion, dizziness or unsteadiness.
Facial weakness
Can the person smile?
Has their mouth or eye drooped?
A rm weakness
Can the person raise both arms?
Speech problems
Can the person speak clearly and
understand what you say?
Time to call 999
A stroke is a medical emergency.
If you see any one of these signs, seek
immediate medical attention.
A transient ischaemic attack or TIA is similar to a stroke but
the symptoms are temporary – usually lasting from a few
minutes up to 24 hours. A TIA is serious and should not be
ignored. If you experience any of the symptoms described
above you must call 999, as there is no way of telling whether
you are having a TIA or a stroke when the symptoms first start.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
2
What do I need to know about stroke if I am South
Asian?
Studies show that in the UK stroke-related deaths are higher
among South Asian people than white people. The reasons for
this are complex and not completely understood.
What we do know is that if you are South Asian you are more
likely to develop high blood pressure, diabetes or high
cholesterol, which are all risk factors for stroke.
Some of the lifestyle factors that increase your risk of
developing these medical conditions, and therefore of having
a stroke, are also known to affect some South Asian people
more than the rest of the UK population. These include carrying
weight around your waist, a lack of exercise and using tobacco.
What factors will increase my risk of stroke?
High blood pressure
High blood pressure is the most important risk factor,
contributing to around 53% of all strokes. South Asian people
are more likely to have high blood pressure than the rest of
the UK population.
Blood pressure is the measure of how strongly your blood
presses against the walls of your arteries when it is pumped
around your body. If this pressure is too high it puts a strain on
your arteries and heart, which can cause health problems and
lead to a stroke or heart attack.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
3
High blood pressure (known as hypertension) develops when
your blood pressure is consistently too high (140/90mmHg or
higher).
High blood pressure puts a strain on all the blood vessels in your
body, including the ones leading to and within your brain. This
makes a blockage more likely to develop or a blood vessel in the
brain to weaken and bleed, both of which could cause a stroke.
What can I do about high blood pressure?
High blood pressure does not have any symptoms so the only
way to check is to have your blood pressure measured
regularly. If you are over 40 you should get your blood pressure
checked at least once every five years and more often if it is high
or you have other health problems. This can be done by your GP
or nurse, or you can check it yourself with a home testing kit.
Leading a healthy lifestyle can help to reduce your risk of high
blood pressure. You can read more about this further on in this
factsheet.
Diabetes
South Asian people are twice as likely to develop diabetes
than the rest of the UK population, and are more likely to develop
it at an earlier age.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
4
Diabetes is a condition caused by too much sugar (known as
glucose) in the blood. This is why people with diabetes may say
they’ve “got sugar”. There are two main types of diabetes:
 Type 1 develops when the body stops producing insulin, a
hormone that helps your body to use up the glucose in your
bloodstream. This type of diabetes usually begins in childhood
or adolescence.
 Type 2 diabetes develops when your body does not
produce enough insulin or when your body does not react to
it in the right way. This type of diabetes is much more common
and tends to develop gradually, usually in adulthood.
Having diabetes almost doubles your risk of stroke. This is
because high levels of glucose in the blood can damage your
blood vessels, making them harder and narrower and more likely
to become blocked. If this happens in a blood vessel leading to
or within the brain it could cause a stroke.
What can I do about diabetes?
As South Asian people are more at risk of developing diabetes it
is important that you get checked by your GP, especially if
you are over the age of 25 and you have any of the other main
risk factors for developing the condition:
•
a history of diabetes in your family
•
you are overweight or obese
•
you have had diabetes during pregnancy.
If you have diabetes, you must have regular check-ups with
your GP or at a diabetes clinic to make sure your blood glucose
and blood pressure stay at healthy levels.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
5
Although there is no cure, diabetes can often be managed by
making changes to your lifestyle, such as altering your diet or
doing more exercise. There are tips about leading a healthier
lifestyle further on in this factsheet.
Atrial fibrillation (AF)
AF is a type of irregular heartbeat that can cause blood clots to
form in the heart. If these clots block the blood supply to your
brain, it can lead to a stroke.
