The latest findings from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study were presented at the American Stroke Association's International Stroke Conference 2007 by principal investigator Dr. Virginia J. Howard of the University of Alabama at Birmingham.

In REGARDS, there are nearly 20,000 whites and blacks aged 45 and older enrolled since 2003. They are all residents of the Carolinas, Georgia, Alabama, Mississippi, Tennessee, Arkansas and Louisiana.

Investigators are attempting to ascertain why stroke is more prevalent in this region of the country and why stroke death rates are higher among blacks.

In this study, Dr. Howard's team focused on behaviors of subjects while experiencing stroke symptoms, asking them what specific symptoms they experienced and what they did in response to those symptoms. The investigators also asked the patients if they had had previous episodes of transient ischemic attacks (TIAs) and if they had sought medical care in those instances.

The study included 451 patients who had received a physician diagnosis of stroke and 2,124 subjects who had had stroke symptoms in the past but had not received a diagnosis from a physician.

Of the latter group, more than two-thirds had experienced one symptom of stroke and nearly one-quarter had at least two symptoms. The most common symptom was sudden numbness in an extremity, which was experienced by approximately 47% of the subjects.

Dr. Howard reported that 51.4% of subjects with undiagnosed symptoms "did not seek medical care for their symptoms."

Higher income was associated with a higher likelihood of seeking medical care for stroke symptoms, while a past smoking history was associated with a lower likelihood of seeking care. Lesser factors associated with not seeking care were a lack of health insurance, previous heart disease, hypertension and diabetes.

"The message for both physicians and patient is to pursue stroke symptoms," Dr. Howard told Reuters Health in an interview after her presentation. "Physicians should be alert to the suddenness of the symptoms."

"We need to get away from the mindset of waiting to contact a physician only if symptoms persist," she asserted. "Physicians need to tell their patients about the symptoms of stroke. There's a lot to remember, so that's why using [mnemonics like] FAST - face, arms, speech and time - are important. They need triggers to remember all of this. Also, patients should be told about the importance of the suddenness of a symptom, or if there are multiple symptoms."

Dr. Howard concluded, "We need to look into the reasons why patients don't seek care ... We need patients to get away from that fear of calling."

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