Quick, name one factor that puts you at high risk of stroke.
If you're like residents of the Cincinnati area who were polled recently, there's roughly a 30 percent chance that you can't do one or the other. It's an improvement over the last poll, taken five years ago, but still far from perfect, says a report in tomorrow's issue of the Journal of the American Medical Association.
That's bad, because knowing the signs of a stroke can help save your life when one happens, and knowing the risk factors can reduce the chance that one will happen.
And "groups of individuals with the highest risk and incidence of stroke, such as persons at least 75 years old, blacks and men, were the least knowledgeable about warning signs and risk factors," the report says.
The test was done by Dr. Alexander T. Schneider and colleagues at the University of Cincinnati, who called 2,173 local residents in 2000. They did the same thing in 1995, and found that 57 percent of those polled could name one warning sign of stroke and 68 percent could name one risk factor. This time, 70 percent named at least one sign that a stroke was occurring and 72 percent named at least one risk factor.
It's possible the increase in knowledge about warning signs is connected with the U.S. Food and Drug Administration approval in 1996 of tissue plasminogen activator (tPA), a clot-dissolving drug that can prevent much of the damage of a stroke if it is given in time, says Schneider, an assistant professor of neurology at the University of Cincinnati.
"There have been media reports about this new treatment, and there might have been a trickling down of knowledge," Schneider says.
It's important to detect a stroke as quickly as possible, because tPA must be given within three hours to be effective, he says. "It isn't used after three hours because of the risk of bleeding and other complications," he explains.
As for knowing the factors that increase the risk of stroke, the slight improvement is not statistically significant, Schneider says. "We have a long way to go," he says.
Recognizing the symptoms of a stroke and paying attention to the factors that increase its possibility are important because of the high toll taken by strokes, Schneider says.
"Stroke is the third leading cause of death and the number one cause of adult disability in the United States," he says. "There are 700,000 strokes a year in this country, and the direct and indirect costs are $45 billion."
Prevention is a lot better than quick treatment, Schneider says, and he would like to see more publicity about risk factors -- for example, on television, which was listed by 32 percent of people in the poll as their main source of information. Magazines were second (24 percent), newspapers third (22 percent), with physicians next (20 percent.) Unhappily, 19 percent of those polled said they gained knowledge because a family member had a stroke.
For the record, the symptoms of a stroke that call for immediate medical attention include:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body;
- Sudden confusion or trouble speaking or understanding speech;
- Sudden trouble seeing in one or both eyes;
- Sudden trouble walking, dizziness or loss of balance or coordination;
- And sudden severe headache with no known cause.
The risk factors for stroke should be familiar, since they are also risk factors for heart attack and other cardiovascular diseases: high blood pressure, smoking, diabetes, a previous stroke or transient ischemic attack, heavy drinking and high blood cholesterol.
You can get more complete information about stroke from the American Heart Association or the National Institute of Neurological Disorders and Stroke.