Posted on February 8, 2007 at 10:50 a.m.

BIRMINGHAM, Ala — Half of those who experience stroke symptoms, including people with health insurance, are unlikely to seek medical treatment, according to UAB research presented Feb. 7 at the American Stroke Association’s 2007 International Stroke Conference in San Francisco.

“People with health insurance were only slightly more likely to seek treatment than people without insurance,” said Virginia J. Howard, M.S.P.H., lead author of the study and an epidemiologist at the University of Alabama at Birmingham (UAB) School of Public Health. “Obviously something needs to be done to address the barriers to stroke treatment and prevention.”

Researchers analyzed data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national, population-based study of African-American and white adults 45 years and older. REGARDS researchers are trying to determine the reason for higher stroke death rates in the southeastern states known as the Stroke Belt — North and South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas and Louisiana. They also want to know why stroke death rates are higher among African-Americans than whites.

The current study looked at behaviors surrounding stroke symptoms. Researchers asked participants if they had experienced any stroke symptoms and, if they had, whether they sought medical care. The symptoms they inquired about included sudden weakness or numbness on one side, sudden loss of vision in one or both eyes, inability to understand what others are saying, and inability to communicate verbally or in writing.

UAB researchers found that 2,124 participants reported they had experienced at least one stroke symptom, but had no confirmed stroke diagnosis. Of those who reported symptoms, 51.4 percent did not seek medical care.

Nearly 47 percent experienced sudden numbness, which was the most common reported symptom, and 24 percent experienced at least two symptoms.

Additionally, the study found that those with an income of $20,000 to $34,999 were 8 percent less likely to seek care that those in other income brackets and the likelihood of seeking care increased with higher income. Those with income of $35,000 to $74,999 were 27 percent more likely to seek care, and those with income more than $75,000 were 55 percent more likely to seek care.

Also, participants who had other medical risk factors for stroke tended to be more likely to seek care — 23 percent more likely if they had past heart disease, and 22 percent more likely for either high blood pressure or diabetes.

Howard said this study was a good starting point in their efforts to understand what causes the Stroke Belt to have its name. One of the goals of their research is to strengthen educational efforts of public health agencies, hospitals and physicians, to encourage the general public, especially those who are most at risk, to be aware of stroke signs and to take them seriously if they occur.

“If you think you might have stroke symptoms, get them checked out immediately,” Howard said. “You could also be experiencing warning signs of a future stroke, and sometimes these signs go away within 24 hours. Neurologists say that even if you’re not having a stroke, there could be something else important going on, so err on the side of caution.”

Co-authors are Daniel T. Lackland, Dr.P.H., Medical University of South Carolina; Judith H. Lichtman, Ph.D, Yale School of Medicine; Leslie A. McClure, Ph.D., UAB School of Public Health; George Howard, Dr.P.H., UAB School of Public Health; Libby Wagner, M.P.H., UAB School of Public Health; LeaVonne Pulley, Ph.D., University of Arkansas for Medical Sciences; and Camilo R. Gomez, M.D., Brookwood Medical Center, Birmingham, Ala.

REGARDS is funded by the National Institutes of Neurological Disorders and Stroke within the National Institutes of Health.