Ominous 'Mini-Strokes' Often Dismissed by Primary Care Doctors
Given these findings on the "overlooked" nature of an important
stroke marker, a report from Robert D. Brown Jr., MD, associate professor of
medicine at Mayo Clinic School of Medicine, is especially compelling. Brown
tells WebMD that a long-term, population-based study of all residents of
Rochester, Minn., suggests that the stroke incidence among white Americans is
256 per 100,000, while the incidence of having a stroke for the first time is
183 per 100,000. "We extrapolated our data to the U.S. population of 273
million," he says. Using the figure of 256 per 100,000 for both white and
Hispanic Americans and an incidence rate of 411 per 100,000 for African
Americans, "a conservative estimate is that there are 750,000 strokes per
year. The previous estimate was 500,000," he says.
"When you combine all strokes and TIAs, our estimate is that 1.2 million
events occur each year," he says. Brown says that the data from Rochester
date back to 1955. "During the 1950s and the 1960s, we saw a decline in the
number of strokes," he says. The decline began to level off in the late
1960 and 1970s, and "in the 1980s and 1990s, we have seen an increase in
the number of strokes." Brown says one explanation for the increase is that
clinicians may "be less vigilant about detecting, treating, and controlling
high blood pressure." But a more probable explanation for the increase, he
says, is that "more people are surviving other ischemic events like heart
attacks. That survival allows them to survive to have the stroke." He says,
too, that since age itself is a risk factor for stroke, longer life expectancy
carries an increased risk of stroke. "These people are [simply] living long
enough to have a stroke," he says.
- New data shows that primary care physicians are sending patients with TIA,
or mini-strokes, home without the proper workup or treatment.
- According to one study, the frequency of strokes and TIAs in the U.S. is
1.2 million events per year, a number much higher than previous estimates.
- The symptoms of stroke or TIA include sudden numbness or weakness of the
face, arm, or leg, especially on one side; sudden confusion; difficulty
speaking or understanding; and sudden, severe headache.