More people survive these brain attacks, but the health problems that cause stroke aren't going away
By Steven Reinberg
WEDNESDAY, Oct. 11, 2017 (HealthDay News) -- While progress is being made in reducing the number of stroke deaths, it seems that more people who experience these brain attacks have significant stroke risk factors, a new study reveals.
The rates of high blood pressure, diabetes, abnormal cholesterol, smoking and drug abuse have all been on the rise in stroke patients over recent years, the study authors said.
The study included over 900,000 people hospitalized for stroke between 2004 and 2014. Each year, prevalence of high blood pressure went up by 1 percent, diabetes rose by 2 percent, high cholesterol went up by 7 percent, smoking increased by 5 percent, and drug abuse jumped 7 percent, the researchers found.
"The risk of dying from a stroke has declined significantly, while at the same time the risk factors are increasing," said researcher Dr. Ralph Sacco. He's a professor of neurology at the University of Miami Miller School of Medicine.
"We are not exactly sure why these increases are occurring," Sacco said.
It's possible that doctors are getting better at diagnosing risk factors. Or certain lifestyle factors may play a role, Sacco suggested. These include obesity, lack of exercise, poor diet and smoking.
The increase of drug abuse among younger patients is especially concerning, he added.
Although the increases in risk factors were seen in all racial and ethnic groups, increases in high blood pressure among blacks and diabetes among Hispanics stood out, Sacco noted.
He stressed that patients need to know their blood pressure, blood sugar and cholesterol levels. "There are great medications that can be used to treat those conditions," Sacco said.
"We need to go further in controlling risk factors, like diet and exercise," he advised.
According to Dr. Salman Azhar, director of stroke at Lenox Hill Hospital in New York City, "The challenge now is to prevent strokes, and if they have had a stroke, trying to prevent a second stroke. This is where the importance of these risk factors comes in."
The responsibility to reduce risk factors lies with patients, but also with the community, he continued.
"It's up to communities to provide access to better food and places to exercise. We have a responsibility as a community and a health system," Azhar said.
The 922,000 people included in the study had been hospitalized for an ischemic stroke, which is caused by a blocked blood vessel in the brain. These are the most common types of stroke.
The number of stroke patients who had one or more risk factors increased from 88 percent in 2004 to 95 percent in 2014, the findings showed.
For hospitalized stroke patients during the 10-year study period, high cholesterol rates more than doubled, from 29 percent to 59 percent, and the rate of diabetes went from 31 percent to 38 percent.
In addition, high blood pressure rates increased from 73 percent to 84 percent, and the prevalence of drug abuse doubled from 1.4 percent to 2.8 percent. Also, kidney failure increased each year by 13 percent, and plaque buildup in the carotid (neck) arteries rose by 6 percent each year, the investigators found.
Dr. David Katz is director of the Yale-Griffin Prevention Research Center in Derby, Conn. He said the improvement in stroke survival "suggests we are relying on advances in treatment while neglecting prevention."
Katz, who is also president of the American College of Lifestyle Medicine, said, "Treating disease is never as good as preserving health and vitality. This study is a precautionary tale of the questionable and costly choices we seem to be making as a culture."
The report was published online Oct. 11 in the journal Neurology.
For more about stroke, visit the American Stroke Association.
SOURCES: Ralph Sacco, M.D., professor, neurology, University of Miami Miller School of Medicine; David Katz, M.D., M.P.H., director, Yale-Griffin Prevention Research Center, Derby, Conn., and president, American College of Lifestyle Medicine; Salman Azhar, M.D.,director, stroke, Lenox Hill Hospital, New York City; Oct. 11, 2017, Neurology, online
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