Clinical burden of stroke greater than that of heart disease in the UK

November 15, 2005

The clinical burden of stroke and transient ischaemic attack (mini-stroke) is now greater than that of coronary heart disease in the UK, concludes an article published online today (Wednesday November 16, 2005) by The Lancet. The authors state that the findings have important implications for the health service provision and research funding allocated to stroke. The publication coincides with the UK's National Audit Office report on stroke services 'Reducing brain damage: faster access to better stroke care' released today.

Stroke and coronary heart disease are caused by events affecting the blood supply to the brain (cerebrovascular) and heart (coronary), respectively. Although these diseases have some common pathology, risk factors, and preventive treatments, clinical services for stroke have been much less well developed than those for heart disease and research funding lags far behind. The lack of investment in stroke has resulted partly from a perception that it is less common than heart disease and that stroke tends to occur in the very elderly whereas heart disease presents in middle age. However, until now, there has never been a reliable study of the comparative epidemiology or relative clinical burdens of cerebrovascular and coronary vascular disease in the same population.

In the Oxford Vascular Study (OXVASC), Peter Rothwell and colleagues followed the outcomes of over 91,000 individuals in Oxfordshire UK from 2002 to 2005. They identified 2024 new vascular events in 1657 individuals: 918 cerebrovascular events, 856 coronary vascular events, 188 peripheral vascular events, and 62 unclassifable deaths. The investigators found that the age of onset of cerebrovascular and coronary vascular events was the same, with half of all events occurring in individuals aged 75 years or older.

Dr Rothwell comments: "Routinely collected mortality data show that coronary heart disease is the leading cause of death in most developed countries. However, although cerebovascular events are less likely to be fatal and so mortality rates are indeed lower, stroke is much more likely to cause major disability. We have shown that rates of acute cerebrovascular events in our population are, in fact, higher than those of acute coronary events...and that the widespread assumption that coronary events occur at younger ages is false...The major under-funding of both clinical services and research for cerebrovascular disease compared with coronary heart disease cannot be justified on the basis of clinical burden."
See also accompanying comment.

Contact: Professor Peter M Rothwell, Stroke Prevention Research Unit, University, Department of Clinical Neurology, Radcliffe Infirmary, Woodstock Road, Oxford OX2 6HE, UK. T) 01865 224237

Notes to editors
Peripheral vascular events are those affecting the blood vessels supplying areas of the body other than heart or brain


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