Stroke a killer for Māori and Pacific Islanders

MEDIA RELEASE
Monday, March 2, 2009

Stroke a real killer for Māori and Pacific Islanders

Stroke incident rates in Māori and Pacific Islanders are now similar to those in developing countries, reveals an AUT University study.

“Stroke rates with Māori and Pacific Islanders have increased by 19 per cent to 66 per cent respectively,” says Professor Valery Feigin, Director of the National Research Centre for Stroke, Applied Neurosciences and Neurorehabilitation, at AUT University.

“They are suffering disproportionately more severe strokes and poorer outcomes.”
New Zealand is more than two times behind other developed countries in the rate of stroke incidence decline and the gap between Māori and Pacific Island stroke rates and European New Zealand is widening at an alarming speed.

“Over the last three decades New Zealand has declined by only 11per cent over the whole population, compared to a worldwide trend of 42 per cent,” he says. “We are well behind other developed countries.”

Currently stroke is the number two killer in the world and if the number of incidents in developing countries continues to rise at the same rate, it will be number one within 20 years.
“Immediate action is now essential to halt the onset of a worldwide epidemic,” says Professor Feigin.

The study is the largest ever stroke review of its kind to date, investigating the worldwide incidence and outcomes of stroke in 28 countries (including New Zealand) over the last four decades.

It was carried out by AUT University’s National Research Centre for Stroke, Applied Neurosciences and Neurorehabilitation, in collaboration with Auckland University and the University of Oxford (UK).

It was the first study to show that the incidence of stroke in low-to-medium income countries has increased by more than 100 per cent, and that people living in these countries face a 20 per cent greater risk of stroke than those living in high-income countries, where the incidence of stroke has declined by 42 per cent.

Stroke is largely environmentally driven and is therefore preventable. Cues include elevated blood pressure, smoking, poor diet (low in vegetables and fruit) and weight gain; all associated with a Western lifestyle.
“About 90% of all strokes would not happen if preventative measures were in place,” says Professor Feigin.

“95 per cent of high blood pressure cases, the main cause of stroke, could be controlled through relatively simple measures.

“Our findings showed that when other countries put preventative measures in place, stroke rates dropped by more than 40 per cent.

There are considerable long lasting disabilities associated with stroke. Among the survivors, around three-quarters are left permanently disabled, with more than half requiring assistance everyday.

“It is a terribly depressing situation for both the patient and their family,” says Professor Feigin. “The overall effect to society is far, far greater than that of heart disease which is currently rated as the number one killer in New Zealand.

“This study only highlights the deficiency in stroke prevention in New Zealand.”
New Zealand clocks up 6000 to 7000 new stroke patients each year with a direct cost to the country of around $150 million. Indirect costs are about two to three times this totalling around $500 million a year. The study suggests that preventative measures could save the country $200 million a year.

Notes to the editors
Key findings
There are diverging trends in stroke among high-income and low to middle income countries over the past four decades, with a 42per cent decrease in stroke in high-income countries and greater than 100 per cent increase in low to middle income countries. Corresponding trends in stroke are observed in younger (<75 years) and older (>75 years) age groups, although the differences are far more pronounced in the older group.

In 2000 to 08, stroke rates in low to middle income countries have, for the first time, exceeded those in high-income countries.

The study has been published online in Lancet Neurology*, *Feigin VL, Lawes CMM, Bennet DA, Barker-Collo S, Parag V. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review. Lancet Neurology 2009; published online. Feb 20. DOI: 10.1016/S1474-4422(09)70025-0.

A media release has been distributed internationally by Lancet Neurology to accompany it. For a copy please contact valery.feigin@aut.ac.nz

For more information or a copy of the study please contact:

Professor Valery Feigin
Director, National Centre for Stroke and Applied Neurosciences and Neurorehabilitation
AUT University

ENDS

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