We need to get active on strokes

Medical researchers sound so many wake-up calls it’s hard to get any rest. But the latest warning klaxon is a significant one that should bestir us. Better though we’re getting at preventing strokes and increasing the survivability of them, we’re both a growing and ageing population. This means that although the harm is being suffered by a smaller proportion of us, the number of people smitten is shaping up to rise scarily; 40 per cent in the coming decade. An increase from about 9000 to 12,000 strokes per year. What’s more, we surely know already which groups should take these figures most personally. The over-65s are particularly in the gun while the tedious tragedy of Ma¯ori and Pacific groups taking a disproportionately heavy wallop is yet again evident. In case there was any real doubt, the parallel warning from the Otago University study is that the services we have in place are geared towards current numbers, not that sort of increase. So, swell. As ever, it’s possible to behold such information glumly and restrict our reactions to nothing more than trying to keep the sense of dread vague. But that’s unwarranted as well as unhelpful. The challenge to translate the information into personal and collective motivation isn’t unreasonable. After all, we have already been gaining traction against stroke rates and the personal steps we can each take are hardly complex or counter-intuitive. There’s a familiar ring to the big risk factors; high blood pressure, high body mass index, a diet low in fruit and vegetables and, to absolutely nobody’s surprise, smoking. The more these studies come out the more clearly we should appreciate the rewards of getting blood pressure checked, reducing sugar intake, and quitting tobacco. For their part, health boards and authorities have planning to do. And regional New Zealand has a particular interest in that. Swift intervention is crucial. Ideally, a stroke sufferer should receive treatment within hours but barely more than one-third of them are helped within that timeframe. Part of the problem has been people waiting too long to call 111, but another significant problem is access to after-hours expertise for those in regional hospitals. Clot-busting medication can help reverse stroke systems if it’s given swiftly enough, but that’s the right call only for carefully selected patients. A pilot scheme called telestroke – a videoconferencing technique that brings after-hours neurological expertise within reach of smaller hospitals – has proven successful, although a cautionary tale presents itself. After a successful six-month pilot, telestroke was discontinued for Nelson, reflecting a view that, by that stage, local staff had been sufficiently upskilled. But after telestroke was withdrawn, the detected improvements in treatment subsided. Whether the service should be applied continually, or periodically, is a matter for expert appraisal. But cases such as this are also a matter in which the public is entitled to show an intelligent interest. And, broadly, a measure of urgency. The leader of the Otago research, Anne Ranta, warns this is not a matter in which we can swing into action later. Ten years from now it would be too late.

We have already been gaining traction against stroke rates and the personal steps we can each take are hardly complex or counter-intuitive.