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(Stroke. 2001;32:1692.)
© 2001 American Heart Association, Inc.

Letters to the Editor

Addressing Healthy People 2010 Objectives for Stroke

Kelly R. Evenson, PhD¹; Dexter L. Morris, MD, PhD²; Wayne D. Rosamond, PhD¹; Jane H. Brice, MD, MPH²; Sara L. Huston, PhD^1,3 Elizabeth M. Puckett, PT³

¹ Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, North Carolina,
² Department of Emergency Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina,
³ North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina

To the Editor:

Healthy People 2010 objectives were set for the United States to improve patient knowledge of early warning symptoms for stroke (objective 12-8) and myocardial infarction (MI; objective 12-2). Objectives were also established to emphasize the importance of calling 911 for emergency care for MI (objective 12-2) and to increase the proportion of eligible MI patients who receive thrombolytic therapy within 1 hour of symptom onset (objective 12-3).¹ However, corresponding objectives for stroke (ie, calling 911 and increasing the proportion of ischemic stroke patients who receive thrombolytic therapy) were not included. We are writing to recommend that although these corresponding objectives for stroke were not established, they are very important and should also be evaluated.

In the United States, stroke is the third leading cause of mortality.² The American Heart Association recommends thrombolytic therapy treatment for ischemic stroke within 3 hours of the onset of symptoms.³ A potential benefit of this therapy is to reduce functional limitations resulting from the stroke,⁴ which may be considerable, as stroke is also the leading cause of neurological disability.⁵ However, most stroke patients arrive at the hospital too late to even be considered for thrombolytic treatment. A review of 48 published studies on prehospital stroke delay indicates that for most studies, the median time from symptom onset to arrival in the emergency department is 3 to 6 hours.⁶ For stroke patients, the use of emergency medical services (EMS) is associated with earlier time to hospital arrival,^{7 8 9 10 11 12 13} time to emergency physician evaluation,^{7 8 11 14 15} time . . . [Full Text of this Article]

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