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Stroke Victims: Treatment

My Lords, I too am grateful to the noble Lord, Lord Rodgers of Quarry Bank, for raising the important, but neglected, subject of stroke and for speaking so eloquently about his own experience. I also congratulate my noble friend Lord Clinton-Davis on his courageous description of his own condition. The vital facts are that there two types of stroke and once the symptoms have been recognised by the face-arms-speech test, and the type of stroke—be it ischaemic or haemorrhagic—discerned by scanning, the appropriate treatment must be carried out urgently. Immediate response to a suspected ischaemic attack is of the utmost usefulness, but the slower process of stroke prevention is equally important. I would like to ask my noble friend whether Her Majesty’s Government are aware of the need for more regular screening of patients: at least an annual check-up by GPs, to include monitoring of blood pressure. Ideally, this should apply to all patients over 40. Does my noble friend agree that people in middle age and older might be encouraged to buy a now easily obtainable blood pressure monitor for their own use? With an ageing population, the burden of stroke care will most likely increase in the future. Professor Paul Durrington, professor of medicine at Manchester Royal Infirmary, advises a far more widespread use of statins, the cholesterol lowering drugs, than is presently the case. He suggests that all middle aged men and older women should be on statins, not merely the 2.5 million for whom they are currently prescribed, if the United Kingdom is to have any real success in combating cardio-vascular disease, the probable precursor to heart attacks and stroke. One low-dose statin is presently available over the counter in high street pharmacies. It will be interesting to hear the attitude of Her Majesty’s Government to this. There is a widespread belief that only those who have grown heavier with age have raised cholesterol levels and therefore need statins. I used to have a high level of cholesterol, and have been on a low-dose statin for the past seven years. I also have a sphygmomanometer and monitor my blood pressure regularly. Both my parents suffered strokes, resulting in my mother’s death and leaving my father severely incapacitated. Neither of them ever smoked and I cannot remember alcohol ever being in our home, except perhaps at Christmas. I doubt that either of them ever had their blood pressure monitored until they became ill. Stroke costs the NHS nearly £1 billion more per annum than heart disease and has an impact of nearly £7 billion on the wider economy. Why, then, has it not been given a higher priority by the Government, given this evidence of its high cost? Appropriate early treatment can save the Health Service money. A campaign to raise awareness of what stroke is, and the importance of urgent early treatment, might rapidly alert the public to the dangers. It should address those groups at higher risk, such as those of Afro-Caribbean descent. At present, according to the findings outlined in the report of the National Sentinel Audit for Stroke, only 30 per cent of patients registered for an urgent CT scan had the scan on the same day. ““Time lost is brain lost”” is a terrible commentary on this situation. Mortality from both coronary heart disease and stroke has fallen over the past few years, but the decline has been more rapid in the case of heart disease. Until prompt treatment becomes the rule it would be too brutal to remind the public in any campaign that may be launched that, heavy and painful burden though the after-effects of heart attack may be, stroke will very likely leave the sufferer incapacitated. Health experts also blame the United Kingdom’s unhealthy diet and lack of encouragement of physical exercise. One in three of Europe’s obese children are British. Although too many schools still adhere to unhealthy and fat-laden meals, bad diet begins at home. It is heartening to see that some schools are writing to parents about their obese children and advising attention to diet for the evidence is that a greatly overweight child will grow up to be a greatly overweight adult. These people may grow up liable to heart attack. Will they also be candidates for stroke, with all its consequent suffering and disability?