What Blacks need to know about stroke

Jet, July 22, 2002 by Nicole Walker

Strokes can strike in an instant. One moment you're laughing with friends over a game of Bid Whist, reading your favorite magazine on the bus ride home or settling in your bed for the night. The next moment, one side of your body suddenly goes numb, your head starts pounding and your vision gets blurry. You try to talk, but can barely speak. You try to move, but you can't. You feel weak, disoriented and scared.

Having a stroke can be a very frightening experience. Stroke affects about 600,000 people in this nation each year, and claims nearly 170,000 lives annually, many of which are African-American. In fact, Blacks ages 35 to 54 are four times more likely to die of a stroke than Whites in the same age group, according to a government report.

But even more chilling is the fact that so many of us know so little about stroke--the nation's No. 3 killer--and even less about recognizing the symptoms or preventing one in the first place. A recent national survey conducted by the American Stroke Association found that only 1 percent of Americans are worried about stroke, largely due to lack of knowledge.

Strokes are also quite costly. Health experts say stroke costs the United States $30 to $40 billion per year including hospitalization and rehabilitation costs and employment wages lost by stroke victims and their caretakers. With numbers like those, you cannot afford the luxury of ignorance when it comes to this health epidemic.

Save your life and the lives of those you love by learning as much as you can about stroke.

* WHAT IS A STROKE?

A stroke is simply a lack of oxygen to the brain. The brain, like every organ of the body, needs oxygen to function. Blood carries oxygen to the brain, but when something stops the blood and the oxygen from reaching any part of the brain, that area of the brain stops working. If that area controls muscle movement, speech, vision or memory, that body function will be impaired, which explains the paralysis, vision and speech problems and memory loss that often accompany a stroke.

Dr. Jeffrey T. Harris, assistant professor of neurology at the University of Alabama at Birmingham's Huntsville campus and director of the stroke program at Huntsville Hospital in Huntsville, AL, explains that the lack of oxygen to the brain could be caused by a blood clot breaking off from somewhere else in the body and traveling to the brain, or from "scar tissue inside arteries "making them act like Velcro so that debris like cholesterol and nicotine sticks to artery walls and forms a blockage, like silt in a water pipe."

"Once that pathway gets too narrow, no blood will get through, and there's your stroke," he says.

Most strokes are caused by blocked arteries in the brain, but in some rare instances, strokes can be caused when a blood vessel abruptly bursts in the brain, causing bleeding in the brain (hemorrhage). Blood vessels can rupture due to a defect in the vessel present since birth, because of high blood pressure or because of severe head trauma.

If a blood clot, errant debris or ruptured vessel prevents brain cells from getting blood for more than a few minutes, then those cells will die. And unlike other cells of the body that can regenerate, such as liver and skin cells, once brain cells are gone, there's no coming back.

* WHAT ARE THE WARNING SIGNS OF STROKE?

"The hallmark of a stroke is that it happens suddenly," informs Dr. Harris. "Other conditions, like diabetes, can do something similar to stroke in which they rob you of certain neurological functions--you get weak, numb or have tingling on one side of your body, or your vision is affected--but they do so over weeks, months or years. Stroke happens--bang!--suddenly. One second you're normal, the next second you're not."

Telltale signs of a stroke are sudden numbness, weakness or tingling in the face, arm or leg, especially on one side of the body; sudden confusion, inability to talk or difficulty speaking or understanding; sudden trouble with walking, dizziness, loss of balance or coordination.

Stroke symptoms also include difficulty with swallowing, loss of bowel and bladder control, trouble seeing in one or both eyes, or double vision, severe headache with no known cause and loss of consciousness.

* WHY IS STROKE SO SEVERE IN BLACKS?

African Americans are more likely to have a stroke and die of stroke than Whites. The reason for the higher incidence, experts say, probably has less to with genetics, and more to do with our lifestyles and economic status.

"We haven't found a gene that's only in Blacks but not in other races that causes us to have strokes," Dr. Harris informs, "so we can't say with any type of certainty that we have a higher incidence of strokes solely because we are Black."

However, Dr. Harris informs that Blacks are more likely to have a stroke and die from it because of other risk factors that are highest in African Americans versus other populations. Risk factors which he attributes to a "larger scale problem."

"We have a higher incidence of high blood pressure, diabetes, smoking, high cholesterol, heart disease, heart attacks," he says. "The reasons for those conditions, to date, are part of a larger scale problem. They're related to poor access to health care, poor health education and social-economic status. We don't understand why we have to take the medications. We don't have the money to afford the medication and we don't have the money to afford the appropriate, healthy diet.