According to the University of Michigan Health System, 800,000 Americans have a stroke each year, and it is the third leading cause of death in the country.
"As the baby boomers get into their 6th, 7th, 8th decades, we're basically facing an epidemic of stroke," said Mathew Reeves, an associate professor in the Department of Epidemiology at Michigan State University who studies data from stroke victims in the state. "There's been a lot of work educating the public about stroke awareness and warning signs. People are getting smarter."
In a study published in April in the journal Stroke, Reeves, along with a group of other researchers, showed that statins, or cholesterol-lowering drugs, taken preventatively may decrease disability after a stroke. A $10,000 grant from the Blue Cross Blue Shield Foundation of Michigan was given in recognition of this research, according to a press release from MSU.
Reeves has used MASCOTS, the Michigan Acute Stroke Care Overview and Treatment Surveillance System, for much of his research in this field. The registry has information about more than 2,600 stroke victims in the state, according to the press release.
Reeves plans to use the grant to explore ways to improve the care of female stroke survivors. About 25 percent of all stroke victims are women that are at least 80 years old, he said.
Some of his research has shown women are less likely to receive perfect stroke care in a hospital setting, according to a press release from the university. Reeves also collected data on quality of life of stroke survivors, and found women, on average, report poorer quality of life than men after a stroke.
"Is there anything we could do to improve the lives of women stroke survivors? That's the ultimate goal," Reeves said. "Awards like this are nice, because it gives you free range to explore other areas."
Reeves and a team of MSU researchers used MASCOTS to complete a meta-analysis a study of studies of research involving the use of tissue plasminogen activator, or tPA, a blood thinner that can dissolve clots, to treat strokes. The meta-analysis showed women are about 30 percent less likely to be given tPA after a stroke, he said.
"Only about 4 to 5 percent of stroke cases are treated with tPA. In that 4 to 5 percent, there is a difference between men and women," Reeves said.
The tPA drug must be given within three hours of the stroke's occurrence, according to UM Health System. Past studies of MASCOTS data from Reeves and other MSU researchers showed female stroke victims have greater "door-to-doctor" times when they come to the emergency room, as well as greater "door-to-image" times (the time it takes to complete a brain scan) than men.
It has not been established exactly why women are less likely to receive tPA for stroke treatment. Reeves said the age of a stroke victim can contribute to whether he or she receives tPA; for example, trials of the drug typically did not include older age groups, and strokes tend to occur in older women.
However, this age factor did not account for the differences in administration of tPA between men and women. Reeves said there is a "laundry list" of reasons that could explain this trend.
"Maybe there's something different in their presentation (of symptoms)," Reeves said. "That doesn't seem in my opinion to be a big thing, but it could be an explanation."
Women are more likely to experience nontraditional signs of stroke, particularly "altered mental state," according to recent research from the Department of Neurology at the UM Health System. This study examined 461 cases of ischemic stroke, the most common type of stroke, and transient ischemic attacks, or "mini-strokes."
The researchers noted that display of nontraditional symptoms may increase the diagnosis time for a stroke. This could cause those with nontraditional symptoms, primarily women, to miss the window in which tPA can be given as treatment.
The five traditional signs of stroke are as follows, from the National Institute of Neurological Disorders and Stroke (Reeves also requested I include these):
• Sudden numbness or weakness of the face, arms, or legs
• Sudden confusion or trouble speaking or understanding others
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, or loss of balance or coordination
• Sudden severe headache with no known cause
Each of these symptoms appears suddenly, and a stroke victim often can have more than one symptom at once, according to the Centers for Disease Control and Prevention. Physicians and the public need to have even greater vigilance for nontraditional stroke symptoms that are not included on this list, and may be overlooked.