Stroke Doesn't Strike Fear in People

Prevention, treatment education are goals of Stroke Awareness Month

THURSDAY, May 2, 2002 (HealthDayNews) -- Stroke is the third leading cause of death in the nation, yet most people are either oblivious to the threat or uninformed about it.

In betting on the latter, the American Stroke Association (ASA) hopes to increase awareness and understanding of stroke risks and prevention during American Stroke Month, which lasts throughout May.

The organization cites surprising figures from a recent survey in illustrating just how uninformed -- or unfazed -- many are about the risk of stroke.

The survey of 1,000 people, taken in February by the ASA, indicates that only 10 people -- or just 1 percent -- considered stroke to be the health threat they feared the most. What makes that more surprising is that no less than 35 percent of the respondents said someone close to them had experienced a stroke.

The top health conditions the respondents worried about were cancer (33 percent), and heart disease or heart attack (13 percent). Stroke in fact tied for last, along with Alzheimer's, arthritis, osteoporosis and stress.

According to Dr. Jeffrey Harris, director of the stroke program at Huntsville Hospital in Alabama and a spokesman for American Stroke Association, one main reason why there appears to be less awareness about stroke is because the symptoms are not as well known.

"Everyone, even children, knows what a heart attack is and what it looks like to have a severe one because you commonly see characters on TV keeling over from a heart attack," he explains.

"The symptoms are very recognizable - - someone will clutch their chest, lose consciousness…," he says. Many heart attack symptoms, however, are more subtle.

But with stroke, the symptoms can be far less dramatic, Harris says: "Some symptoms are just problems with dizziness, the slurring of speech, loss of vision in an eye, or maybe your balance will be off."

And since those symptoms can be misinterpreted as many other conditions, many don't recognize the problem and -- sometimes at their peril -- don't respond appropriately.

Strokes occur when a part of the brain is deprived of oxygen long enough to impair the function of that area. That deprivation of oxygen can be caused either by a blood clot in the brain, a clot that has broken off from another part of the body and traveled to the brain, or the rupture of a blood vessel in the brain.

The diminished brain function can be manifested in anything from paralysis to memory impairment or loss of speech, depending on how long blood flow to the brain is disrupted.

That's where the importance of thrombolytic (clot-busting) drugs comes into the picture. If given to a patient within a few hours of a stroke, the drugs can minimize the amount of damage to the brain.

However, with so few recognizing the symptoms of a stroke, that's a big "if," and the ASA wants to prevent people from even reaching that point by encouraging the prevention of strokes in the first place.

That involves addressing the known "modifiable" risk factors for stroke, which include smoking, high blood pressure, high cholesterol and diabetes, to name a few.

"Smoking alone is a huge risk factor for stroke, especially in women," says Harris. "Even smoking one pack of cigarettes a day increases the risk of stroke in women by sixfold, or 600 percent."

Another common risk factor that frustrates experts -- because it's not nearly as well-addressed as it should be -- is an irregular heartbeat condition called atrial fibrillation.

"Strokes resulting from atrial fibrillation are far too common because they are highly preventable simply with a blood-thinning medication," explains Dr. Vladimir Hachinski, a professor of neurology at the University of Western Ontario, London, Ontario.

"Sadly, however, only about a quarter of people who have this condition take the medications, and you just have to ask yourself, 'Why?'" he says. "The answer is clearly lack of awareness and likely a bit of denial."

Hachinski says that in addition to an uninformed public, the medical community itself is partly to blame in not always identifying the early symptoms of stroke.

"It starts in medical school," he says. "Even medical students are intimidated by neurology because the brain is perceived as being so complicated, so they tend to veer towards other fields.?

To address the problem on all levels, ASA's campaign is extending its efforts to include educating medical students about stroke; providing health-care providers with better information on stroke treatments, and promoting guidelines that better address caring for stroke survivors.

"Our goal is to try to reduce stroke in this country by 30 percent over the next few years," Harris explains. "But we've really got a long way to go before we can even make a dent in the incidence of stroke."

The ASA cites the latest figures, from 1999, as showing that stroke accounted for about one of every 14.3 deaths in the United States, costing the nation nearly $50 billion in direct and indirect costs. About 600,000 people suffer a stroke every year and 160,000 people die; only heart failure and cancer kill more people.

What To Do

Visit the American Stroke Association for much more information on stroke risk factors and treatments.

And the National Institute of Neurological Disorders and Stroke has much more information on strokes.

SOURCES: Jeffrey Harris, M.D., spokesman, American Stroke Association, and director, stroke program, Huntsville Hospital, Huntsville, Ala.; Vladimir Hachinski, M.D., professor, neurology, University of Western Ontario, London, Ontario; American Stroke Association press release
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