America is suddenly losing battle to prevent deadly strokes after four decades of progress

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Functional rehabilitation in an office of a physical therapist after a cerebrovascular accident (CVA) also known as a stroke.

After four decades of progress preventing strokes that affect 800,000 Americans and kill up to 140,000 annually, progress has stalled, and in some states strokes are again increasing, according to a new report from the Centers for Disease Control and Prevention.

The study, released Wednesday, shows that stroke death rates failed to continue to decline in 38 states during the 2013–2015 period, resulting in an estimated 32,593 excess stroke deaths that may not have occurred based on previous rates of decline. The data was compiled by the U.S. National Vital Statistics System from the National Center for Health Statistics at the CDC. The increase came after successive declines in stroke deaths for every three-year period studied by the CDC between 2000 and 2013.

Today strokes are the fifth-leading cause of death in the country, but 80 percent of strokes are preventable, according to the World Health Organization.

A stroke occurs when blood flow to an area of brain is cut off and brain cells are deprived of oxygen and begin to die, resulting in the loss of abilities, such as memory and muscle function, controlled by that area of the brain.

Strokes can often be prevented by two methods. Dr. Quanhe Yang, senior scientist, Division for Heart Disease and Stroke Prevention at the CDC, said one is by adopting a healthy lifestyle, such as not smoking, eating a healthy diet that is low in salt and sugar and high in fruits and vegetables, being physically active and maintaining healthy weight. The second is by better managing the risk factors. “If you have high blood pressure, high cholesterol or diabetes, you need to keep them under control by maintaining a healthy lifestyle and taking the proper medications,” Yang said.

“This is a wake-up call. We have to remember that 80 percent of strokes are preventable. Every one of us can do something to regain the momentum in the decline of the number of strokes.”
-Dr. Quanhe Yang, senior scientist, Division for Heart Disease and Stroke Prevention at the CDC

Obesity is another cause for concern, because it is a major cause of hypertension, which is the single most important modifiable risk factor for stroke, according to the CDC report. Despite recent improvements, nearly half of the 75 million U.S. adults with hypertension do not have their blood pressure under control.

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The current stall in progress preventing strokes is taking place in 3 out of 4 states across the United States and, surprisingly, not just in the 11 states in the Southeast known as the Stroke Belt, because those states have had higher stroke death rates historically than the U.S. average. Those states are Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia.

The CDC study could not conclude that any single factor or group of factors is directly responsible. However, poor diet, physical inactivity and lower-than-average social economic status — which often results in a lack of access to health insurance coverage and access to medical care — all contribute to the higher rates of strokes in these states and around the country, Yang said.

Signs of a stroke

Recognizing the signs and symptoms of a stroke and understanding the importance of calling 911 is critical to ensuring that stroke patients receive the best care as quickly as possible. Stroke symptoms tend to occur suddenly. Signs to look out for include weakness or numbness on one side of the body, confusion, trouble speaking or understanding, trouble seeing in one or both eyes, trouble walking, dizziness or loss of balance or severe headache.

The American Stroke Association tells people to remember the acronym FAST, which can be used as a mnemonic to help detect and respond quickly to stroke victims. The acronym stands for “Facial drooping,”Arm weakness,” “Speech difficulties” and “Time to call 911.”

Yang said if you think someone is having a stroke, you should first ask the person if they are able to smile, to see if one side of the face is drooping. Next, ask the person to raise both arms up to check for arm weakness. Then ask the person to repeat a sentence to see if they can speak clearly, and then call 911 immediately.

Time is of the essence because while a person is having a stroke, their brain cells are dying, so it’s imperative that they get the care they need immediately. “Get the person an ambulance and get them to the hospital so that they can get the proper treatment,” Yang said. “This will increase the chance of survival. Every minute counts,” he added. Yang does not recommend driving yourself or someone having a stroke to the hospital. An ambulance can alert the hospital to the person’s arrival and get the necessary equipment ready.

A person having a stroke is typically experiencing a blood clot, so “clot busting medication” will be necessary, he said. “It’s a very time-sensitive procedure, and after three to five hours the effectiveness of procedure is greatly reduced.”

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