Sedgwick County, Kansas EMS
Stroke

Every 45 seconds, someone in America has a stroke.  About 700,000 Americans will have a stroke this year.  Stroke is our nation's No. 3 killer and a leading cause of severe, long-term disability.  The American Stroke Association spends more on stroke-related research and stroke-related programs than any other not-for-profit organization, second only to the federal government.

Impact of Stroke

Every 45 seconds, someone in America has a stroke. Every 3 minutes, someone dies of one.

Stroke killed an estimated 163,538 people in 2001 and is the nation's third leading cause of death, ranking behind diseases of the heart and all forms of cancer. Stroke is a leading cause of serious, long-term disability in the United States. 

• In 2004 the estimated direct and indirect cost of stroke was $53.6 billion.
• Each year about 700,000 people experience a new or recurrent stroke. About 500,000 are first attacks, and 200,000 are recurrent attacks.
• From 1991 to 2001 the death rate from stroke declined 3.4 percent, but the actual number of stroke deaths rose 7.7 percent.
• Each year about 40,000 more women than men have a stroke. Because women live longer than men, more women than men die of stroke each year. Women accounted for 61.4 percent of U.S. stroke deaths in 2001.
• The 2001 death rates per 100,000 population for stroke were 56.5 for white males and 85.4 for black males; and 54.5 for white females and 73.7 for black females.
• About 4.8 million stroke survivors are alive today.
• In 1999, more than 1.1 million American adults reported difficulty with functional limitations, activities of daily living, etc., resulting from stroke. 
• From the early 1970s to early 1990s, the estimated number of noninstitutionalized stroke survivors increased from 1.5 to 2.4 million.
• In the National Heart, Lung, and Blood Institute's Framingham Heart Study, among ischemic stroke survivors who were at least 65 years old, these disabilities were observed at six months post-stroke:

What is Stroke?

Stroke is a type of cardiovascular disease. It  affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it starts to die.

Clots that block an artery cause ischemic (is-KEM-ik) strokes. This is the most common type of stroke, accounting for 70-80 percent of all strokes.

Ruptured blood vessels cause hemorrhagic (hem-o-RAJ-ik) or bleeding strokes.

When part of the brain dies from lack of blood flow, the part of the body it controls is affected. Strokes can cause paralysis, affect language and vision, and cause other problems. Treatments are available to minimize the potentially devastating effects of stroke, but to receive them, one must recognize the warning signs and act quickly!

What Are the Effects of Stroke?

The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow can't reach the region that controls a particular body function, that part of the body won't work as it should.

If the stroke occurs toward the back of the brain, for instance, it's likely that some disability involving vision will result.  The effects of a stroke depend primarily on the location of the obstruction and the extent of brain tissue affected.

Right Brain
The effects of a stroke depend on several factors including the location of the obstruction and how much brain tissue is affected.  However, because one side of the brain controls the opposite side of the body, a stroke affecting one side will result in neurological complications on the side of the body if affects. For example, if the stroke occurs in the brain's right side, the left side of the body (and the right side of the face) will be affected, which could produce any or all of the following:

• Paralysis on the left side of the body   
• Vision problems   
• Quick, inquisitive behavioral style   
• Memory loss

Left Brain
If the stroke occurs in the left side of the brain, the right side of the body (and the left side of the face) will be affected, producing some or all of the following:

• Paralysis on the right side of the body   
• Speech/language problems   
• Slow, cautious behavioral style   
• Memory loss

Stroke Risk Factors

Risk factors are traits and lifestyle habits that increase the risk of disease. Extensive clinical and statistical studies have identified several factors that increase the risk of stroke. Most of them can be modified, treated or controlled. Some can’t.

The more risk factors you have, the higher your chances to have a stroke. The best way to prevent a stroke is to reduce your stroke risk factors. A health care provider can help you change factors that result from lifestyle or environment.

What risk factors for stroke can be controlled or treated?

