National Study Shows that Stroke Symptoms Are Common Among Population with No Stroke History
Baptist Stroke Center Medical Director Co-Authored the Study

Jacksonville, Florida, November 6, 2006 -- At least 18 percent of adults with no documented history of stroke report having had one or more stroke symptoms such as sudden numbness or weakness on one side of the body, according to a study by neurologists associated with the University of Alabama-Birmingham (UAB).

The federally funded study compared people in eight Southeastern states in the so-called "stroke belt," with people throughout the country, and also compared the incidence of stroke symptoms in African Americans compared to Caucasian Americans. Baptist Medical Center Downtown neurologist Sean C. Orr, MD, medical director of the Baptist Stroke Center, took part in the study; he was previously associated with UAB.

Orr and his colleagues, including epidemiologist and lead author Virginia J. Howard, MSPH, showed that people with more stroke factors (such as high blood pressure, diabetes and smoking), African Americans, and those with lower income, less education and poorer health status were more likely to have one or more stroke symptoms. This suggests that many of these stroke symptoms reported during the study may have been small strokes that went undiagnosed.

Researchers in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) Study looked at a random sample of 18,462 adults older than 45 years -- average age 65.8 -- who had not been diagnosed with stroke. The sample incorporated those at risk for stroke, including 7,567 African Americans (41 percent of the total sample, a higher ratio than in the general population), and 6,534 (35.4 percent of the sample) residents of the "stroke belt."

In telephone interviews, participants provided information about demographics, general quality of life and medical history, including whether a physician had ever told them they had a stroke and whether they had experienced the sudden onset of any of six stroke symptoms. Brief physical examinations were conducted three to four weeks later. A stroke risk score was calculated for each individual based on demographics, behaviors and other risk factors, with higher scores indicating a greater risk for stroke.

A total of 3,292, or 17.8 percent, of the participants reported having had one or more stroke symptoms -- 8.5 percent reported sudden numbness on one side of the body; 5.8 percent reported sudden weakness on one side of the body; 4.6 percent reported sudden vision loss in one or both eyes; 2.7 percent reported sudden loss of the ability to understand what others were saying; and 3.8 percent reported the sudden inability to express themselves in speech or writing.

Because awareness of stroke symptoms is low, Orr said it is possible many patients who have suffered stroke were completely unaware that these symptoms represented injury to the brain and that seeking treatment might be able to prevent a second, more disabling stroke.

"We believe there is a large number of patients who have suffered stroke, but don't know it," says Orr. "I frequently have to break the bad news that a stroke has occurred and often, it's a total shock to the patient and family. Having a greater understanding of stroke symptoms will improve the chance of getting care early when damage can be limited the most."

Orr said the results of the REGARDS study back up his clinical experience that many patients are unaware of stroke symptoms. "This gives us an even greater sense of urgency to get the word out," he says. "It will also serve as a stimulus for further studies that can help us to better understand demographic patterns and etiologists of stroke. We hope to find opportunities to target high-risk populations in ways that we were unaware would be helpful before.

"The study also reinforces the important role of primary care doctors and physician extenders," Orr adds. "They are uniquely placed to be the first caregivers to be told of signs and symptoms of stroke. This study should help them feel more comfortable about referring their patients for a higher level of evaluation."