Stroke epidemic in India - time to prioritize prevention strategies.

N Communicable Diseases (NCD) pose great heal th burden and presents enormous challenge for health and national economies. Stroke is the second leading cause of death after ischemic heart disease and major cause of disability worldwide (World health statistics 2011). Current data suggest that approximately 20 million people suffer from stroke each year, 5 million die and 5 million more are left with chronic disability.1 I n I n d i a a n d o t h e r d e ve l o p i n g countries, rapid demographic, lifestyle, and socioeconomic transitions have significantly contributed to the emergence of the stroke epidemic.2 Attributable causes are increased prevalence of hypertension (contributed by work related stress), altered food habits, aging and rising tobacco consumption. Recent data, taking account of stroke survivors and stroke-caused deaths, suggest higher stroke rates as compared to the developed nations; the prevalence rate being 545.10 per 100 000 (95% CI, 479.68 to 617.05) and annual incidence rate of first-ever stroke (FES) at 145.30 (95% CI, 120.39 to 174.74); overall 30-day case fatality being 41.08%.3 Another study from Mumbai stroke registry showed 28 day fatality rate of FES cases at 29.8% and 38.5% were left with moderate to severe disability.4 With rising healthcare cost and failing economy, it is imperative to focus on primary and secondary prevention of stroke. Modification of risk factors itself can help achieve 2% reduction in overall stroke mortality per annum.5 The first significant step towards this goal is to col lect census verif iable demographic data on stroke incidence Editorial