Hispanics are at the highest risk of getting a stroke and, yet, are also the group least likely to seek treatment – a potentially fatal decision, experts say. The faster a stroke victim gets clot-busting treatment, the more likely they are to survive.
"We basically scare people so much about strokes, it motivates them to denial," says Dr. Lewis Morganstern of the University of Michigan, an expert on stroke disparities. "What we haven't done a good job of is telling people there is an effective treatment, that people are in control of their own destiny."
About 795,000 Americans have a stroke every year. It is the nation's leading cause of disability and the No. 3 killer. Symptoms include: sudden numbness or weakness in the face, arm or leg, especially on one side; sudden trouble speaking or understanding speech, seeing or walking; a sudden super-severe headache.
While some strokes are caused by bleeding in the brain, the vast majority are ischemic strokes, the clot kind that the drug TPA can help treat, but only if given within a few hours of the first symptom.
Yet 14 years after TPA hit the market, only about 5 percent of U.S. patients get it. The low percentage is due not only to problems within the health care system, but also because only about a third of stroke sufferers get to the hospital in time for testing to tell if they're a good candidate.
Everyone needs to know that they must act fast if they experience or witness stroke symptoms.
The new research on care for stroke victims comes because of data showing that African-Americans have strokes at twice the rate of whites and are more likely to die. Hispanics are at increased risk of stroke as well. Both populations also tend to have strokes at much younger ages than whites.
Georgetown researchers tracked ischemic strokes for a year in Washington, and found black patients received TPA less often than whites in part because of slower hospital arrival despite community surveys that found widespread knowledge about stroke symptoms.
"No, you can't wait to see if your symptoms go away," says Dr. Chelsea Kidwell, a Georgetown neurologist who heads the project. "No, you should not call your relative or friend. ... You've got to call 911."
The findings echo a major study that Morganstern leads in Corpus Christi, Texas, where Mexican-Americans were 40 percent less likely than whites to call 911 for a stroke.
The most common mistake among all populations when feeling a stroke symptom is to go rest.
Adding to the confusion are so-called ministrokes, a TIA or "transient ischemic attack" where an artery is blocked for a few minutes, leaving no permanent damage. But it's a warning sign that a major stroke may be imminent, something prompt care to treat risk factors like high blood pressure might avert. Other studies have found half of people who have a TIA never tell a health provider.
It takes community-specific research to learn what act-fast messages work, Morganstern says. His Corpus Christi project recently taught middle-school students to call 911 if they witness someone having stroke symptoms, with homework assignments to teach their parents, too thus reaching a hard-to-target population. Next, the project is designing ways that local Catholic churches can help with stroke education.
In Washington, Kidwell is working with ambulances to bypass the closest hospital for one of three certified "stroke centers" hospitals with 24-hour special capabilities to give TPA.
The Associated Press contributed to this report.