Encouraging news about preventing second strokes

If you've had a stroke, or know someone whose lived through one, you know that a second stroke can carry serious danger.

So using statins - drugs normally used to control cholesterol - might help, according to an article about research on statins preventing second strokes in high-risk groups:

Statins reduce recurrent stroke risk in patients with type 2 diabetes and metabolic syndrome despite the higher risk of cardiovascular events and recurrent stroke in these populations, researchers found.

As always, consult your doctor - be an advocate.
 

Good news: Recurring stroke rate declines

Despite the topic here, a stroke-dedicated blog is NOT a downer - here's some encouraging recent news about how the recurrent stroke, vascular event rate on decline during past 50 years:

During a 50-year span, the annual event rate of strokes and major vascular events declined by roughly 1% per decade each, according to an analysis of nearly 60 secondary prevention trials.

Preventing recurring strokes - new guidance

One stroke risk factor: having a previous stroke. Now, new guidelines for recurrent stroke prevention:

A joint committee representing the American Heart Association and the American Stroke Association has published updated evidence-based recommendations on the prevention of ischemic stroke among survivors of ischemic stroke or transient ischemic attack; the statement has been published online Oct. 21 in Stroke. ...

"The recommendations in this statement are organized to help the clinician who has arrived at a potential explanation of the cause of ischemic stroke in an individual patient and is embarking on selection of a therapy to reduce the risk of a recurrent event and other vascular outcomes," the authors write. "Our intention is to update these statements every three years, with additional interval updates as needed, to reflect the changing state of knowledge on the approaches to prevent a recurrent stroke."

One is too much - prevention must improve

Preventing recurrent strokes needs improvement

The study, published in Neurology, was based on 10,399 people in South Carolina who had a hospital discharge diagnosis of stroke in 2002. The results showed that nearly 25% of people who had a stroke died within one year from any cause and 8% had another stroke within a year.

These risks rose steadily one year after the initial stroke. By the end of four years after a stroke, the risk of another stroke was 18% and the risk of death was 41%.

“Furthermore, the risk of recurrent stroke was between three and six times higher than the risk of heart attack at different points during the study,” researcher Wuwei (Wayne) Feng, MD, MS, with the department of neuroscience at the Medical University of South Carolina, says in a news release. “Our findings suggest that South Carolina and possibly other parts of the United States may have a long way to go in preventing and reducing the risk factors for recurrent strokes.”

One part of preventing second strokes

If it happens once, it can happen again.

Most importantly, there are ways to prevent second strokes. One is to reduce the "bad" cholesterol level. There are other elements of prevention. Among them: Watch your blood pressure and weight. Don't smoke. Control alcohol intake. Exercise (check with the doctor first).

High cholesterol-treating statins can help prevent second strokes in some cases:

The 10-year study of nearly 800 people who had strokes found a 35 percent lower incidence of second strokes and a 57 percent lower death rate among those who took statins compared to those who didn't, according to a report in the May 26 issue of Neurology.

Statins include blockbuster medications such as Crestor, Lipitor, Pravachol and Zocor.

Don't assume you suddenly need a statin, but this story is one more argument to keep working with your doctor to monitor your cholesterol and other stroke risks.

(Photo from the National Library of Medicine)

Prompt care means better outcome

Fewer lasting effects, shorter hospital stays, lower costs.

Not a bad deal.

A recent study in The Lancet Neurology spells out that it seems prompt treatment of transient ischemic attack (TIA, or mini-stroke) patients means fewer problems, including additional strokes.

Now, that's good news.

From a MedPage Today article:

Urgent care was associated with an estimated savings of about $890 per patient, which, if extrapolated to the entire population of the U.K., could yield savings of nearly $100 million in acute care costs per year, the researchers said.

"In addition," they said, "the reductions in disability rates at six months might lead to a reduction in the long-term usage of the health service in the community."

So, as stated: prompt, good care means less change of another stroke, fewer patients becoming disabled, lower costs. It follows that it's important if you are in a position to help a stroke victim, you must help that person to get proper care.

Stroke survivor resources

If you've already lived through a stroke, you don't want another. A good Web resource on a project called Steps Against Recurrent Stroke (S.T.A.R.).

Just a few facts that demand your attention:

• Three-quarters of a million Americans experience a stroke each year, and at least 1 in four (25%-35%) will have another stroke within their lifetime.
• Within 5 years of your first stroke, your risk for another stroke can increase more than 40%.
• Recurrent strokes often have a higher rate of death and disability because parts of the brain already injured by the original stroke may not be as resilient.
• Within five years of a stroke, 24 percent of women and 42 percent of men will experience a recurrent stroke.

And some recommendations that make a great deal of sense:

• Stop smoking
• Keep blood pressure, cholesterol and diabetes under control
• If you have an irregular heartbeat work with your doctor to control it
• Eat a healthy diet
• Increase physical activity

This advice won't cover everyone in specific terms of stroke causes (see this link about cryptogenic strokes, which describes my own stroke history). Still, it's good general advice for one and all.