Stroke care a ‘sorry story of neglect’

UNCONTROLLED high blood pressure, as well as causing stroke, is now emerging as the major cause of cognitive impairment, the Irish Heart Foundation (IHF) has warned.

IHF president Prof Eoin O’Brien said stroke management in Ireland remains a sorry story of neglect with victims of the devastating illness still largely treated without appropriate care.

And there was no “logic” in blaming the recession for putting off the establishment of a national network of stroke units, Prof O’Brien told a major conference on stroke in Dublin.

“The long-term financial rewards of preventing stroke must be balanced against the short-term expedient of claiming that the recession makes the establishment of stroke units financially non-viable,” he said.

More than 30,000 people in Ireland are survivors of stroke, many of whom have significant residual disability.

Prof O’Brien said 5,000 strokes could be prevented every year if high blood pressure was controlled.

“I must add another scientific fact to the reality of the laudable increase in longevity in our country and that is that uncontrolled high blood pressure – in addition to causing stroke – is now emerging as the major cause of cognitive impairment in many ways a more daunting societal threat than stroke,” he warned.

IHF medical director Dr Brian Maurer said Health Minister Mary Harney is set to be presented with a report from the Cardiovascular Health Policy Group.

The group was established by the minister in September 2007 to advise on updating cardiovascular health policy, including devising a national strategy for stroke care.

Their report will stress the importance of significant investment, not only in stroke management, but in prevention. But the Department of Health will not comment on the funding issue until after the recommendations are costed.

Management of acute stroke and its consequences in Ireland was poor by western medical standards, said Dr Maurer.

“We don’t have enough stroke units in this country. We don’t have the organisation of acute stroke services developed to the level that they should be. We don’t administer clot busting drugs to enough patients – we do have the drugs but we do not have the infrastructure to organise their delivery. This report will address all those problems,” he said.

While services for people with acute heart attacks were very good by international standards, Ireland needed to ensure that the most up-to-date and effective treatments were available to patients. That would mean reconfiguring the acute services that were available, said Dr Maurer.