The number of younger people suffering strokes across Canada is rising at an alarming rate and is expected to increase more in the coming decade, posing a significant challenge to the health-care system, reveals a new report by the Heart and Stroke Foundation.
The report, published Thursday, found that in the past decade the rate of strokes among people in their 50s has increased by 24 per cent, and by 13 per cent for people in their 60s. It also notes that international studies are predicting stroke rates among those aged 24-64 will double in the coming 15 years.
Data from the Public Health Agency of Canada suggest the costs associated with strokes, which includes doctor visits and lost productivity, total $3.6-billion every year.
The report warns this number will climb even higher, to difficult-to-sustain levels, if the number of strokes in Canada increases at predicted rates.
Although factors such as poor diet and excess weight are a major part of the problem, it's not just the overweight and obese who have to worry. People who are at a normal weight but are physically inactive also face a heightened risk of stroke, according to the foundation.
"Our lifestyle issues are catching up with us," said Michael Hill, a Calgary-based stroke neurologist and spokesman for the Heart and Stroke Foundation. "Humans are born to move. You've got to move to live."
A stroke is a sudden loss of brain function that occurs when blood flow to the brain is interrupted or blood vessels in the brain rupture. Strokes can strike at any age and, in some cases, doctors never determine the cause. But in many instances, lifestyle factors, such as inactivity, smoking and excessive alcohol intake can be contributing factors.
The foundation's 2014 report on stroke notes that, over all, treatments for stroke are improving and death rates are declining. But those gains could be offset by the aging population, the fact more stroke patients have multiple chronic conditions that make them even more challenging to treat, and the growing number of younger people suffering strokes.
Dr. Hill said one of the major frustrations is that despite the advances in early diagnosis and treatment to help improve outcomes for stroke patients, unco-ordinated system design and a lack of public education often stands in the way. This is a major issue, considering that when a person is having a stroke, every second counts.
The report is calling on more hospitals to create agreements so that when a person is suffering a suspected stroke, ambulances can bypass the closest hospital to reach a facility that can provide special emergency stroke care. The hospital should also be alerted before the patient's arrival so it can prepare. The report notes that under half of Canadian hospitals with a stroke system have agreements in place to be notified when a stroke patient is on the way. It also found that only a small number – less than one-third – of hospitals that provide stroke services administer clot-busting drugs, which can stop or reverse the effects of stroke if they are administered within four-and-a-half hours.
In an ideal world, stroke patients should be scanned as soon as they get to the hospital so doctors can determine if they are candidates for clot-busting drugs. This is not happening nearly enough, the report says.
But the public also has some work to do in understanding the signs of stroke and calling 911 immediately. Half of stroke patients arrive at the hospital nearly six hours after symptoms start. Among 20- to- 39-year-olds, that stretches to more than eight hours.
Jen Bogart was one of the lucky ones. She woke up experiencing vision, balance and speech problems and a headache last September and didn't know what to make of it. Neither did a doctor, who sent her home from a clinic when a concerned friend brought her in for assessment. Later that night, Ms. Bogart, who lives in Charlottetown, collapsed. She had suffered a major stroke. Luckily, clot-busting drugs saved her life. But her story is a reminder that strokes can hit any time. Ms. Bogart is active and healthy, but doctors discovered a small hole in her heart called a patent foramen ovale. About one in four adults have PFO and it appears to be linked to an increased chance of stroke. NHL player Kris Letang, who suffered a stroke earlier this year, has PFO.
There are five important warning signs of stroke that shouldn't be ignored, even if they seem to go away in a few minutes: weakness (sudden loss of strength or sudden weakness in face, arm or leg); trouble speaking or understanding; sudden vision problems; sudden severe and unusual headache; sudden loss of balance, especially if other symptoms are present.
The report, which is based on data from the Canadian Institute for Health Information and stroke research conducted by the foundation, found that two-thirds of stroke patients have at least one chronic condition, such as high blood pressure, diabetes, cancer or heart disease, which can make the treatment of stroke that much more problematic.
Next year, a medication called NA-1, pioneered by Toronto's Dr. Michael Tymianski, will be tested on stroke patients as part of a clinical study. The drug may be able to inhibit a protein that causes damage to brain cells. If it is administered by paramedics, it can help delay the damage caused by strokes until patients are at the hospital to receive other treatments.