CHAPTER ONE

1.0       INTRODUCTION

1.1       BACKGROUND OF THE STUDY

Factors responsible for stroke among men aged (45-65) in Makera, are discussed under modifiable factors and non-modifiable factors. The modifiable factors are: Hypertension (High blood pressure), cigarette smoking, diabetes, sickle cell disease, atrial fibrillation, poor diet and socio-economic factors. Some of the non-modifiable factors are: Age, heredity (family history), race, sex, transient Ischaemic attack (TIA) or heart attack.

According to World Health Organization; WHO, (2006) “Cerebro vascular accident (stroke) is rapidly developing clinical signs of focal (or global) disturbance of cerebral function, lasting more than 24 hours or leading to death, with no apparent cause other than that of vascular origin.”.

World Heart Organization (2010), stated that Hypertension, is the single most important risk factor for stroke. It causes about 50% of Ischaemic strokes and also increases the risk of haemorrhagic stroke.

The damage that hypertension causes among men aged (45-65) happens over time and is often only diagnosed when considerable damages has already happened to the body’s blood vessels, which later on lead to stroke. WHO also reported that symptoms associated with hypertension include: tiredness, confusion, vision changes, angina-like chest pain, heart failure, haematuria, epistaxis, arrhythmia and tinnitus.

Ross and Wilson, (2010).Stated that “In contrast to a stroke, a Transient Ischaemic Attack (TIA) is a brief period of reversible cerebral deficit”. Mostly there is a short period (minute or hours) where there is weakness of a limb, los of speech followed by a complete recovery. TIA usually precedes a stroke or less commonly myocardial infarction. Stroke is one of the primary cerebrovascular that occurs when the normal blood supply to the brain is disrupted. Strokes are characterized as either ischaemic strokes, which involves a blockage of one or more blood vessels supplying the brain, or haemorrhagic stroke, in which blood vessels to the brain rupture. Brunner et al., (2011).

According to Burke (2010), stroke can occur at any age, but the highest incidence is in people over 65 years of age. Males have an increased incidence, as do with a family history of stroke. African Americans have twice the risk of developing stroke, Caucasians and Hispanics have a higher risks of strokes a younger age, often due to the presence of diabetes, hypertension and obesity.

Diabetes, which is modifiable factor off stroke affects 9.6% of American over age of 20years and 21% of Americans over the age of 60 years. Rosamond et al., (2008).

According to the National statistics on diabetes, the estimated number of Americans with diabetes is 20.8 million with an additional 41million with pre-diabetes.

National diabetes statistics (2015), stated that “with the rise in the obesity epidemic and the rising age of the population this number will undoubtedly increase in the future”. The relative risk of stroke in a person with diabetes ranges from 1.8 to 6.0 and diabetes tend to have strokes at a younger age. Pre-diabetes is a risk factor for the development of diabetes mellitus and in patients with a history of TIA or stroke, impaired glucose tolerance double the risk of stroke. Ross and Wilson, (2016).

While diabetes is a known risk factor for vascular disease and stroke, more data support the idea that the effects of abnormal blood glucose can adverse health consequences like stroke even before frank diabetes develops. Felton, Ogden, et al., (2015).

Hyperglycaemia in the setting of an acute stroke is known to extend the ischaemic penumbra and has an adverse effect on neurologic outcome.Burke, (2015).

1.2       STATEMENT OF THE PROBLEM

Cerebrovascular accident (stroke)across the globe has been a major cause of morbidity and mortality of both young and old, male and female.

Hence, the researcher investigated the morbidity, mortality and the factors responsible for stroke among men of these age group

1.3       RESEARCH QUESTIONS

1.        What are the factors, particular to men of this age group?

2.        What are the preventive measures in reducing the incidence of stroke among this group?

3.        How informed are men of this age group on the factors responsible for stroke?

4.        How has the ongoing campaign on the reduction of stroke benefited these age group?

1.4       OBJECTIVE OF THE STUDY

-        To identify factors responsible for stroke

-        To describe the factors that are responsible for stroke and their preventive measures

-        To access the knowledge of factors responsible for stroke among men aged (45-65) in Makera.

-        To estimate the percentage composition of each factor contributing to the incidence of stroke.

1.5       SIGNIFICANCE OF THE STUDY

-        This study will benefit people of various age groups at risk of stroke.

-        It will assist the health workers in achieving the optimal information and render the care needed by men in this age group.

-        It will enlighten the general public on the risk factors, instant actions to be taken and various preventive measures.

-        This study will shed more light on why men in this age group are mostly affected.

1.6       SCOPE OF THE STUDY

This study encompasses the various individuals (men) who fall within this age (45-46) in Makera, Kaduna South, Kaduna State.

1.7       OPERATIONAL DEFINITION OF TERMS

·       Hypertension: This is persistently high blood pressure.

·       Transient ischaemic attack (TIA): Is a brief period of reversible cerebral deficit.

·       Ischaemia: A deficiency in the supply of blood to a part of the body.

·       Aneurysm: A local dilatation of a blood vessel usually an artery.

·       Haemorrhage: An escape of blood from a ruptured blood vessel, internally or externally.

·       Morbidity: The state of being diseased.

·       Thrombosis: The formation of a thrombus or blood clot.

·       Anoxia: Lack of oxygen to an organ or tissue.

·       Hemiparesis: Paralysis on one side of the body.

·       Metabolism: This is the sum of the physical and chemical processes involved in anabolism and catabolism.

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