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El ictus en pacientes de covid, cuatro veces más mortal que en aquellos que no se han contagiado Un dolor de cabeza intenso puede ser síntoma de ictus. Pexels.
Uno de cada cuatro adultos mayores de 25 años sufrirá a lo largo de su vida un ictus, una enfermedad cuya supervivencia depende del tiempo de reacción entre el episodio cardiovascular y la atención hospitalaria Los hábitos de vida saludables ayudan a reducir entre un 80 y un 90% los casos de ictus El peor dolor de cabeza de tu vida , el debilitamiento de una parte de la cara, brazos o piernas , pérdida de visión o imposibilidad para comprender o articular palabra . Son los principales síntomas del ictus, una enfermedad que solo este año afectará a 14 millones de personas en todo el mundo, según la Sociedad Española de Neurología (SEN). Esta enfermedad cerebrovascular es ya la segunda causa de muerte en la población española y la primera en mujeres . También es la primera causa de discapacidad adquirida en el adulto y la segunda de demencia.
Causas y prevalencia por edad "Se denomina ictus a cualquier episodio en el que se interrumpe el flujo sanguíneo que llega al cerebro. La causa más frecuente suele ser por un coágulo en alguno de los vasos que le suministran sangre, es lo que llamamos ictus isquémico. Pero también puede producirse por la rotura de alguno de estos vasos, produciendo una hemorragia : en este caso se tratará de un ictus hemorrágico", explica la doctora María Alonso de Leciñana, Coordinadora del Grupo de Estudio de Enfermedades Cerebrovasculares de la Sociedad Española de Neurología (SEN).
La incidencia de esta enfermedad aumenta significativamente con la edad, sobre todo a partir de los 65 años, y este incremento es exponencial a partir de los 85 años , tanto para los ictus isquémicos como para los hemorrágicos. El envejecimiento de la población y el aumento de la esperanza de vida indican que las enfermedades cerebrovasculares seguirán aumentando. En todo caso, el ictus no es una enfermedad que afecte solo a personas mayores. Según datos del registro de la SEN, el 27% de los ictus atendidos en los hospitales españoles corresponden a personas de menos de 65 años y 8% a pacientes con menos de 50 años.
Ictus y Covid 19, dos enfermedades unidas La relación entre ictus y Covid 19 ha sido un argumento habitual en estos meses de pandemia. "En este tiempo se ha publicado numerosa información, en ocasiones contradictoria, sobre la incidencia de ictus en enfermos de Covid 19. Aunque como en otras infecciones, el estado proinflamatorio y de hipercoagulabilidad inducido por el coronavirus puede desencadenar la aparición de ictus en pacientes predispuestos, actualmente no podemos afirmar que la infección por coronavirus aumente específicamente el riesgo de padecer un ictus y desde luego el ictus no es una de las principales complicaciones de la infección", señala Alonso. Sin embargo, la doctora explica que los datos sí apuntan a que los pacientes con Covid 19 que sufren un ictus lo padecerán de forma más grave y tendrán peor evolución .
El riesgo de muerte o dependencia en pacientes con ictus y con Covid 19 es hasta cuatro veces mayor que en los pacientes no contagiados por el virus. A demás, el ictus es la complicación neurológica grave más frecuente entre las personas que han padecido coronavirus, de acuerdo al registro que está llevando a cabo la Sociedad Española de Neurología.
"Aunque en este momento el ictus no es una de las complicaciones principales de la Covid 19, algunos estudios también apuntan a que tener antecedentes de ictus aumenta tres veces el riesgo de fallecer por esta infección. Por lo tanto, aconsejamos a todas aquellas personas que hayan superado un ictus, igual que al resto de la población, que sigan estrictamente las normas para evitar el contagio", mantiene la facultativa.
Hábitos de vida saludable para prevenir el ictus Independientemente de la edad como factor de riesgo, existen otros muchos factores de riesgo modificables como el consumo de tabaco, de alcohol, la inactividad física, la dieta poco saludable, el estrés, la hipertensión, la fibrilación auricular, el colesterol, la diabetes o la obesidad, que si se previenen o se tratan adecuadamente, ayudarían a reducir entre un 80 y un 90% el número de nuevos casos. A este respecto, el Grupo de Estudio de Enfermedades Cerebrovasculares acaba de publicar un documento con consejos sobre hábitos saludables para evitar el desarrollo de esta enfermedad, entre los que destacamos los siguientes.
Tabaco fuera De acuerdo a este documento, las personas fumadoras tienen el doble de riesgo de sufrir un ictus isquémico y entre dos y cuatro veces más de padecer un ictus hemorrágico. Además, el humo del tabaco también se ha relacionado con daño arterial temprano y, la exposición al humo en personas no fumadoras, también se ha asociado con un incremento del riesgo de ictus. Se ha calculado que, al cabo de un año de abandonar el tabaco, el riesgo de ictus se reduce a la mitad y que a los cinco años el riesgo se iguala al de los no fumadores.
Más alcohol, más riesgo de ictus También existe una clara relación entre el consumo excesivo de alcohol y el riesgo de ictus. El consumo excesivo de alcohol se asocia sobre todo con un aumento del riesgo de ictus hemorrágicos . Por otro lado, el consumo de grandes cantidades de alcohol en cortos periodos de tiempo se asocia como responsable de un importante factor de riesgo de los ictus isquémicos.
Estrés letal El estrés crónico también se ha relacionado con un mayor riesgo de padecer enfermedades cerebrovasculares. Mientras que el estrés psicosocial supone un factor de riesgo para esta enfermedad tan importante como la diabetes, el estrés laboral también se ha relacionado con un aumento en el riesgo de sufrir ictus , sobre todo en el caso de los ictus isquémicos.
Exceso de kilos, otro factor de riesgo La obesidad es un factor de riesgo establecido para el ictus. El exceso de peso está directamente relacionado con otros factores de riesgo como el sedentarismo, la hipertensión arterial o la diabetes . Cualquier persona obesa que consiga disminuir al menos un 10% de su peso original conseguirá reducir un 21% del riesgo de sufrir un ictus.
Dieta cuidada Una dieta baja en sal y en grasas saturadas y rica en frutas y vegetales y la práctica regular de actividad física moderada o intensa (al menos cuatro horas a la semana) también se asocia a menor riesgo de ictus. Por esa razón, es aconsejable la práctica de actividad física moderada de 150 minutos a la semana o la actividad física vigorosa de 75 minutos semanales para reducir el riesgo de ictus.
La contaminación, nuevo factor desencadenante Multitud de estudios epidemiológicos han demostrado la existencia de una relación directa entre la contaminación del aire y la incidencia de enfermedades vasculares. Se atribuye a la contaminación atmosférica el 19% de la mortalidad vascular y el 21% de las muertes por ictus .
Finalmente, los expertos de la SEN ponen el acento en la importancia de la atención temprana en cualquier episodio sospechoso. "Independientemente del tipo de ictus del que estemos hablando, se trata de una enfermedad cuya evolución y pronóstico depende enormemente del tiempo en el que se tarde en revertir esta situación. En el caso del ictus, cada minuto cuenta . Por eso es tan importante llamar al 112 ante la presencia de algún síntoma", concluye la doctora Alonso.
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