UAE: Doctors raise alarm as stroke patients get younger

Doctors are alarmed with the rising number of younger stroke patients with around 9,000 to 12,000 UAE residents suffering from a stroke every year – with half of them under the age of 45, which is 20 years younger than the global average age of 65, according to Sheikh Khalifa Stroke Institute (SKSI).

Two cases were recently registered at Zulekha Hospital Sharjah. One was a 45-year-old male resident who was under medication for his diabetes. He was a smoker and recently experienced sudden weakness on the left side of his face and arm. Following clinical and radiologic examination, he was found to have an acute stroke for which he was treated, and then recovered.

There was another 42-year-old patient, who was hypertensive and on erratic medication. He had obstructive sleep apnea and an erratic dietary schedule. His sedentary lifestyle led to recurrent minor strokes. He was found to have stenosis of a major artery in the brain and with optimal management, he showed complete improvement.

Doctors said both patients had stroke risk factors which were not controlled and exacerbated by sedentary lifestyle.

Stroke is the second most common cause of death in the UAE, after a heart attack. It is also a leading cause of permanent disability. Stroke happens due to the sudden blockage of brain blood supply usually due to a blood clot. This can result in death of brain tissue (neurons) within minutes and cause stroke symptoms.

“Stoke, however, is preventable,” Dr Sandeep Burathoki, consultant interventional radiologist at International Modern Hospital Dubai, told .

“Individuals who get strokes usually suffer with sudden onset of limb weakness, speech difficulty, or difficulty in finding words, and an inability to use their hand or legs. If the patient arrives at the hospital or stroke centre within the window period of four and half hours, the clot can be dissolved using medicines, commonly known as clot busters,” he added.

“Advancement of endovascular treatment allows these clots to be removed from the brain using special metallic mesh (stent) or vacuum pump, and this treatment is offered up to eight hours of stroke onset and, in certain cases, up to 24 hours,” he added, underscoring: “Stroke can be prevented in 50 to 80 per cent of patients with lifestyle modification, which is extremely important in the prevention of stroke.”

Dr Gene Ann Thomas, specialist neurologist at Zulekha Hospital Sharjah, noted: “A significant proportion of the UAE population belongs to the younger age group. Hence, the higher incidence of stroke in these younger groups is truly alarming.”

“Like most lifestyle disorders which have shown a rise in the last few decades, stroke is linked to many modifiable factors like sedentary lifestyle, diet, and work stress. In the last few years, Covid has also been linked to vascular events like stroke and heart attacks. Smoking has also been linked with a multiplicative risk of stroke,” she added.

“Given the morbidity and mortality associated with young stroke patients, this calls for attention towards diet, exercise, and risk factor control starting with our younger generation,” she emphasised.

Dr Bahareh Bazooyar, specialist neurologist at Canadian Specialist Hospital Dubai, also highlighted “the worrying trend of younger stroke patients in the UAE, with the average age of onset now at 45".

She noted: “The country’s highly urban environment encourages a fast-paced lifestyle that can lead to stress, lack of physical activity, and reliance on high-calorie diets, increasing the risk of high blood pressure and diabetes among younger people.”

“There must be an emphasis on awareness and early screenings as this will lead to more frequent identification of risk factors in younger age groups,” she added.

Dr Victor Urrutia, professor of clinical neurology and director of the Sheikh Khalifa Stroke Institute (SKSI), said technology and AI (artificial intelligence) are helping in finding risk factors and future treatments of strokes.

He told : “We are doing work to extend the reach of hospitals by using telemedicine. This is so that we can ensure that even distant hospitals are acute stroke-ready hospitals which can identify and treat strokes right away.”

“We have worked with local healthcare personnel to develop the stroke system of care. Specifically, we helped Tawam Hospital to become a compressive stroke centre, and we have visited the Al Dhafrah region to assist hospitals for stroke treatment readiness,” added Dr Urrutia, who is also director at the Johns Hopkins Hospital’s Comprehensive Stroke Centre.

Meanwhile, Dr Anoop Narendran, specialist neurosurgeon at Medcare Royal Specialty Hospital, said: “People should adopt preventive measures to avoid risks of stroke. They should have regular health checkups to monitor blood pressure, blood sugar, and cholesterol levels as this helps identify and manage risks early on.”

"Apart from that they should maintain a healthy diet, exercise regularly, stay hydrated and manage their stress,” he added, warning that stroke is really dangerous as it often comes without warning signs.

He also warned to watch out for strokes that resolved themselves. “There is a subset of patients where stroke either almost happened or it was so small that the person was able to recover functionally right away, and therefore the symptoms appeared and disappeared within minutes,” he said.

“Patients who have have a TIA, a transient ischemic attack, have a higher risk of having a stroke in the next 30 to 90 days, and a subset of them have an even higher risk of having a stroke in the next 48 hours. So, the same way that we recommend that patients who have symptoms of stroke go to the emergency department to be dilated, we recommend that somebody who has symptoms of stroke that resolves right away, should also go to the nursing department right away,” he added.