"The heart will no longer be the cause of most sudden deaths, leaving behind an ever-growing population of the elderly disabled by stroke and vascular dementia ," writes James F. Toole, M.D., and colleagues from Wake Forest University Baptist Medical Center in an editorial in the current issue of the Journal of the American Medical Association (JAMA).
Toole, past president of the International Stroke Federation, says using ultrasound to screen people for narrowed arteries in the neck is the best way to identify people at excess risk for stroke. He recommends that men undergo a baseline ultrasound screening of their carotid arteries between the ages of 50 and 60, depending on their overall health. He says that both men and women with diabetes, hypertension or a family history of stroke all of which increase the risk of stroke should be screened even earlier.
The North Carolina Stroke Association chapter of the National Stroke Association has conducted a pilot study using ultrasound to screen people for stroke. The results are currently being evaluated.
More than 500,000 new strokes occur each year in the United States, and it has been estimated that carotid artery disease may be responsible for 20 percent to 30 percent of them.
"The critical dilemma is how best to identify patients at excess risk for stroke before events occur," writes Toole in JAMA.
In an editorial in the British Medical Journal in September, Toole, a professor of neurology at Wake Forest Baptist, said that screening is the best way to identify vessel disease that is pre-clinical, or before symptoms develop.