Why do so many Scots die from a stroke?

The Herald Scotland

29-05-2025

His son, James has told the Herald he had to wait 17 hours for the surgery that might have saved his life and are demanding changes to treatment in Scotland.
It has emerged that an NHS Greater Glasgow and Clyde's Significant Adverse Event Review (SAER) into Mr Bundy's death from August of last year, seen by the Herald states that there is no night-time provision - between 8pm and 8am - for thrombectomy across any health board area in Scotland.
What is a stroke?
A stroke occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. This can lead to brain cells dying within minutes. Strokes are medical emergencies that require prompt treatment to minimize brain damage and potential complications.
What is the stroke rate in Scotland?
The European Standardised Rate for strokes in Scotland in 2022-23 year was 479.2 per 100,000 of population, the highest since the start of Public Health Scotland's records in 2013-14, when it was 398.0.
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--------------------------------------------------------------------------------------------------------------------------Nearly 20,000 Scots have died from strokes over five years to the end of 2022.
There were 3,806 deaths in Scotland in 2023 where cerebrovascular disease, including stroke, was the underlying cause.
There are approximately 12,000 hospital admissions for stroke each year in Scotland, averaging 33 admissions per day.
In 2023/24, the number of new cases of cerebrovascular disease, including stroke, in Scotland was 239 per 100,000 population. This represented a nine per cent decrease compared to 262 per 100,000 in 2014/15.
Why do people die from a stroke?
Primarily because it disrupts the blood supply to the brain, depriving brain cells of oxygen and nutrients.
Brain tissue is highly sensitive to oxygen deprivation.
Within minutes, affected brain cells begin to die.
If blood flow is not quickly restored, critical areas of the brain that control breathing, heart function, and consciousness can be permanently damaged.
Eight five percent of case are ischemic strokes and they are caused by a blocked artery (blood clot or atherosclerosis).
James Bundy (left) with late father Tony (Image: Contributed) Brain tissue beyond the blockage begins to die and swelling (cerebral edema) can increase pressure inside the skull, compressing vital brain areas or cutting off additional blood flow.
Why have so many Scots died from a stroke?
Stroke is one of the biggest causes of Scotland after heart disease and cancer.
It has in the past been seen as being due to a combination of health inequalities, lifestyle factors, and systemic issues in prevention and treatment. While stroke mortality in Scotland has declined over recent years, it has historically been higher than in many other parts of the UK and Europe.
According to the Scottish Public Health Observatory, over the 20-year period from 1990 to 2010, Scotland had higher mortality rates for cerebrovascular disease, including stroke, than those in the rest of the UK and other Western European countries.
Public Health Scotland in a briefing last year said Scotland has a "high prevalence" of the risk factors associated with cerebrovascular disease such as smoking and high blood pressure. Despite a substantial decrease in rates of death over previous decade, treating and preventing stroke was seen as a national clinical priority for Scotland
According to University of Edinburgh guidance about strokes from last year there is concern that given increasing population exposure to some of the key risk factors for stroke in Scotland - obesity, smoking, alcohol misuse, high blood pressure, diabetes - that the incidence of stroke may increase in future years.
What treatments are available for stroke victims in Scotland?
Treatment for stroke in Scotland involves immediate medical intervention followed by rehabilitation: Thrombolysis involves the administration of clot-dissolving medication and is for ischemic strokes.
Thrombectomy involves the surgical removal of a blood clot from a brain artery.
Medications are often needed to control blood pressure, cholesterol, and prevent further clotting.
Multidisciplinary teams provide physiotherapy, occupational therapy, and speech-language therapy.
Community-based programs also support patients in regaining independence.
The Scottish Government's Stroke Improvement Plan launched three years ago emphasised equitable and timely access to diagnosis, treatment, and rehabilitation services across all regions.
What is the outlook for stroke survivors?
According to Public Health Scotland as of 2023, survival rates have improved, with 84% to 86% of patients surviving 30 days or more following their first emergency admission to hospital with a stroke over the past ten years.
(Image: Getty) However, recovery can vary. Some individuals recover fully, while others may experience long-term disabilities.
Rehabilitation can take months or years and may involve adapting to new ways of living.
But support services are available to assist stroke survivors in their recovery journey.
How can strokes be prevented?
According to the NHS, preventative measures include maintaining a healthy diet and regular exercise, controlling blood pressure and cholesterol levels and avoiding smoking and excessive alcohol consumption.
Additionally, managing underlying conditions like atrial fibrillation with appropriate medications can reduce stroke.