Strokes on the rise From the cover
What’s happening
At the same time, Harris County is experiencing fewer stroke-related deaths per capita than the state and national levels. From 2018-22, Harris County had a stroke mortality rate of 15.5 deaths per 100,000 residents, which is lower than both the state average of 18.9 and the national average of 22.2, according to data from Harris County Public Health.
Strokes are becoming more prevalent in younger populations as risk factors historically seen in older populations, such as hypertension, are now showing up among younger people, El Jamal said. There has been a slight increase in self-reported stroke prevalence in Harris County, said Dr. Ericka Brown, director of Harris County Public Health’s community health and wellness division.
Dr. Sleiman El Jamal, the medical director of neurology at HCA Houston Healthcare Northwest, said nationwide, a stroke occurs every 40 seconds with over 800,000 strokes a year. Stroke cases are up 15.7% for ages 45-64 nationally in the last decade, according to the Centers for Disease Control and Prevention, and up 14.6% among ages 18-44.
Harris County deaths from 2018-20 (per 100,000 residents) Stroke death rate by demographic
Heart disease deaths in Harris County Black White Hispanic Asian/Pacific Islander Average Age-adjusted mortality rate (per 100,000)
3.5% 2.9% to from 2020-22. The percentage of adults who experienced a stroke in Harris County rose from
60
250
50 40
200
30
150
20
100
10
50
0
Female
Male
Black
White Hispanic/ Latino
Asian/ Pacific Islander
0
2016 2017 2018 2019 2020 2021
SOURCES: HOUSTON STATE OF HEALTH, HARRIS COUNTY PUBLIC HEALTH, CENTERS FOR DISEASE CONTROL AND PREVENTION, TEXAS DEPARTMENT OF STATE HEALTH SERVICES/COMMUNITY IMPACT
The stroke care designation system allows first responders to transport patients to the most equipped facilities. From most advanced to least: Local stroke centers Level I – Comprehensive 1 HCA Houston Healthcare Northwest 2 Houston Methodist Willowbrook Hospital
Explained
A closer look
Dr. Pam Zelnick, a vascular neurologist at Houston Methodist Willowbrook Hospital, said a stroke occurs when there is a lack of blood flow to a specific part of the brain. The most common type of stroke, ischemic, occurs when the blood supply to a blood vessel in the brain is blocked or reduced, preventing brain tissue from receiving oxygen, El Jamal said. Hem- orrhagic strokes occur when a blood vessel bursts, causing bleeding and irritation in the brain. El Jamal said the location of the stroke in the brain determines the effects it has on overall health, mobility and speech.
Local hospitals and health care providers are working to expand and advance stroke care for patients close to home. Hospitals can choose to pursue accreditation for different levels of stroke care. For example, The Joint Commission first granted HCA Houston Healthcare Northwest its Gold Seal of Approval for Advanced Comprehensive Stroke Center in 2022, and the hospital was recently reaccredited, Community Impact previously reported. “There’s a lot of these metrics that have been instituted nationwide to provide the best possible care according to best practice guidelines that have been published, and we, as residents, train on,” El Jamal said. “It’s a very intense and rigorous process for very important reasons because that really impacts patient care.” According to Texas Health and Human Services, each level must meet the department-approved national stroke standards of care, participate in the hospital’s regional advisory council and stroke plan, and submit data to a certifying body and the state health department.
Level II – Advanced Level III - Primary 3 St. Luke’s Health - The Vintage
Level IV – Acute Stroke Ready No stroke designation 4 St. Luke's Health - Springwoods Village
4
Stroke risk factors From 2016-24 in Harris County, death rates for the following risk factors increased. SOURCE: HARRIS COUNTY PUBLIC HEALTH/ COMMUNITY IMPACT
249
Spring
Heart disease: +3.1%
99
45
Klein
1
Hypertension: +24.1%
3
1960
2
Diabetes and obesity: +29.8%
N
SOURCE: TEXAS DEPARTMENT OF STATE HEALTH SERVICES/COMMUNITY IMPACT
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