Stroke awareness campaigns need improvement

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Mass media interventions have been implemented to improve emergency response to stroke given the emergence of effective acute treatments. A new study shows that campaigns aimed at the public may raise awareness of symptoms and signs of stroke, but have limited impact on behavior.

Mass media campaigns can be successful in improving knowledge and changing behaviors in other fields of health and safety promotion. Unlike other interventions, such as stroke patient education and community stroke screening programs, mass media campaigns have the potential to improve knowledge and awareness and change the behaviors of a large number of people.

The study suggests that new campaigns to educate the public on the signs and symptoms of stroke should follow the principles of good design and be robustly evaluated.

1. Lecouturier J, Rodgers H, Murtagh MJ, et al. Systematic review of mass media interventions designed to improve public recognition of stroke symptoms, emergency response and early treatment. BMC Public Health 2010; 10: 784. (open access)

Hemorrhagic stroke risk rises by 22% with use of vitamin E

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A study has found a 22 percent increased risk of hemorrhagic stroke in people who take vitamin E supplements, and recommends people should be cautious about indiscriminate widespread use of the vitamin. The study also found a slight 10 percent reduction in ischemic stroke risk linked to vitamin E use.

Reducing or eliminating the use of vitamin E is recommended because the consequences of hemorrhagic stroke are generally more severe than those of ischemic stroke, according to the study.

Other preventive strategies, such as blood pressure and cholesterol lowering drugs and living a healthy lifestyle, have far stronger effects on reducing ischemic stroke than intake of vitamin E, the researchers said.

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1. Schurks M, Glynn RJ, Rist PM, et al. Effects of vitamin E on stroke subtypes: meta-analysis of randomised controlled trials. BMJ 2010; 341: c5702. (open access)

Stroke prevalence in Cuba as high as in developed countries

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A Cuban study indicates that stroke prevalence in Havana and Matanzas provinces is similar to that reported for Europe and North America, and higher than that observed in other Latin American countries.

Prevalence of stroke among adults aged 65 years and older was 7.8 percent, and was higher in men. Risk factors found in this population were history of hypertension, low HDL cholesterol, history of ischemic heart disease, carrier of one or two apolipoprotein E4 genotype alleles, male sex and older age.

Stroke is the third leading cause of death in the world, with the highest death rates in low- and middle-income countries. According to the World Health Organization (WHO), about 5.71 million people died from stroke in 2004, and it is estimated that this number will climb to 6.3 million in 2015 and 7.8 million in 2030.

In 2001, 85.5 percent of the world’s stroke deaths occurred in developing countries. In the past 20 years, in developed countries, there has been a 29 percent decline in the incidence of all types of stroke, especially in women, and a 25 percent reduction in death due to stroke, except for hemorrhagic stroke.

In Cuba, stroke is also the third cause of death. According to WHO and the Pan American Health Organization (PAHO), in 2000, stroke was the first or second leading cause of death in 25 Latin American and Caribbean countries, and in 2002, it caused 272,000 deaths in 27 countries of the region.

Developing countries are still undergoing a rapid, unparalleled demographic transition in which chronic non-communicable diseases (NCDs) are progressively assuming greater importance. Of the 35 million deaths from NCDs in 2005, 80 percent occurred in low- and middle-income countries, where the majority of the world’s population lives.

1. Llibre JJ, Valhuerdi A, Fernandez O, et al. Prevalence of stroke and associated risk factors in older adults in Havana City and Matanzas Provinces, Cuba (10/66 population-based study). MEDICC Review 2010; 12(3): 20-26. (open access)

Mexican Americans with atrial fibrillation at higher risk of stroke


Mexican Americans with atrial fibrillation are at an increased risk of stroke and are more likely to experience severe recurrences of stroke than do non-Hispanic whites, a new study shows. Atrial fibrillation is a heart rhythm abnormality that affects more than two million adults in the United States.

Access to care and socioeconomic factors may have contributed to the  higher risk among Mexican Americans. Mexican Americans are less likely than whites to have a primary care physician and are less likely to have graduated from high school.

1. Simpson JR, Zahuranec DB, Lisabeth LD, et al. Mexican Americans with atrial fibrillation have more recurrent strokes than do non-hispanic whites. Stroke 2010; 41: 2132. (open access)