Cigarette smoking is the #1 preventable risk factor for stroke. The nicotine and
carbon monoxide in tobacco smoke reduce the amount of oxygen in the blood.
They also damage blood vessel walls, making clots more likely to form.

Cigarette smoking increases the risk of coronary heart disease by itself. When it
acts with other factors, it greatly increases risk.

Other factors include high blood cholesterol, high blood pressure, physical inactivity, obesity and diabetes.

Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot.

Cigarette smoking is the most important risk factor for young men and women. It produces a greater relative risk in persons under age 50 than in those over 50.

Women who smoke and use oral contraceptives greatly increase their risk of coronary heart disease and stroke compared with nonsmoking women who use oral contraceptives.

Smoking decreases HDL (good) cholesterol. Cigarette smoking combined with a family history of heart disease also seems to greatly increase the risk.

19% of California adults were smokers in 1999.

Sources: American Heart Association. CA Dept. of Health Services

Numbness or weakness of the face, arm or leg, especially on one side
Severe headache
Dizziness, loss of balance or coordination
Difficulty speaking, understanding speech, seeing or walking

Because stroke injures the brain, the victim may not realize what is happening. To a bystander, the victim appears confused, but someone must summon emergency help immediately.

If you or someone you know is experiencing symptoms, call 911 and ask to be transported immediately to a certified stroke center such as Good Samaritan Hospital in San Jose or Stanford Hospital in Palo Alto.

Clot-busting drugs, including “tissue plasminogen activators” or t-PA, are FDA-approved treatment for strokes. This drug can cure people who otherwise would be crippled, but it must be given within three hours. A side effect can be dangerous bleeding, so clot busting drugs cannot be used for hemorrhagic strokes or if fall or trauma occurred during the stroke.

Family and friends as well as bystanders who attempt to help stroke victims may not recognize the warning signs or the need for rapid transportation.

Stroke symptoms are hard to identify and are often mis-diagnosed by emergency medical personal.

Only hospitals with certified stroke centers are equipped to immediately treat stroke victims well within the three-hour window.

Patients often wait for their primary care physicians in the emergency room instead of seeking immediate treatment by neurologists at certified stroke centers.

In the U.S., some 700,000 people experience a stroke annually.

More than 170,000 of those patients die.
Half of stroke deaths occur before the patient reaches the hospital, according to the American Stroke Association.

Strokes are the 3rd leading cause of death in the United States.

They accounted for more than one of every 15 deaths in the country in 2001.

Public health burden immense, says American Heart Association
Cost to the nation estimated at $50 billion each year
$70K per stroke patient average cost

Clots or bleeding that disrupt blood flow to the brain cause strokes.

Blood clots cause up to 85% of all strokes and are called “ischemic strokes”.
Bleeding or “hemorrhagic” strokes constitute the remainder.

Clot-busting drug “tissue plasminogen activator” or t-PA is the only FDA approved treatment for strokes

Must be given within a 3-hour window

Industry and Medicare estimates that only 1% of patients who experience stroke receive this treatment.

Stroke symptoms in both men and women are often not recognized so medical care is often delayed.
Women do not experience classic symptoms.
Effective emergency transport systems can be lacking.
Not all emergency centers and hospitals implement acute care and longterm treatment protocols.