December 4, 2013
News Review From Harvard Medical School -- Many Causes for Drop in Stroke Deaths
The U.S. stroke death rate has dropped 30% in the last 11 years, and a new report takes a look at the reasons. Because of the decline in deaths, stroke has slipped from third to fourth place among U.S. causes of death. Several causes appear to have had a role in this decline, a co-author of the report said. George Howard, Dr.P.H., is quoted in a December 3 article from HealthDay News. He said the most important reason may be improvements in control of high blood pressure. Another reason may be the reduction in smoking rates, he said. Cholesterol levels have declined as a result of better medicines. Treatments for stroke patients also have improved, Howard said. Howard teaches in the School of Public Health at the University of Alabama at Birmingham. He is a professor of biostatistics. The new report is a scientific statement from the American Heart Association and American Stroke Association. The journal Stroke is scheduled to publish it December 6.
By Reena L. Pande, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
We continue to make progress in decreasing the rates of death from stroke in the United States. A new study shows that stroke deaths have dropped by nearly 30% in the last decade. That is great news. Yet stroke remains a leading cause of death and disability.
What is a stroke? A stroke happens when a part of the brain doesn't get enough blood flow. This is called an ischemic stroke. A stroke can also occur when a blood vessel breaks and causes bleeding in part of the brain. This is called a hemorrhagic stroke.
The symptoms that arise from a stroke depend on what part of the brain is affected. Symptoms can include:
- Weakness or being paralyzed on one side of the body
- Garbled speech or loss of speech
- Visual changes, such as blurred vision or double vision
- Loss of balance or lack of coordination
Many factors can increase a person's risk of stroke. Some of the more common risk factors include:
- High blood pressure
- High cholesterol
- Abnormal heart rhythm (such as atrial fibrillation)
- Some medicines (for example, birth control pills in younger women)
What Changes Can I Make Now?
The most important way to reduce death from stroke is to take action and get treated quickly. The faster treatment begins and the sooner you get therapy after a stroke, the better your chances of recovery.
One way to figure out if someone is having a stroke is to remember the letters F-A-S-T.
1. F stands for face drooping. A stroke may make one side of the face droopy. Asking someone to smile can make this more obvious.
2. A stands for arm weakness.
3. S stands for speech difficulty. People having a stroke may be unable to form words or may have difficulty speaking.
4. T stands for time. Time is critical. When it comes to getting treatment for a stroke, faster is better. That means you need to get to the hospital right away. If something is really wrong, calling 911 is the safest first step. In fact, studies have shown that people who call emergency services often get life-saving treatment faster and stand a better chance of recovery.
Better recognition of stroke and earlier care may be two of the reasons for lower death rates from stroke. Several other factors may be contributing as well. These include:
- Fewer people smoking
- Improved cholesterol control and use of statin medicines
- Better blood pressure control
So, to limit your risk of ever having a stroke, it is also important to live healthy, eat right and exercise regularly. All of these can help to keep blood pressure and cholesterol under control.
What Can I Expect Looking to the Future?
This report is great news. It tells us that all the hard work of many advocacy and professional groups is getting out the message. People are hearing that stroke is a major problem, that it's preventable and that early recognition is key.
But we still have a lot of work to do. Despite the good news, stroke remains one of the leading causes of death in the United States. And it's still a major cause of physical limitation and disability. I hope that continued efforts in education, outreach and advocacy will help us continue to lower rates of death from stroke in the future.