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Are You at Risk? Stroke is the Third-Leading Cause of Death in the United States

Posted on: Monday, 18 July 2005, 21:00 CDT

Knowing the risk factors, the symptoms and the need to get to an emergency room immediately all are key to reducing disability and death when it comes to stroke.

It's the message that state health officials and health organizations are working to send to the public and to health care workers.

"Our push right now is to get people to realize that numbness of the hands or tingling of the face might not just be your arm falling asleep," said Jamie Hahn, program manager of the Nebraska Health and Human Service System's cardiovascular health program.

The state has received a grant from the Centers for Disease Control and Prevention, which has been involved in stroke awareness efforts nationally, to improve stroke awareness and prevention. The state and the Nebraska Stroke Foundation in May launched a three- year "Strike Out Stroke" campaign with similar goals.

One message of that effort is that stroke, usually associated with the elderly, can happen at any age, Hahn said. Several of the examples featured on the www.strikeoutstroke.org Web site are teens.

The state and the American Heart Association are working on statewide plans on stroke prevention, awareness and care, with the state's plan to include heart disease.

"What we need to start doing is educating the public about warning signs and educating health care providers about what can and should be done," said Rajaena Appleby, community heart and stroke director for the American Heart Association in Omaha.

The heart association also plans to launch an awareness campaign later this year aimed at blacks, who have a greater risk of stroke, working with organizations such as the Black Family Health and Wellness Association.

People can avoid stroke, said Dr. Thaddeus Woods, director of Bergan Mercy Medical Center's emergency medicine department.

Don't smoke. And make sure you exercise, lose weight, watch your blood pressure and are aware of any family history of stroke.

"The boring thing that no one wants to talk about is prevention," he said.

What is stroke? Stroke is a brain injury that occurs when the blood supply to part of the brain is disrupted. When blood can't get through, the affected part of the brain can't get oxygen and brain cells begin to die. Strokes can be preceded by ministrokes, or transient ischemic attacks, that can serve as warnings for strokes.

Did you know?

Stroke is the third-leading cause of death in the United States, as well as in Nebraska and Iowa. Nationally, stroke kills about 163,000 people a year, about one of every 15 deaths. In Nebraska, stroke killed 1,126 people in 2001, accounting for about one in every 13.5 deaths. However, Nebraskans are less likely than other U.S. residents to die of stroke. The state's stroke mortality rate ranked 12th lowest among the 50 states and the District of Columbia in 2000. In Iowa, stroke claimed 2,073 people in 2003 and annually accounts for 7 percent to 8 percent of deaths. Costs: Americans will pay about $57 billion in 2005 for stroke-related medical costs and disability. Sources: American Stroke Association, Nebraska Health and Human Services System, Iowa Department of Public Health.

Leading risk factors Those that can't be controlled or treated Age: Stroke can happen at any age, and about 30 percent of strokes occur in people under age 50. After age 55, the risk doubles every decade. Gender: Stroke is more common among men than women, but women account for more than half of all stroke deaths. Heredity: Your risk is higher if parent, grandparent or sibling has had a stroke. Black people have a higher risk of stroke. Those that can Medical conditions: High blood pressure, diabetes, high cholesterol and artery and heart diseases. Those who have already had a stroke or mini-stroke are at greatest risk. Habits: Cigarette smoking is the No. 1 preventable risk factor for stroke; female smokers who use some forms of birth control have an even higher risk. Excessive alcohol use also increases risk. Physical inactivity, obesity or both can increase blood pressure and cholesterol and thereby risk of diabetes, heart disease and stroke.

Major types Ischemic: Make up about 80 percent of all strokes. Involve blockage of a blood vessel supplying the brain. Blockage occurs when clots form at fatty deposits inside vessels or when clots travel from other parts of the body to the brain.

Treatment: tPA, or tissue plasminogen activator, the clot#- #busting drug, can be administered through an IV to select patients within three hours of symptom onset, with the best outcomes in 90 minutes. Later, doctors can surgically remove blockage from arteries or use balloon angioplasty or stents to remedy fatty buildup. Hemorrhagic: About 20 percent of strokes occur when a weakened blood vessel in or around the brain ruptures. Leaking blood crushes brain tissue around it.

Treatment: Surgery or other procedures to repair burst artery. Sources: American Stroke Association, Stanford Stroke Center, Dr. Pierre Fayad.

New surgical technique: Corkscrew plucks out blood clots

Physicians can thread a miniature corkscrew into the brain that can pluck out a deadly blood clot during an ischemic stroke and quickly restore the flow to blocked blood vessels.

SOURCES: The Associated Press; Concentric Medical Inc.

Brain hemispheres

Left hemisphere (half) controls body's right side

Right hand Speech Written language Number skills Reasoning

Right hemisphere controls body's left side

Left hand Spacial sense Musical, artistic ability and awareness, creativity

Stroke warning signs Sudden numbness or weakness of face, arm or leg, especially on one side of body. Sudden confusion, trouble speaking or understanding. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness or loss of coordination. Sudden severe headache with no known cause.

Other important but less common symptoms: Sudden nausea, fever and vomiting that comes on in minutes or hours. Brief loss of or decrease in consciousness.

Note the time of onset of symptoms if possible. It could be important in treatment. If you're having symptoms, it's a medical emergency. Call 911.

Sources: National Stroke Foundation, American Stroke Association

Source: Omaha World - Herald

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