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Stroke accounts for approximately one out of every 20 deaths in the United States, and it is the fifth leading cause of death behind heart disease, cancer, unintentional injuries and chronic lower respiratory diseases.
According to the American Heart Association’s 2019 update on heart disease and stroke statistics, someone in the United States has a stroke every 40 seconds—and nearly one-quarter of those individuals have had a previous stroke. The majority are ischemic stroke, also referred to as brain ischemia or cerebral ischemia, and about 90% of strokes are attributed to modifiable risk factors such as hypertension, obesity, hyperglycemia, smoking, atrial fibrillation and hyperlipidemia.
An elevated blood pressure (BP) is probably the most potent risk factor for stroke. Studies have shown the rate and risk of stroke are significantly impacted when the BP is lowered, and recent evidence suggests a systolic BP <120 mm Hg may be the ideal target. Another powerful risk factor is atrial fibrillation, which independently increases risk fivefold across all ages.
While it is true stroke risk increases with age, strokes can—and do—occur at any age. In 2009, 34% of those hospitalized for stroke were under the age of 65. In addition, the complications after a stroke can be lifechanging and costly. Common, serious complications can include brain edema, pneumonia, urinary tract infection, deep vein thrombosis, depression or other emotional changes and seizures. The risk of having a first stroke is twice as high for non-Hispanic black men compared to white men, and they are more likely to die or have stroke-related disabilities.
Education and prevention using evidence-based guidance are key components for decreasing the risk and rate of stroke. Despite improvement in public awareness of stroke risk factors and warning signs, almost 38% of those surveyed in 2016 could not identify any risk factors and over 27% could not identify warning signs. Educating patients, especially those in high-risk groups, on the importance of stroke prevention and knowing the warning signs is key to getting early, time-sensitive treatment and improved outcomes.
Find the information you need to make a measurable difference in the lives of your patients who are at risk for a stroke in Evaluation and Management of the Possible CVA in the Emergency Department, now available in the AANP CE Center!
Available completely free for AANP members, this activity is designed to educate NPs on the risk factors for stroke, clinical guidelines and ways to formulate a plan of care in the emergency department for the patient with suspected stroke.