Select Committee on Science and Technology Minutes of Evidence

Supplementary evidence by The Stroke Association

  1.  What emerging opportunities do you perceive for research on scientific aspects of heart disease and stroke over the next five to 10 years? And in the longer term (10-25 years)?


  Derek Wanless has focussed on the importance of life style factors in the development and progress of chronic illness. Older people stand to be major beneficiaries of the change in emphasis that  Wanless recommends. Whereas the benefits have been identified effective strategies for bringing about these benefits have not been defined.

  Further advances in imaging and, through imaging, better classification of stroke by site and extent of anatomical damage.

  Advances in evidence-based rehabilitation, re-training and the facilitation of recovery (plasticity) using adjuvant procedures.

  Improved quality of evidence through the NSCRN—for therapeutic, surgical and rehabilitation procedures.

  2.  Although age is the single biggest risk factor for heart disease and stroke it seems that little attention is paid to underlying questions about how intrinsic ageing processes at the cell and molecular level contribute to the specific pathology that is seen in these conditions. Is this perception accurate?

  The intrinsic ageing process is of limited relevance in this field. Less is known about the mechanisms of lacunar stroke and vascular dementia.

  3.  What opportunities do you see to develop links with complementary activity concerned with other aspects of ageing, particularly those based within other disciplines? How successful have any effort been to build such links? What problems have been encountered?

  There is scope for collaboration with BHF, Diabetes UK, Alzheimer's Society and with Help the Aged to mention a few.

  The small amount of research money available to The Stroke Association is an impediment. On the other hand there is in practice joint funding of strong research groups eg the Cambridge Stroke Group receive funding from BHF for their work on the imaging of carotid plaque. The European Prospective Investigation into Cancer EPIC is an example of broad collaboration (MRC, CRC). The EPIC-Norfolk group at Cambridge (Prof K-T Khaw) The Norfolk cohort belongs to the infrastructure of a large prospective population study of approximately 25,000 men and women aged 45-79 years. It is examining the determinants of stroke incidence and mortality with particular emphasis on modifiable risk factors diet and physical activity, and biological mechanisms such as raised blood pressure, inflammation, haemostasis and glucose metabolism.

  4.  Do you think that the research councils and other research funding organisations give appropriate recognition to the importance of ageing ingeneral, and to cardiovascular system ageing in particular? If not, what actions do you think might remedy the situation?

  The Research Councils face a dilemma. They are committed to supporting high quality research. Historically the restricted research capacity of ageing research per se has limited the growth of first class teams and the conception of first class projects. Fortunately cardiovascular research has had the wealth of the BHF behind it.

  The Funders' Forum for Research in Ageing & Older People has not been a success thus far.

  Small organisations have been expected to deliver the same quick wins which were delivered by the Cancer Funders' Forum.

  5.  How do you think the general public perceives the issues surrounding ageing of the cardiovascular system? Is enough effort being directed at engaging with the general public in this respect?

  Witness the prospects for the implementation of Derek  Wanless's proposals. We need acceptance of the message that stroke and CHD, and the changes which underlie them, are in large measure avoidable. Stroke and CHD are not inevitable accompaniments of ageing. We need to sustain prevention with evidence-based campaigns. Without more effective strategies for the prevention, treatment, and rehabilitation of stroke based upon good research, the cost of this disease can only increase.


  Awareness of the gravity of stroke in UK is alarmingly low amongst both the general public and some health professionals.

  TSA conducted a survey of 1,006 members of the general public, 200 General Practitioners and 75 Accident and Emergency Doctors from across the UK as part of The Stroke Association's Stroke Awareness Week, which ran from 4 to 10 October. The survey intended to ascertain levels of knowledge on stroke, treatment and prevention. Results demonstrate a lack of knowledge of the severity of stroke, particularly amongst some health professionals, women and young people.

  Every year over 130,000 people in UK have a stroke. Results show that most people think stroke is a minor condition with 34 per cent of people estimating that there are only 50,000 people or less that have a stroke each year. Perhaps more alarming however, health professionals considerably underestimate the scale of stroke, with only 14 per cent of GPs and 28 per cent of A&E doctors accurately estimating the scale of the condition.

  The number of women that have a stroke each year is also underestimated. Over 74,000 women have a first stroke each year. This is more than double other serious conditions such as breast cancer, which has 40,000 new cases each year. The survey found that 61 per cent of the general public believe serious conditions like breast cancer affect more women in the UK than stroke.

  The serious consequences of stroke are equally misunderstood. Ninty-three per cent of women surveyed do not rate death as one of the most common consequences of stroke, despite the fact stroke is responsible for 13 per cent of all deaths in women.

March 2005

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