News Release

Free stroke screenings may pay off by revealing hidden risk

Peer-Reviewed Publication

American Heart Association

NEW ORLEANS -- You may want to stop the next time you see a stroke screening at a health fair or your local mall -- especially if you smoke, are over 65 years old, or have heart disease or elevated levels of cholesterol, according a new study.

Researchers from Buffalo, N.Y., announced their results here today at the American Stroke Association¹s 25th International Stroke Conference. The American Stroke Association is a division of the American Heart Association. In this study, 1,331 people who had not had a stroke were screened for stroke risk. Eighteen percent (239 people) were found to have blockages in their carotid arteries -- the vessels carrying blood to the brain -- that were severe enough to warrant follow-up consultation with a physician. When the carotid arteries are blocked, blood may not be able to reach the brain and a stroke can result.

"Screening everyone may not be justified, but screening those who have two or more risk factors is, because we've found that they have a significantly higher chance of having a blockage," says the study's lead author Adnan I. Qureshi, M.D., of the department of neurosurgery at Syracuse University-New York Medical Center in Buffalo. "We were surprised at the large number of people we found to be at higher risk."

People who were over 65 years of age were 4.1 times more likely to have significant blockages -- defined by the researchers as 60 percent or more blockage -- than those who were under 65. There was also heightened risk of blockage for those who smoked (two times higher), had pre-existing heart disease (2.4 times higher) or extremely high cholesterol, or hypercholesterolemia, (1.9 times higher). People who were taking medication to treat their high cholesterol were considered to be hypercholesterolemic for the purposes of the screening, says Qureshi.

People who attended the screenings -- part of the Western New York Stroke Screening Program -- were able to have their carotid arteries examined by the use of a technology known as Doppler ultrasound, a noninvasive test that "photographs" blood vessels and shows obstructions in blood flow. The ultrasound tests were available at the screening sites which included malls and health fairs.

"The risk factors identified in the study are based on information that almost everyone has -- cholesterol levels, whether they smoke or not or have heart disease -- and by appropriately utilizing it, we can determine who is most likely to benefit from getting a carotid artery Doppler ultrasound," says Qureshi.

Identifiying a significant blockage is important, says Qureshi, because it can help physicians prevent a stroke. Previous studies have shown the usefulness of a procedure called carotid endarterectomy, which is a surgical technique used by physicians to clear out severe blockages from the carotid arteries to help prevent future strokes.

"Our focus is to educate people so that they know more about what can increase their risk of stroke," says Qureshi. "By using the carotid Doppler in those people with major risk factors, we can determine if they have blockages and refer them to a physician."

The screenings were free of charge to the public, paid for by a local group of businesses. They were staffed by medical professionals such as nurse practitioners and physicians volunteering their time.

Qureshi says his group believed that the best way for the screening service to be successful was to take it to the people -- malls, health fairs and other areas where people gather frequently.

"The person gets to meet a physician right there on the spot and we can screen all the risk factors the person has," says Qureshi. "The physicians go over each risk factor in detail and explain how these factors can add up to raise a person's risk of stroke."

Qureshi says that his team of researchers is currently gathering follow-up data on these people to determine the impact of the screenings on those who received them.

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Co-authors are Vallabh Janardhan; Susan E. Bennett; Andreas R. Luft; L. Nelson Hopkins; and Lee R. Guterman. Guterman is the senior investigator and director of the Western New York State Screening Program.


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