Action on Stroke Month closes on a high

Guest blog by Dr Clare Walton, Research Communications Officer at The Stroke Association

Today marks the end of Action on Stroke Month 2013 and what an amazing month it’s been! We’ve seen more than 100 community fairs, thousands of people taking part in Step out for Stroke Walks, Stroke Association bike rides and everyone getting into the spirit of taking action on stroke.

The Stroke Association’s final story of the month has looked at blood pressure hotspots across Britain. As many of us working in health know, high blood pressure is present in over half of all strokes and remains the single biggest risk factor. We collected and analysed

over 54,000 blood pressure readings taken at our Know Your Blood Pressure events all over the country and found there was appreciable variation between counties. People living in North East Lincolnshire were found to have the highest blood pressure, putting them at increased risk of stroke.

The theme of this year’s Action of Stroke Month has focussed on the emotional impact of stroke. Our report, Feeling overwhelmed highlighted the fact that stroke survivors and their families say that the emotion effects of stroke are often more devastating than the physical.

In keeping with the theme, the research department held a roundtable event, bringing together leading researchers to discuss the issue of Depression and Anxiety after stroke. Research in this area is taking off, but we learned that there is still much more to be done if we are to adequately support stroke survivors and their carers when dealing with these distressing conditions.

It is timely that today also marks that last day of the European Stroke Conference. For most of this week, more than 3,500 attendees from around the world have gathered at the Excel centre in London to discuss the hottest breakthroughs and biggest challenges in current stroke research.

As usual, the focus of the conference has been on large clinical trials in acute stroke, with the release of final results for many new trials (i.e. INTERACT-II , STICH-II and PHANTOM-S). Perhaps the most exciting of these were the results of CLOTS-3 trial showing that intermittent pneumatic compression devices fitted to the legs of immobile stroke survivors in hospital can significantly reduce the risk of deep vein thrombosis (DVT). DVT is a common cause of death or morbidity after stroke and there is currently no good way to prevent it in stroke patients so these positive findings are very encouraging.

It made a refreshing change to hear about the CHIMES trial– the first randomised clinical trial to test Traditional Chinese Medicine in stroke. Although the trial outcome is neutral – showing no benefits but also no negative side effects of Neuroaid on stroke recovery – it was positive to see such a well-executed large trial addressing the effectiveness of a herbal supplement. Neuroaid is already used widely in China and approved by the Chinese National Drug Administration despite no data to show efficacy.

There was a slight negative atmosphere in some of the sessions, with researchers reflecting on the myriad of failed stroke trials that have gone before. Professors Werner Hacke and Hans-Christoph Diener were jointly awarded the JJ Wepfer Award for their past achievements in acute stroke and stroke prevention, respectively. Their award lectures both focused on the difficulties that surround stroke trials and how we can learn from past mistakes to design stronger clinical trials that are more likely to succeed in the future.

There were numerous smaller oral presentations and hundreds of posters, giving us a glimpse of the breakthroughs being made all around the world. It was notable that the majority of the accepted abstracts had come from the UK, a testament to the strength of our stroke research community.

A particular treat for me was an oral session on non-invasive brain stimulation techniques organised by Professor Wolf-Dieter Heiss. We heard from Professor Heiss and three other leading scientists about how these techniques are being used to encourage recovery of both motor and cognitive deficits after stroke, and with promising results.

Non-invasive brain stimulation techniques, which work by activating the cortex with either a magnetic field or electrical current applied to the scalp, appear to enhance the effect of stroke rehabilitation therapies in some patients. This can help them to relearn lost abilities more quickly and to a greater degree. The next steps will be to design large clinical trials that test these techniques as an adjunct to traditional rehab therapies.

Taking some of the messages from the conference together with the stories we’ve been hearing throughout Action on Stroke Month, there is still much more to be done to tackle the rising problem of stroke. We’ve come a long way in the last few decades in both our understanding and treatment of stroke, and in public awareness. But the full burden of this devastating condition, both on the UK economy and on the lives of families, is not yet widely appreciated.

Given that the prevalence of stroke is set to increase by about 20-30% by 2025, we need to invest now in research to develop better prevention strategies and treatments to support stroke patients cope with the long-term effects of stroke. We also need to listen to stroke survivors to make sure we focus our research efforts where they will really make a difference.

Stroke has traditionally been a neglected condition, receiving a far reduced investment in research than other conditions such as cancer and heart disease. But now that stroke has become the second biggest cause of mortality in the world, it has become a disease that health policy makers cannot ignore.

At his lunchtime talk on Thursday, Professor Charles Wolfe summarised it well, saying:  “Stroke is now on the agenda in most countries, so let’s build on that momentum”.