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Wednesday, 30 January 2013

Stroke – brain attacks fighting back

Perhaps no illness strikes as much denial of fear as stroke.  Healthy one moment, potentially life like disability the next.  Whether thromboembolic or hemorrhagic, the consequences can be profound, the impacts on family disturbing.  

Yet, stroke takes second fiddle to heart disease in all aspects.  It ranks third in causes of Canadian deaths with an estimated 50,000 new strokes every year.  Six times as many live with the consequences of a stroke, just over 1% of the Canadian population. Only 1/3rd of stroke victims recover all or most of their function, 40% are moderately or severely disabled, 10% require long term care, and 15% die from the initial insult.  Learn more at the great organization, although infamously named Heart and Stroke Foundation statistical information where stoke remains in the shadows.

 PHAC has a developed a vested interest in stroke, and more in an upcoming posting.  See details of their work at PHAC synthesis 2011

The notable change in the graph is that while numbers of deaths have remained fairly constant, rates of deaths, hospitalization, and numbers of hospitalizations have been consistently decreasing since the early 90’s.    The benefits of reduced smoking, better blood pressure control, lipid control efforts, and in some cases low dose anti-thrombotics (ie. low dose aspirin).

Further improvements would require stemming the increase in diabetes, increasing physical activity further and lots of discussion on reducing salt consumption (see DrPHealth Jan 2012 Sodium reduction)

Overall, a hidden public health success story, that barely makes the public health agenda.  One of the reasons, three of the main preventive actions result from using pharmacotherapy – and perhaps a strong indication on the need to collaborate on disease prevention efforts that combine drugs with lifestyle interventions.  

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