• High blood pressure -- High blood pressure (140/90 mm Hg or higher) is the most important risk factor for stroke.  It usually has no specific symptoms and no early warning signs. That’s why everybody should have their blood pressure checked regularly.
• Tobacco use -- Cigarette smoking is a major, preventable risk factor for stroke. The nicotine and carbon monoxide in tobacco smoke reduce the amount of oxygen in your blood. They also damage the walls of blood vessels, making clots more likely to form. Using some kinds of birth control pills combined with smoking cigarettes greatly increases stroke risk.  If you smoke, get help to quit NOW!
• Diabetes mellitus -- Diabetes is defined as a fasting plasma glucose (blood sugar) of 126 mg/dL or more measured on two occasions. While diabetes is treatable, having it still increases a person's risk of stroke. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight. This increases their risk even more. If you have diabetes, work closely with your doctor to manage it.

• Carotid or other artery disease -- The carotid arteries in your neck supply blood to your brain. A carotid artery narrowed by fatty deposits from atherosclerosis (plaque buildups in artery walls) may become blocked by a blood clot. Carotid artery disease is also called carotid artery stenosis.
  
  People with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke. Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles. It's caused by fatty buildups of plaque in artery walls.

• Atrial fibrillation -- This heart rhythm disorder raises the risk for stroke. The heart's upper chambers quiver instead of beating effectively, which can let the blood pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results.
• Other heart disease -- People with coronary heart disease or heart failure have a higher risk of stroke than those with hearts that work normally. Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects also raise the risk of stroke.
• Transient ischemic attacks (TIAs) -- TIAs are "warning strokes" that produce stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke. It's very important to recognize the warning signs of a TIA or stroke. Call 9-1-1 to get medical help immediately if they occur.
• Certain blood disorders -- A high red blood cell count thickens the blood and makes clots more likely. This raises the risk of stroke. Doctors may treat this problem by removing blood cells or prescribing "blood thinners."
  
  Sickle cell disease (also called sickle cell anemia) is a genetic disorder that mainly affects African Americans. "Sickled" red blood cells are less able to carry oxygen to the body's tissues and organs. They also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke.
• High blood cholesterol -- A high level of total cholesterol in the blood (240 mg/dL or higher) is a major risk factor for heart disease, which raises your risk of stroke. Recent studies show that high levels of  LDL ("bad") cholesterol (greater than 100 mg/dL) and triglycerides (blood fats, 150 mg/dL or higher) increase the risk of stroke in people with previous coronary heart disease, ischemic stroke or transient ischemic attack (TIA). Low levels (less than 40 mg/dL) of HDL ("good") cholesterol also may raise stroke risk.
• Physical inactivity and obesity -- Being inactive, obese or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke. So go on a brisk walk, take the stairs, and do whatever you can to make your life more active. Try to get a total of at least 30 minutes of activity on most or all days.
• Excessive alcohol -- Drinking an average of more than one alcoholic drink a day for women or more than two drinks a day for men can raise blood pressure and may increase risk for stroke.
• Some illegal drugs -- Intravenous drug abuse carries a high risk of stroke. Cocaine use has been linked to strokes and heart attacks. Some have been fatal even in first-time users.

What are the risk factors for stroke you can't change?

• Increasing age -- People of all ages, including children, have strokes. But the older you are, the greater your risk for stroke.
• Sex (gender) -- Stroke is more common in men than in women. In most age groups, more men than women will have a stroke in a given year. However, women account for more than half of all stroke deaths. Women who are pregnant have a higher stroke risk. So do women taking birth control pills who also smoke or have high blood pressure or other risk factors.
• Heredity (family history) and race -- Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke. African Americans have a much higher risk of death from a stroke than Caucasians do. This is partly because blacks have higher risks of high blood pressure, diabetes and obesity.
• Prior stroke or heart attack -- Someone who has had a stroke is at much higher risk of having another one. If you've had a heart attack, you're at higher risk of having a stroke, too.

For stroke information, call the American Stroke Association at 1-888-4-STROKE.

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last update: 06/20/07
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