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)?
DELIVERY OF
"PREVENTIVE" MEASURES
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.
NEW SURVEY
REVEALS SEVERITY
OF STROKE
STILL WIDELY
UNDERESTIMATED
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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