National Stroke Strategyの観点から見た課題

抄録

Stroke causes significant burden both on the individuals and on the society, which necessitates national stroke strategies. Three issues which are considered to be important from the viewpoint of national stroke strategy are mentioned in this article : effects of community prevention program in Japan, stroke unit (SU) in the UK, and Brain Attack Campaign in the US.
In Japan, community stroke prevention program has been proven to be effective in reducing stroke incifdene.
SU was proven to be effective in reducing mortality, increasing home discharge, improving ADL and QOL, and shortening length of hospital stay. In the UK, SU has been widely introduced. A survey in 1998 showed that there are 184 SUs in the UK and 52% of stroke patients were treated in SU.
In the US, Brain Attack Campaign was strated to realize thrombolytic therapy using t-PA for cerebral in-farction within 3 hours from onset. Public education on stroke warning sings and on the need of emergent response at onset is indispensable for the campaign.
Systemic approaches such as a community stroke prevention program, the introduction of SU, and Brain Attack Campaign are considered to be important cores of future Japanese stroke strategies.