What is the truth behind the rise in strokes? Anyone?

News channels are awash today with the latest horror story – that strokes have risen over past 15 years among working-age people.  Cue health “experts” and charity spokespeople of various guises rushing to the TV sofa’s to point accusing fingers at the Great British public’s failure to take enough exercise, and our consumption of too much sugar/salt/fat, to explain the rise.

Newspapers are also falling over themselves to tell us that the latest health crisis is all our own fault. This is the Daily Mail‘s lead paragraph:

“Strokes among middle-aged men have soared because of obesity and lack of exercise, experts said yesterday.”

“Their research shows the number of cases is up 46 per cent on 15 years ago. For women in the same 40s and 50s age group the rise is 30 per cent.”

Or this from the Independent (with obligatory photo of a couple of fat blokes):

“Sharp rise in strokes among people of working age leaves thousands devastated by disability”

“The Stroke Association said the increase was due to more unhealthy lifestyles”

Undoubtedly health choices have a part to play in preventing strokes, perhaps a significant part for all I know, but before we all give ourselves a stroke worrying about the latest health scare let’s just be aware of the facts.

The Stroke Association study these headlines refer to, states that in 2000 there were around 4,260 hospital admissions for strokes among men aged between 40 and 54 in England, compared to 6,221 in 2014. For woman the figures are 3,529 in 2000, to 4,604 in 2014.

Over a similar period, the UK population has grown by over 5 million – and, according to the ONS  (since 2001) “there have been high levels of net inward migration, adding to the population at younger working ages”. I don’t have the precise numbers for England (rather than the UK) nor the increased numbers of men aged 40 to 54 living in England today compared with 15 years ago but the chances are they have risen since 2000. What matters is the % of the 40-54 year olds experiencing strokes today vs 2000, not the rise in absolute number of strokes surely?

I can’t help but wonder why the percentage changes have not been reported?

Lost in the story is also the fact that “hospital admission practice” (mentioned in passing in the press release) is also having an impact on the rise in numbers. Have we got better at diagnosing strokes over the last 15 years (probably)? Could that also account for some of the rise?

We should also note that the causes of strokes are many and various. The BBC managed to find two young stroke victims on its web site, one was a 34 year old whose stroke was caused by a (previously undiagnosed) heart condition and the second was a “very fit” (49 year old), who was “in the gym six days a week”, “ate healthily”, but had (again undiagnosed) high blood pressure. Neither of those men appear to had a stroke as a result of their lifestyle choices – far from it.

But does the BBC lunchtime news talk about either the population growth or indeed, the possible improvement in diagnosis as possible reasons for the “rise”? Does it bother to alert the “fit and healthy” that they may still be at risk of stroke even if they have a perfect diet and  take regular exercise? (eg according to the Stroke Association “South Asian and black people in the UK are also at increased risk of stroke. Although the reasons for this are not completely understood, we do know that black people are twice as likely to have a stroke compared to white people and that black and South Asian people also tend to have strokes at a younger age than white people.”)

No. Nor any mention of the fact that if you have had (often undiagnosed) TIAs (mini strokes) you are at high risk; likewise you are at higher risk if there is a family history of strokes.

The tack taken by the Stroke Association and health journalists across the board is nothing less than irresponsible. The data extracted from the NHS by the Stroke Association shows a snap shot of the number of strokes occurring amongst those of a certain age in England and nothing more. The headlines/soundbites from them creates an impression that the sole cause of the “rise” in strokes amongst 40-54 year olds is “lifestyle choices”.  That is nothing more than a hypothesis/best guess/hobby horse from the health spokespeople. It is not only not backed up by any evidence presented in its press release or elsewhere, it runs the risk of leading to stigmatization of those suffering from strokes (“it’s their fault”) and creates a false sense of security among the fit and healthy – but otherwise vulnerable groups – that they are low risk or risk free.

It also displays, yet again, sheer laziness from the so-called journalists. When I spoke to the BBC after the lunch time news edition to put some questions to them; why they had shown the rise in strokes in absolute terms and had not factored in population growth in the last 15 years; whether there was any evidence to show if diagnosis had improved; and whether they had figures showing the percentage of stroke victims defined as obese, it was quite clear they had not even considered these points. Indeed they started off by trying to tell me that they thought the figures had taken into account population growth.

By the Six O’clock news, the BBC had added a line to its report stating the increase in the number of strokes “can’t be accounted for by population growth and by changes in the way strokes are treated. Experts say obesity and sedentary lifestyles are to blame.” But that was as far as they were willing, or able, to go.

Where is the journalism from the media? All they seem to have done, by and large, is to have taken the Stroke Association press release and top and tailed it with a “personal story” and/or a sound bite from a “health expert”.  More importantly, where is the responsibility from the the Stroke Association to provide the UK population with factually accurate, evidence-based information? Why have they stooped to shock tactics?

Still it seems to fit the agreed current narrative of the health lobby that “lifestyle” is the root of all our health problems. And “health journalists” seem to happily gobble up and spew back out whatever froth they are fed. They have ceased to be the fifth estate, examining the validity of the claims made. They have become the mouthpieces for their friends and colleagues working in health. They may as well just give health campaign groups their login and password and go sit on a beach.

Until the wider health lobby (in which we must include journalists as well as campaign groups) gets off this bandwagon and starts giving people the full facts however dull, rather than the spin that suits their beliefs or grabs the headlines, we should simply ignore everything they say. As an increasing number of people are clearly doing already. And government must start to consider whether health authorities should, in the interests of Public Health, continue to outsource it’s services to charities that persist in playing fast and loose with the facts.

Tags: BBC, Daily Mail, Independent, rise in strokes 40-54 years, Stroke Association, stroke rates soar