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Commentary: A Comparison of Stroke Risk Factors Between Men and Women with Disabilities
This article addresses an important but frequently neglected topic—stroke prevention in people with preexisting disabilities. A review of the literature quickly reveals evidence-based preventative guidelines for major medical conditions such as high blood pressure (HBP), transient ischemic attack (TIA), atrial fibrillation, and diabetes, as well as modifiable lifestyle risk factors (e.g., smoking, alcohol, illicit drugs) that contribute to the development of a stroke (American Heart Association [AHA], 2005). In fact, 80% of strokes can be prevented if there is long-term adherence to these prevention standards. According to the AHA (2005), regular stroke assessments should begin at the age of 20.
One of Hinkle’s central messages is that adults of all ages, genders, and ethnicities may benefit from stroke risk assessment and long-term management of conditions and lifestyle practices that put them at increased stroke risk. Although national campaigns have slightly increased the public’s knowledge of stroke, they typically have not produced the outcomes desired. For instance, only 70% of Americans can correctly name one stroke sign and 72% can name one stroke risk factor (Schneider et al., 2003). With regard to HBP, the principal medical condition contributing to the development of stroke, only 30% of patients typically know that they have HBP; another 25% are aware that they have HBP but do not control it with prescribed medication (AHA, 2005). These findings suggest that a blend of public and health education is pivotal, along with routine stroke risk factor assessment and the evaluation of the efficacy of subsequent treatment modalities.
Although males in this study as in society are at increased risk for stroke, more women die of stroke (61.5%) compared with men (AHA, 2005). There also now exists the Evidenced-Based Guidelines for Cardiovascular Disease Prevention for Women (Mosca et al., 2004) with significant preventive care ramifications.
In closing, it should be recognized that as the number of stroke risk factors increases so does the likelihood of a stroke. Therefore, recognition and management of these stroke risk factors are imperative for all patients, those with and without disabilities.
American Heart Association (2005). Heart disease and stroke statistics—2005 update. Dallas, TX: Author.
Mosca, L., Appel, L. J., Benjamin, E. J., Berra, K., Chandra-Strobos, N., Fabunmi, R. P., et al. (2004). Evidence-based guidelines for cardiovascular disease prevention in women. Circulation, 109, 672–693.
Schneider, A. T., Pancioli, A. M., Khoury, J. C., Rademacher, E., Tuchfarber, A., Miller, R. et al. (2003). Trends in community knowledge of the warning signs and risk factors for stroke. Journal of the American Medical Association, 289, 343–346.