Some studies suggest that South Asian people are less likely to
have AF than white people. However, if you are South Asian and
do have AF, your risk of stroke could be slightly higher, because
you’re more likely to have other risk factors (such as diabetes
and high blood pressure) as well.
What can I do about AF?
Your doctor can test whether you have AF by checking your
pulse and performing an electrocardiogram (ECG) – a simple
and painless test that records the rhythm and electrical activity of
your heart.
If you have AF you can be treated with blood thinning medication
such as warfarin, or drugs called novel oral anticoagulants,
which can reduce your risk of stroke by 50–70%.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
6
High cholesterol
Cholesterol is a fatty substance and is vital for your body to
function properly. Most of the cholesterol in our body is made by
the liver, but it can also be absorbed from some of the foods
we eat.
Cholesterol is carried in your blood by proteins and when they
combine they form lipoproteins. There are two types of
lipoprotein:
 Low-density lipoprotein (LDL) carries cholesterol from your
liver to the cells that need it. It is often called ‘bad
cholesterol’ because if there is too much, it can build up in
your artery walls.
 High-density lipoprotein (HDL) is known as ‘good
cholesterol’ because it carries cholesterol away from the cells
and back to your liver, where it is either broken down or
passed out of the body.
It is the overall balance of good and bad cholesterol in the body
that affects your risk of having a stroke. Too much bad
cholesterol in your blood can cause fatty deposits to build
up in your arteries and restrict the flow of blood. It also
increases the chance of a blood clot developing.
South Asian people are more likely to have high levels of
total cholesterol in their blood than people in other ethnic
groups. In addition, some research suggests that South Asian
people’s cholesterol is made up of lower levels of HDL and that
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
7
their LDL is more likely to cause fatty deposits compared to
people in other ethnic groups.
What can I do about high cholesterol?
High cholesterol has no noticeable symptoms, so you need to
have your cholesterol level checked, especially if you are over
40 and have any of the other main risk factors for developing the
condition:
 a history of heart disease or high cholesterol in your family
 you are overweight
 you have high blood pressure or diabetes.
Your GP can check your cholesterol level with a simple blood
test. Making changes to your lifestyle can help to reduce your
cholesterol but if your doctor thinks that you are at a high risk of
developing heart disease or stroke he or she may suggest that
you take medication to help reduce your cholesterol. Drugs
called statins can help to prevent fatty deposits forming and
reduce your risk of stroke.
Your lifestyle
Some of the factors that increase your risk of stroke are things
that you can’t control like your age, gender, ethnic origin, family
history and medical background. However there are other factors
related to your diet and lifestyle that you can change.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
8
Tobacco
Smoking doubles your risk of having a stroke and the more
you smoke, the greater your risk. Smoking reduces the amount
of good cholesterol in your blood and carbon monoxide from
cigarette smoke damages artery walls and makes your blood
more likely to clot.
Many South Asian people do not smoke cigarettes, but some
groups, like Bangladeshi men, have very high levels of
cigarette smoking compared to the rest of the population.
Using gutka, qimam/kimam, paan or naswar (sometimes
known as ‘smokeless tobacco’ products) is also harmful to your
health. Studies have shown that people who use them are more
likely to die from a stroke than people who don’t.
Other products like bidi/beedi and shisha include tobacco so
if you smoke these you are at risk of the same kinds of diseases
as cigarette smokers, including stroke. The World Health
Organisation has shown that in one session of using shisha you
can inhale as much smoke as if you smoked 100–200 cigarettes.
The nicotine in tobacco is highly addictive so giving up is not
always easy, but there is a lot of support available to help
you. You should be able to find an NHS service near to you, who
can give you advice on the best way to quit. Speak to your GP or
call the NHS Smokefree helpline to find your nearest service.
You can find helpline numbers at the end of this factsheet.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
9
Alcohol
If you do drink alcohol, keep within the safe limits recommended
by the government. The guidelines say that men and women
should drink no more than 14 units per week.
Drinking a lot in a single session is particularly risky, as it can
cause your blood pressure to rise very quickly. To reduce your
risk:
 spread out your drinking over the week
 have several dry days in a week.
