Stroke: Morbidity, Risk Factors, and Care in Taiwan

Abstract

Stroke is the third leading cause of death and the most common cause of complex disability in Taiwan. The annual age-standardized mortality rate of stroke is steadily decreasing between 2001 and 2012. The average years of potential life lost before age 70 for stroke is 13.8 years, ranked the fifth in the cause of death. Its national impact is predicted to be greater accompany aging population. The most common type of stroke was ischemic stroke in Taiwan. Small vessel occlusion was the majority of ischemic strokes subtype. Age, gender, hypertension, diabetes hyperlipidemia, obesity, atrial fibrillation, and smoking were important contributory factors to stroke morbidity. The standard treatment for acute ischemic stroke in Taiwan is providing the intravenous thrombolysis with recombinant tissue plasminogen activator (IV tPA) therapy for ischemic stroke patients within 3 hours of symptom onset. However, the rate of IV tPA therapy for patients with acute ischemic stroke is still low in Taiwan. Therefore, improving the public awareness of stroke warning signs and act on stroke and improving in-hospital critical pathway for thrombolysis would be the most important and urgent issues in Taiwan. To improve acute stroke care quality, a program of Breakthrough Series-Stroke activity was conducted from 2010 to 2011 and stroke centers were established in the medical centers. For the prevention of stroke, it was successful to increased annual smoke cessation rate through the 2009 Tobacco Hazards Prevention Act and decreased obesity rate through a nationwide weight-loss program conducted by Health Promotion Administration from 2011 to 2013 in Taiwan.

Caspase-3 inhibitor prevents the apoptosis of brain tissue in rats with acute cerebral infarction

“…Due to its high incidence and fatality rate, it has become one of the most serious diseases affecting human health (1,2). The pathological basis of acute cerebral infarction is the disruption of blood supply in the brain, with ischemia and hypoxia causing ischemic necrosis and cerebral malacia in focal brain tissue (3). In the acute stage of cerebral infarction, vascular occlusion can lead to a reduction in blood flow in the affected region and create a hypoxic state; cerebral hypoxia and recanalization cause a stress response, leading to the release of a large number of free radicals and the stimulation of brain cells, causing neuronal cell apoptosis that ultimately results in a loss of biological function (4,5).…”

5,7-Dimethoxycoumarin inhibits neuronal apoptosis by targeting caspase-3 expression in rats with acute cerebral infarction

“…The disease is characterized by blockage of blood to brain tissues leading to ischemia and hypoxia followed by necrosis of cerebral tissues [3]. The advanced stage of the disease involves generation of reactive oxygen radicals inducing neuronal cell death and subsequent activity impairment [4,5].…”

Free-Radical Processes in Stroke Patients with Vascular Comorbidity

“…Th e decrease of stroke morbidity and increase of treatment effi cacy is a priority task of practical health care [3].…”