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Older Stroke Patients Are Getting Better Treatment
Date:2/8/2010

More get recommended therapies, study finds

MONDAY, Feb. 8 (HealthDay News) -- Older Americans who have strokes are getting better treatment, possibly because of a nationwide program encouraging use of guideline-recommended therapies, a new study shows.

"What we saw in the course of the study, the six years from 2003 to 2009, was remarkable improvement in treatment of all age groups," said Dr. Gregg C. Fonarow, professor of cardiology at the University of California, Los Angeles, and lead author of a report published online Feb. 8 in advance of print publication Feb. 23 in Circulation.

"Because older patients started with lower treatment rates, they had even more dramatic improvement," he said.

The study looked at age-related treatment of more than 500,000 people admitted to 1,256 hospitals for ischemic stroke, in which a blood clot blocks a blood vessel in the brain. Between 70 and 80 percent of all strokes are ischemic, Fonarow estimated.

Older people are more vulnerable to stroke damage. Each 10-year increase in age means a 31 percent reduction in the possibility of discharge home from a hospital and a 27 percent increase in the likelihood of death in the hospital, the study found.

But some hospitals had been reluctant to use aggressive therapy for older stroke patients because they feared side effects. One such side effect is excess bleeding tied to the use of a powerful clot-buster, called tissue-plasminogen activator (tPA), Fonarow said.

A program of the American Heart Association and the American Stroke Association, "Get With The Guidelines--Stroke," promotes use of seven therapies for ischemic stroke, including the quick use of tPA to break up a clot.

"In all seven recommended measures, we saw substantial improvement over time in all age groups," Fonarow said. "For tPA, treatment was started in 20 percent of patients over 90 before the program. That increas
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