Weight
Studies in England have shown that South Asian people carry
more weight around their waist than the rest of the
population. If you carry extra weight around your waist you are
more likely to develop diabetes, high blood pressure or other
health problems.
The South Asian Health Foundation suggests that South Asian
men whose waist measures over 90cm and South Asian women
whose waist measures over 80cm should be considered
overweight.
Diet
Eating a healthy, balanced diet can help to lower your blood
pressure and the amount of cholesterol in your blood. It can also
help to control diabetes. All of this will reduce your risk of
having a stroke.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
10
We should all eat a variety of fruit, vegetables, starchy food and
protein. Here are a few tips for eating a healthy diet:
 Eat more fruit and vegetables
Fruit and vegetables are an important source of vitamins and
minerals and you should aim to have five portions of fruit and
vegetables every day.
A third of your daily diet should be made up of starchy foods
such as bread, cereals, rice and potatoes. Doubling up on
these at mealtimes, by combining potato with chapatti, rice,
puri or naan for example, can lead to an unbalanced diet. Try
to rebalance your meals by adding more vegetables or a
salad.
 Eat more fibre
Foods that are high in fibre help to reduce the amount of
cholesterol in your blood, so eat more wholegrain cereals,
brown rice or grains such as couscous.
 Eat more healthy protein
Meat, fish, beans, lentils and peas are all good sources of
protein and you should aim to have two portions every day.
Most red meat is high in saturated fat, which can raise your
cholesterol, so limit the amount you eat.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
11
Vegetarian or vegan sources of protein include tofu,
mycoprotein (such as Quorn), textured vegetable protein and
tempeh.
Milk and other dairy products can also provide a good source
of protein but try to use low fat options. When making lassi,
paneer, yoghurt or pudding use semiskimmed instead of fullfat milk.
 Cut down on fat and sugar
We all need small amounts of fat and sugar in our diets, but
too much can lead to weight problems. Food that has been
fried in butter or ghee will contain high amounts of fat.
Sweetmeats such as jalebi, ladoo, gulab jamun and burfi
contain a lot of sugar, so try not to eat them every day.
 Try new ways of cooking
How you prepare your food is just as important as what you
eat. Steaming, boiling and grilling are all healthier than frying,
which adds extra fat. Fried foods such as samosas, pakoras,
chips or fried bread like bhaturas or puri should be enjoyed as
occasional treats, rather than a regular part of your diet.
 Watch the salt
Too much salt can increase your blood pressure. Therefore
you should not eat more than 6g (or a teaspoon) of salt per
day. Much of the salt we eat is ‘hidden’ in processed foods
such as ready meals, sauces and snacks like chevda, ganthia,
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
12
sev and salted nuts. Keep these as an occasional treat and
avoid adding salt to food when you’re cooking or at the table.
Exercise
Regular exercise can reduce your risk of having a stroke by
lowering your blood pressure and helping you to maintain a
healthy weight.
Some South Asian people (Pakistani and Bangladeshi people in
particular) are known to exercise less frequently than the rest of
the population.
Research shows that regular exercise can reduce your risk of
stroke by 27%. You should aim to do at least 30 minutes of
moderate physical activity five or more times a week. You
don’t have to do all 30 minutes at once, it can be broken up into
smaller blocks of time throughout the day.
You can choose any form of exercise as long as the activity
increases your heart rate and makes you feel warm and a little
out of breath. So, you could try yoga or dancing or simply make
small changes to the things you do every day – walking to the
shops or using the stairs instead of a lift can all count towards
your daily total.
If you haven’t been active for some time, and especially if you’re
over 40 or have a medical condition, make sure you speak to
your doctor before you start doing lots of physical activity.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
13
How can I find out more?
Talk to us
At the Stroke Association, our helpline team can give you
information about stroke and tell you about services and support
available in your local area.
Call us on 0303 3033 100 (Monday to Friday, 9am-5pm) or email
[email protected]
You can speak to our helpline in any language you choose
through a telephone interpreter. Just call us, tell us the
language you’d like to use, your name and telephone number
and we will call you back – there’s no charge for using this
service.
