Louisiana has a high incidence of strokes; stroke care centers are a long distance from some communities
African Americans suffer strokes at a higher rate than whites
NEW ORLEANS (WVUE) - Louisiana has a high prevalence of strokes and in some areas of the state residents have nearly an hour’s drive to the nearest stroke center.
Monica Ernst is a stroke survivor and an American Heart Association Circle of Red member.
“I would work out probably about three to five times a week. I was very healthy, and I was doing Body Combat and what happened was, the left side of my body went numb, my face started to droop, my peripheral vision went out,” said Ernst.
The physical changes were obvious to someone exercising near her, too.
“Thankfully, I had a friend that was working out behind me and she knew something wasn’t right, so she called my husband and he met me there and we went to the emergency room and they thought it was actually a migraine because I’m not taking any medication, I don’t have any pre-existing condition and sure enough they found out that I had a hole in my heart and a clot went through and I had a stroke,” said Ernst.
While Ernst’s stroke was rooted in something rare, strokes are very common because of other reasons. The CDC says every 40 seconds someone has a stroke in the U.S. and every four minutes someone dies of stroke.
Dr. Merritt Brown is in the Neurosurgery and Neurology section at LSU Health New Orleans and discussed the types of strokes.
“Strokes come in two varieties, the most common one is where a blood vessel that’s in the brain gets blocked by a blood clot and the brain is deprived of blood flow. The brain is so metabolically active that any part of it that doesn’t get a certain amount of oxygen and nutrients will start to shut down. Unless you restore that blood flow quickly, that part of the brain is going to be permanently damaged and the stroke is actually the permanent damage to those parts of the brain,” said Brown.
He said stroke symptoms should not be ignored.
“Strokes in any capacity are really a medical emergency,” said Dr. Brown.
There are some telltale signs.
“Sometimes you can have symptoms that are very, very subtle but the main things to watch out for is if one side of your body, if the arm or the leg feels heavy; if you start to notice in a loved one’s face that it looks like they have a facial droop that they didn’t have before; if it looks like they’re slurring their words; if it looks like they’re having issues being able to find their words, or they just seem like they’re not responding the normal way that they had before,” Brown stated.
According to the NIH, Louisiana is part of the so-called “Stroke Belt.”
Alyana Samai, MPH, is Director of Neuroscience at West Jefferson Medical Center. She discussed what might contribute to being part of the Stroke Belt.
“You can see a very high incidence and prevalence of stroke in that population. A lot of the reason for that is, there are a lot of theories but likely it is due to the fact that we like our food, we have really rich food, we have a really rich culture, and we also live historically, compared to the rest of the country, we live a very sedentary lifestyle.”
CDC data shows Louisiana has a stroke mortality rate of 44.1 per 100,000 people.
“The reason for that clot forming is usually related to something along the lines of high blood pressure, diabetes, high cholesterol, obesity, lack of physical activity. The usual risk factors that you hear about for a lot of chronic diseases,” said Samai.
And the risk of having a first stroke is nearly twice as high for Blacks as for Whites says the CDC.
“The prevalence of stroke among African Americans is known to be higher, that’s a national statistic, that’s not just in Louisiana, and that ties into a lot of other risk factors that are known to be higher in African American populations,” Samai said.
Brown says smoking is a big risk factor for stroke.
“So, some of the nicotine, some of the substances that are in tobacco products can actually lodge themselves in the side of blood vessel walls and make them much more likely to harden, just like high blood pressure can do the same thing, it can make those blood vessels harden. If they end up having enough of a blockage, it can actually shrink the caliber of the vessel to a point where blood doesn’t flow well past that blockage,” Brown stated.
Keeping blood pressure in check is also important to reduce the risk of stroke.
“Make sure that your blood pressure is in a good range, make sure that your cholesterol is checked every so often especially if you’re over 40 or 50 years old,” said Brown.
“Stroke is usually caused by a lot of the most preventable diseases,” she said.
They said time is critical, in terms of stroke outcomes.
“As soon as you start to have problems really the clock starts and the quicker that we’re able to treat a patient, the quicker that we’re able to open up one of those blocked vessels the more likely somebody is to not suffer significant damage,” said Brown.
But according to an analysis by Kaiser Health News, 19% of Louisiana’s population lives more than 45 minutes from a certified stroke center.
In the New Orleans area, the situation is far better. West Jefferson Medical Center and Ochsner are certified stroke centers.
“Annually, we are privileged to treat about 1,500 patients per year. It can be higher or lower depending on the year. Those numbers vary but we are the only stroke center, certified stroke center on the west bank of Louisiana,” Samai stated.
And some other area hospitals have certifications as “primary” stroke care facilities.
Brown says proximity to stroke centers aside, get to the closest hospital possible.
“One of the biggest things that I can recommend to folks that aren’t necessarily next to a major center is getting to any hospital is really going to be crucial because the associations that community hospitals have with some of the major hospitals can be the difference between you being able to get to a center that can perform a lot of these therapies,” he said.
Through partnerships, patients can be transported from a smaller hospital to a stroke center.
“Most times if we have an agreement, especially in Louisiana, if you’re at a hospital that’s remote from one of the major centers, whether it’s something that we can use, transportation, ground transportation or air transportation in some ways, getting people to that center as quickly as possible via one of the community hospitals, could be again the difference between life and death quite frankly,” said Brown.
Samai said the fight to improve access to health care is far from over.
“We know that there are definite disparities in just the ability to receive medical treatment and that’s something I think at a national level we need to be focused on,” said Samai.
Ernst is happy she got medical attention soon after her stroke symptoms began.
“I was so thankful,” she said.
And Ernst is grateful her stroke did not cause long-lasting effects.
“Yes, I know quite a few people that have residual side effects that are really debilitating and it’s sad and I’m very fortunate that I don’t have that,” she said.
CDC data indicates nine of the 10 Delta parishes in the New Orleans area have stroke death rates that are higher than the national average for adults 35 years of age and older. Of those parishes, St. John Parish has the highest at 98.9 deaths per 100,000 people. The national rate is 72.6.
FOX 8 requested comment from the Louisiana Department of Health on the proximity of stroke centers to some communities but the agency said no one was available.
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