Most blacks ring up a friend or relative, not 911, when they have stroke symptoms, a new study suggests.
In the study, published today online in the journal Stroke, Georgetown University Medical Center researchers surveyed 253 community volunteers living in a predominantly black, urban area of Washington, D.C., about how they would handle stroke symptoms. Eighty-nine percent said that they would call 911 first.
When the researchers interviewed 100 patients hospitalized for stroke in the same geographical area, however, only half said they had arrived at the hospital by ambulance.
Almost half had delayed seeking medical help because they thought symptoms weren't serious. Three-fourths called family or a friend.
"There's a disconnect about knowing what to do and actually doing it in a real-life situation," says Chelsea Kidwell, director of the Georgetown University Stroke Center.
About 6.5 million Americans have had a stroke; 3.7% of blacks have had a stroke, while among whites, the rate is 2.2%, the American Heart Association says.
Kidwell says many people aren't aware there is a treatment for stroke, called tPA, or tissue plasminogen activator. It's a clot-busting drug that can reduce the debilitating aftereffects of a stroke. It's critical that tPA be administered within the first few hours after symptoms appear.
"Embarrassment at calling an ambulance and bringing attention to themselves, not wanting their neighbors to know what's going on" also can be a factor, Kidwell says.
A stroke is not like a heart attack, so it is easier to ignore at the onset, says Ausim Azizi, a professor of neurology at Temple University School of Medicine in Philadelphia. "It doesn't cause pain or shortness of breath -- it's somewhat benign until it's too late," he says.
Cultural factors play a role, too, he says. Blacks may "want to have a friend to go with them, so they have safety. It's about trust -- is the medical system going to do the right thing by them or not?" Azizi says.
"This study is a great example of how some of the most practical, important issues of stroke care are right in front of us. How do we get these patients to treatment?" says David Liebeskind, associate neurology director at the UCLA Stroke Center. He says people need to know that stroke symptoms can resolve initially because the body tries to compensate, leading someone to believe there's not a problem any more -- but the blockage is still there and medical care is needed.
Liebeskind recommends everyone ask themselves or a loved one what they would do if they experienced stroke symptoms, and have a plan.