Get online
We have lots of information about stroke and how to prevent it
on our website. Go to stroke.org.uk
Read our publications
We also produce a range of other leaflets and factsheets about
stroke and related issues. You can download these for free or
order a printed copy to be posted to you via our website
stroke.org.uk or by calling the helpline on 0303 3033 100.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
14
Some of our other factsheets include:
 High blood pressure and stroke (F06)
 Diabetes and stroke (F15)
 Atrial Fibrillation (AF) and stroke (F26)
 Smoking and the risk of stroke (F19)
 Alcohol and stroke (F13)
 Healthy eating and stroke (F08)
 Exercise and stroke (R07).
Our leaflet How to prevent a stroke is also available in Bengali,
Gujarati, Hindi, Punjabi and Urdu.
Other useful contacts
If you’re looking for more information the following organisations
may also be able to help. All are UK wide unless otherwise
stated.
Please note that details of these organisations are for
information only. We are not recommending or endorsing anyone
by including them in this factsheet.
NHS Brainstroke
Website: www.brainstroke.org.uk
Provides information about stroke for South Asian communities,
including information in Urdu, Sylheti, Punjabi and Gujarati.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
15
NHS Inform
Website: www.nhsinform.co.uk
Provides health and care information for people in Scotland. Its
‘Common health questions’ section has information on blood
pressure, diet and lifestyle.
Blood Pressure UK
Website: www.bloodpressureuk.org
BP Info Line: 0845 2410989
Works to lower the nation’s blood pressure and tries to prevent
stroke and heart disease. A range of publications is available.
British Heart Foundation
Website: www.bhf.org.uk
Heart Helpline: 0300 330 3311
Publications Order Line: 0870 600 6566
Offers a wide range of publications on heart conditions and blood
pressure. The helpline is staffed by cardiac nurses who can
provide information on heart and health issues.
British Nutrition Foundation
Website: www.nutrition.org.uk
Tel: 020 7557 7930
Email: [email protected]
Provides information on nutrition and healthy eating.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
16
Confederation of Indian organisations (UK) Stroke project
Website: www.ciostrokeproject.co.uk
Tel: 0116 266 8068
Works to prevent stroke in South Asian communities and to
ensure that their needs are included within national and local
policy and services.
Diabetes UK
Website: www.diabetes.org.uk
Careline: 0845 120 2960
Provides information and support for those affected by diabetes.
Heart UK
Website: www.heartuk.org.uk
Helpline: 08454 505 988
Email: [email protected]
Works to prevent premature deaths caused by high cholesterol.
On Fridays the Helpline provides dietary advice in Punjabi, Urdu
and Hindi.
NHS Smokefree
Website: www.smokefree.nhs.uk
English helpline: 0800 022 4332
Urdu helpline: 0800 169 0881
Punjabi helpline: 0800 169 0882
Hindi helpline: 0800 169 0883
Gujarati helpline: 0800 169 0884
Bengali helpline: 0800 169 0885
Offers information and support for stopping smoking.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
17
South Asian Health Foundation
Website: www.sahf.org.uk
Tel: 020 3313 0677
Email: [email protected]
Promotes healthcare research in the South Asian community
and campaigns on health issues.
Weight Concern
Website: www.weightconcern.org.uk
Tel: 020 7679 1853
Email: [email protected]
Offers advice and information on healthy eating and weight loss.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
18
About our information
We are committed to producing clear, accurate and unbiased
information for stroke survivors, their families and friends. To
produce our publications we use information from professional
bodies and other reliable sources including NIC, SIGN, Royal
College of Physicians, medical journals and textbooks. For a list
of all the sources used in this factsheet go to stroke.org.uk
© The Stroke Association 2014
Factsheet 32 version 3.1
Published March 2016.
Next review March 2018.
The Stroke Association is a Company Limited by Guarantee,
registered in England and Wales (No 61274). Registered office:
Stroke Association House, 240 City Road, London EC1V 2PR.
Registered as a charity in England and Wales (211015) and in
Scotland (SC037789). Also registered in Isle of Man (No 945)
Jersey (NPO 369) and serving Northern Ireland.
Stroke Association Factsheet 32 version 3.1 March 2016
Call our helpline on 0303 3033 100 or visit stroke.org.uk
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