The whole problem here is the single-minded focus on prevention. I'm sure by focusing on stopping the neuronal cascade of death by these 5 causes in the first week the 30-day death rate could be dropped substantially. But the stroke medical world is willfully blinded by the status quo of prevention only. The cures to the neuronal cascade of death are BHAGs(Big Hairy Audacious Goals)
that no one seems to be willing to undertake.
https://www.medpagetoday.com/Cardiology/Strokes/67732?
Stroke deaths in the U.S. may be on the upswing again after a decline in recent decades, according to a CDC Vital Signs report.
Stroke mortality fell each year from 2000 to 2013, from just under 120 to 70 per 100,000. But after that, stroke deaths climbed back up by 4% every year, reaching 75 per 100,000 in 2015, according to Robert Merritt, MA, a health scientist at the CDC.
"My
explanation would be a continued struggle in this country with risk
factors," he said during a press telebriefing, citing hypertension,
diabetes, and physical inactivity among other examples. Two more reasons
for the comeback of stroke deaths: the difficulty of recognizing stroke
symptoms and the reluctance to seek care, he added.
"I think the systemic changes are being made -- we've seen the
advances in tPA, the clot busting drugs. All those things are very good.
But if the risk factors remain high, and people don't call 911 when they have a stroke, it's going to offset all those good things that are going on," Merritt warned.
The decline in stroke death slowed down in 38 states over the
2000-2015 period. In fact, most Southern and Southwestern states showed a
renewed uptick in these deaths. The Midwest, on the other hand, saw
continued declines in stroke deaths.
Certain subpopulations also appeared to be increasingly vulnerable to
fatal strokes during this time, namely Hispanics and African Americans,
who remain at highest risk for stroke death, researchers said.
"This is an important wake-up call. The majority of strokes we see
are avoidable and we know how to prevent them," said CDC Director Brenda
Fitzgerald, MD, during the briefing.
Health
systems have an important role in finding patients with undiagnosed or
unmanaged stroke risk factors, in working with emergency medical
services to identify strokes and get patients transported to the
hospital quickly, and in implementing systems of care that encompass stroke care from hospital admission to discharge and recovery.
For their part, healthcare professionals can identify and treat
hypertension, obesity, diabetes, high cholesterol, smoking and other
risk factors, Merritt said.
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