Approximately 15 million people worldwide have a stroke every year. Of these, almost 6 million die, while a further 5 million are left permanently disabled. But although stroke is the one of the leading causes of death globally, many people remain unaware of the signs and symptoms to look out for, therefore putting their health at risk.

The American Heart Association/American Stroke Association (AHA/ASA) state that around 1 in 3 Americans are unable to recall the warning signs of stroke.

Furthermore, a recent AHA/ASA study revealed that many women in the US are unaware of stroke warning signs, even though they are at much greater risk of stroke than men.

“This lack of recognition of stroke signs and symptoms could be a significant barrier to reducing death and disability related to stroke in the US,” says Dr. Lori Mosca, who led the study. “This is critically important because delays in getting care costs lives and hinders functional recovery.”

May is National Stroke Awareness Month - an annual campaign introduced in 1989 that aims to increase public awareness of stroke in an attempt to tackle the condition once and for all.

In line with this campaign, this week’s spotlight feature looks at the signs and symptoms of stroke, the risks associated with the condition and what can be done to increase stroke awareness.
What is stroke?

A stroke occurs when an artery or blood vessel becomes blocked, restricting blood flow to the brain. This leads to brain cell death, and, subsequently, brain damage.

How a person is affected by stroke depends on where in the brain the stroke occurs and how much of the brain is disturbed. Many stroke patients experience impaired speech, movement and memory. In severe cases, patients may suffer paralysis or even death.

There are two main types of stroke - ischemic stroke and Hemorrhagic stroke. Ischemic stroke is the most common, accounting for around 87% of all strokes. This occurs when the arteries are blocked by blood clots or a gradual build-up of plaque and other fatty deposits.

Hemorrhagic stroke occurs when a blood vessel in the brain splits, leaking blood into the brain. Although only 13% of all strokes are caused by this, it is responsible for more than 30% of all stroke deaths.
The risk factors

There are many risk factors for stroke, many of which are out of our control. For example, individuals over the age of 55 are at greater risk of stroke, as are African-Americans, Hispanics and Asian/Pacific Islanders. Individuals who have a family history of stroke or TIA (Transient Ischemic Attack) are also more likely to have stroke themselves.

And women are more likely to have stroke than men. In the US, around 55,000 more women than men have a stroke every year.

But there are also risk factors for stroke that are within our control - one of the most important being high blood pressure, or hypertension. According to the National Stroke Association, people who have high blood pressure are one and a half times more likely to have stroke than those who have normal blood pressure.

“The No. 1 stroke risk factor is high blood pressure. It’s important to check your blood pressure regularly and talk to your doctor about healthy levels for you,” says Dr. Jeffrey L. Saver, professor of Neurology at the University of California Los Angeles and a spokesperson for the ASA.

High cholesterol also increases the risk of stroke, as cholesterol can block blood flow in the arteries. Furthermore, High cholesterol can raise the risk of heart disease and atherosclerosis - risk factors for stroke in themselves.

Smoking is another risk factor. Compared with non-smokers, those who smoke are at double the risk of stroke. It reduces the amount of oxygen in the blood, meaning the heart has to work harder to pump blood around the body. This means blood clots find it easier to form in the arteries, which can cause a blockage.

Those who are overweight or obese are also at increased risk of stroke. Excessive weight can increase the risk of high blood pressure, High cholesterol and diabetes.

But, regardless of the array of risk factors for stroke, the ASA state that 58% of Americans do not know if they are at risk for the condition. A 2009 UK study found that of more than 2,000 participants, less than half were able to identify stroke risk factors.

Talking to Medical News Today, Dr. Kate Holmes, assistant director of research at the UK Stroke Association, says such lack of awareness is a concern:

Act F.A.S.T

It seems that the lack of identification of stroke risk factors is not the only concern. There is a serious lack of awareness regarding the warning signs and symptoms of stroke. As stated earlier, only 1 in 3 Americans know what symptoms to look out for.

The main symptoms of stroke include sudden drooping or numbness on one side of the face, weakness or numbness in one arm and difficulty with speech. F.A.S.T is an easy acronym to remember these symptoms, and it instructs what you should do if you notice these symptoms in an individual:

  F. Face drooping: Ask the person to smile. Is their smile uneven?
  A. Arm Weakness: Ask the person to raise both arms. Does one arm drift downward?
  S. Speech Difficulty: Is the person’s speech slurred? Are they able to speak or hard to understand? Ask them to repeat a simple sentence. Can they repeat it accurately?
  T. Time to call 911: If a person shows any of the symptoms, even if they disappear, call 911 (999 in the UK) and get them to the hospital immediately. Note the time the symptoms first appeared.