New Zealand's increasing stroke numbers largely preventable says leading AUT neuroscientist

Stroke is New Zealand's silent killer, ten times more deadly than our annual road toll. Each day, on average, 21 New Zealander's will suffer a stroke and over 2000 people die every year.

Professor Valery Feigin, director of AUT University's new National Institute for Stroke and Applied Neuroscience (NISAN) says stroke - combined with traumatic brain injury - is the leading cause of disability and death in this country, and perhaps needlessly so.
"Unlike most other developed countries where stroke incidence has declined by 42% over the last three decades, between 1981-2003 stroke incidence in New Zealand declined by only 11% - and only in New Zealand Europeans. In Maori and Pacific people it has increased by 19% and 66% respectively."

The traditional view of stroke is that it is unavoidable, untreatable and genetically determined condition. Feigin says there is now overwhelming evidence to disprove this.
Stroke is an acute vascular injury to the brain - the result of an arterial rupture or blood clot, dependent upon where in the brain the injury occurs. Stroke impairment can lead to memory loss, blindness, paralysis and speech problems.

The key risk factors of stroke include elevated blood pressure, smoking, poor diet, excessive body weight, high cholesterol and a sedentary lifestyle. By managing these alone, Feigin says the likelihood of stroke can be reduced by 80%.

"Maori and Pacific people, who constitute about one third of New Zealand's population, are disproportionately affected by stroke. Stroke incidence in these ethnic groups has increased over the last 20 years, as opposed to decreased stroke numbers in European/Pakeha New Zealanders," he says.

According to Rex Paddy, Chief Executive of the Stroke Foundation's Northern Region, one person in six will have a stroke in their lifetime. The average age of Maori having a stroke is 60 and for Pacific people it is 65. This compares with age 75 for those from European backgrounds, says Paddy.

AUT's stroke research centre is currently investigating the causes of stroke and rehabilitation of stroke sufferers in partnership with the Stroke Foundation.

Paddy says the collaboration with AUT is vital in reducing the incidence of stroke and the impact it has upon the delivery of health care in New Zealand.

"Around 7000 people have a stroke each year. Just the acute hospital care alone for these people costs around $150M. Stroke patients account for more hospital and resthome bed days than any other condition. The impact on health care costs is enormous."

Currently costing the country over $450M per year in combined hospital and rehabilitation related costs stroke incidence in New Zealand is the second highest amongst developed countries.

"There is a huge amount of stroke research going on in New Zealand because suddenly it has been realised the burden of stroke can be reduced through prevention, urgent treatment and rehabilitation," says Paddy.

"It makes a difference by developing new treatments for acute stroke and new ways of delivering rehabilitation for those who have had a stroke. It also provides hope for those who have a disability that in the future new treatments may be available to reduce their disabilities."

Professor Feigin leads the ARCOS (Auckland regional stroke community study) research along with co-director and AUT Professor of Rehabilitation Kathryn McPherson and other University of Auckland researchers. Funded by the Health Research Council, ARCOS - the first research study in the world to look at stroke incidence and outcomes in 28 countries - includes a randomised control trial to reduce stroke recurrence.

"Recurrent stroke leads to re-admissions, higher disability and mortality. Overall in New Zealand, 25% of people suffer a secondary stroke, whereas the global average is 15-20%, says Feigin.
The development of acute treatments has turned stroke into a treatable medical emergency. New work is just starting on the psychological impact of stroke on individuals and their families. There are many research projects looking at different types of therapy and their relative benefits.

So far, the stroke research institute has attracted over $8M of external funding. Previously overshadowed by heart and cardiovascular disease, stroke and traumatic brain injury are now seen as a problem of growing importance says Feigin.

Click here to find out more.