Majority of Americans Ignore Stroke Symptoms
February 9, 2007 8:36am CST
The trend is a disturbing one, because rapid treatment can mean the difference between life and death, and between a minor and a major disability. "People don't need to be afraid to go get these symptoms looked at," said study author Virginia J. Howard, an epidemiologist with the University of Alabama-Birmingham. "They may be nothing, but prevention is so much better than treating the stroke. This is not like the boy who cried wolf." Howard presented her findings Wednesday at the American Stroke Association's annual meeting in San Francisco. According to the association, about 700,000 people in the United States suffer a stroke each year, and about 150,000 people die of stroke, making it the third leading cause of death in the United States. Between 15 percent and 30 percent of stroke survivors will suffer permanent disability. Racial and regional disparities in stroke prevalence and death are well-known. In particular, black Americans have higher death rates from stroke, and blacks and other people living in the southeastern United States are more likely to suffer a stroke. This presentation is part of a larger study trying to tease out the mysteries of the so-called U.S. Stroke Belt: the Carolinas, Georgia, Alabama, Mississippi, Tennessee, Arkansas and Louisiana, which have higher-than-average stroke death rates. "We're looking at reasons for the differences in stroke mortality between different people and different parts of the country," Howard explained. Researchers have already recruited more than 20,000 participants and are working toward 30,000. Participants include black and white adults aged 45 years and older. For this part of the study, researchers asked participants if they had experienced any stroke symptoms (such as sudden weakness, numbness, sudden loss of vision) and, if so, whether they had sought medical care. Researchers also asked if a health-care professional had told participants that they had suffered a stroke or a transient ischemic attack (TIA) -- also called a "mini" or "warning" stroke. Slightly more than half (51.4 percent) of those who reported symptoms but no physician diagnosis of a stroke did not seek medical care, the researchers said. Participants were 23 percent more likely to seek medical care if they had prior heart disease and 22 percent more likely if they had either high blood pressure or diabetes. Income also played a role in the decision to seek help. People with yearly incomes between $20,000 and $34,999 were the least likely to seek care -- in fact, they called for help 8 percent less frequently than people with incomes below $20,000 per year, the researchers found. Rates of care-seeking began to rise once more as incomes climbed past $35,000 a year. For example, compared to people with incomes under $20,000, those with an income of $35,000 to $74,999 were 27 percent more likely to seek care, and those with incomes above $75,000 were 55 percent more likely to seek care. Participants with health insurance were only marginally more likely to seek care, so insurance wasn't the prime issue here. "That's not explaining why people don't go," Howard said. She said that, in the case of stroke, knowledge really is power. "People don't think you can prevent a stroke, but you can," Howard said. "You just have to be aware of the risk factors and pay attention to those before you have a stroke." Risk factors include smoking, diabetes, high blood pressure, high cholesterol, family history, prior stroke, and advancing age, according to the American Heart Association. Experts also urge Americans to get to know the warning signs of a stroke, which include: sudden numbness or weakness of the face, arm or leg, especially on one side of the body; sudden confusion, including trouble speaking or understanding; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, or loss of balance or coordination; sudden, severe headache with no known cause. "This is really, really important," said Dr. Donald DiPette, chairman and professor of internal medicine at Texas A&M Health Science Center College of Medicine and Scott & White Hospital. "That's hundreds of thousands of people that we can educate. This is the first step before we can do something about it. You have to recognize the symptoms, you have to be seen, and the earlier we see you, the more likely we can do something about it. If it's a false alarm, that's great. But you've got to be seen," DiPette said.