Focus on Stroke

Despite being the third most common cause of death in the UK (and a leading cause of disability), stroke tends to receive less attention than the other “big killers” of cancer and heart disease. However, while it may not often make the headlines, stroke is a major focus of worldwide research.

On the newly launched NIHR “Focus on Stroke” website, Professor Anthony Rudd, the National Clinical Director for Stroke, describes just how far research has taken us from a time when it was considered “the duty of the physician to explain to the patient, or to his friends, that the condition is past relief, that medicines and electricity will do no good and that there is no possible hope of cure”.1

In the last few decades, research has dramatically increased our understanding of causes, prevention and treatment, as well as how to improve life for people who survive stroke. Much of this research is reflected in CRD’s NIHR databases, which include nearly 1000 systematic reviews, economic evaluations and health technology assessments focusing on stroke.

Recent systematic reviews have examined the possible influence of factors such as dietary fiber,2 cholesterol,3 and glycaemic control4 on the risk of stroke, while others have looked at post-stroke treatments as diverse as dual-antiplatelet therapy,5 acupuncture,6 and multidisciplinary care for discharged patients.7

One important aspect of systematic reviews and health technology assessments is their ability to spot where future research efforts should be focused. Two recent overviews of the effects of therapeutic hypothermia (i.e. deliberately cooling patients after they have had a stroke) found only small-scale and somewhat inconsistent clinical evidence.8,9 However, therapeutic hypothermia is now the subject of a major study including 1500 people from 25 European countries,10 and is just one of many approaches that researchers hope may help in the future battle against stroke.

References

  1. NIHR “Focus on Stroke” website. http://www.crncc.nihr.ac.uk/focus_on/stroke/Focus_on_StrokeAccessed 21st February 2014.
  2. Dietary fiber intake and risk of first stroke: a systematic review and meta-analysis. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=12013028493&UserID=0#.Uwd0Qfl_uSo
  3. Cholesterol levels and risk of hemorrhagic stroke: a systematic review and meta-analysis. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=12013029788&UserID=0#.Uwd0dfl_uSo
  4. Efficacy of intensive control of glucose in stroke prevention: a meta-analysis of data from 59197 participants in 9 randomized controlled trials. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=12013011516&UserID=0#.Uwd0nvl_uSo
  5. Risk-benefit profile of long-term dual- versus single-antiplatelet therapy among patients with ischemic stroke: a systematic review and meta-analysis. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=12013057152&UserID=0#.Uwd00Pl_uSo
  6. Acupuncture for dysphagia following stroke: a systematic review. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=12012026827&UserID=0#.Uwd1Afl_uSo
  7. Multidisciplinary care for stroke patients living in the community: a systematic review. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=12013019361&UserID=0#.Uwd1Kvl_uSo
  8. Safety and efficacy of therapeutic hypothermia for acute ischemic stroke. Systematic review and Meta-analysis. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=32014000004&UserID=0#.Uwd1a_l_uSo
  9. Evidence overview of therapeutic hypothermia. http://www.crd.york.ac.uk/crdweb/ShowRecord.asp?AccessionNumber=32013000023&UserID=0#.Uwd17fl_uSo
  10. EuroHYP-1 trial. http://www.eurohyp1.eu/# Accessed 21st February 2014.

Page last updated: 2 July, 2014