Stroke research lags far behind funding for other major causes of death in Europe

Despite being the second leading cause of death worldwide, funding for stroke research lags far behind funding for other major causes of death in Europe, according to a study in Stroke: Journal of the American Heart Association.

Previous studies in the United States had similar findings, indicating that under-funding of stroke research may be a worldwide problem that has potentially devastating health and economic implications, said lead researcher Sarah T. Pendlebury, B.M., B.Ch., an internal medicine specialist at John Radcliffe Hospital in Oxford, United Kingdom.

Researchers who reviewed funding patterns in nine European countries concluded that compared to coronary heart disease (CHD) and cancer, stroke received substantially less funding for research. In most countries, cancer research received at least 10 times more funding than did stroke research.

“As a consequence of the aging population in both the developed and developing world, it is projected that stroke will shortly become the most common cause of premature death worldwide,” said senior author Peter M. Rothwell, M.D., Ph.D., professor of clinical neurology at the University of Oxford. “Stroke is already the most common neurological disorder in Europe and the most common cause of neurological disability in the developed world. Research into acute treatment and rehabilitation are important, but research into stroke prevention is absolutely vital if we are to offset the projected increase in the clinical and financial burden of stroke.”

To determine the scope of the under funding phenomenon, a group of investigators reviewed financial data from 2000 to 2001 from nine countries (Belarus, Estonia, Switzerland, Turkey, Norway, Netherlands, Austria, U.K., and Poland). The review focused on research funding distributed by healthcare associations, charities and government-funded organizations and included funding for CHD, cancer, and stroke research. The information was gleaned from annual reports, Internet Web sites, and from direct communication with the associations and organizations.

Stroke funding as a percentage of the total funding for stroke, CHD and cancer was uniformly low, ranging from 2 percent to 11 percent across the different countries.

Researchers compared stroke funding to cancer-related funding. Stroke funding ranged from 2 percent of total cancer-related funding in Norway and the Netherlands to 17 percent of total cancer-related funding in Switzerland.

They also compared stroke research funding to CHD research funding. Funding for stroke research lagged far behind in eight of the nine countries, ranging between 2 percent (Austria) and 58 percent (Switzerland). Only Turkey allocated more funding for stroke research (38 percent more) than for CHD research.

“This low stroke research funding occurs despite healthcare costs that are at least as high and probably higher for stroke as cancer and CHD,” researchers said.

Rothwell acknowledged that the lower funding of stroke research probably reflects public misperceptions about stroke.

“The public perception is that stroke is something that people die of or that it only occurs in the very elderly,” he said. “Ironically, both are completely wrong. You are less likely to die of a stroke than a heart attack, but you are much more likely to be left with major disability. And 50 percent of strokes occur in people under 75 years of age.

“Strangely, the public tends to fear stroke much more than heart attack because of the thought of being left dependent; yet, people don’t tend to give so generously to stroke charities. Perhaps stroke is a condition they just don’t like to think about.”

The most obvious way to correct the imbalance in funding would be for government agencies that fund healthcare research to make funding proportional to the clinical burden of the disease on society, Rothwell continued. Few agencies currently allocate research funding in that manner. With respect to allocation of available funds for stroke research, he encouraged putting far more money into stroke prevention.

“I think all areas are in need, but in terms of potential impact on the burden of the disease, prevention must be the major priority,” Rothwell said. “More than perhaps any other condition, prevention is better than cure when it comes to stroke.”

According to the American Stroke Association – a division of the American Heart Association – the estimated direct and indirect cost of stroke in the United States in 2004 will be $53.6 billion.

“In the United States, stroke is the No. 3 killer and a leading cause of disability,” said Robert J. Adams, M.D., chairperson of the American Stroke Association advisory committee. “Ideally, funding for disease research should be proportional to its impact on society and on the opportunities available for progress in science.”

Co-authors of the study are Ale Algra, M.D., Ph.D.; Marie-José Ariesen, M.Sc.; Goksel Bakac, M.D.; Anna Czlonkowska, M.D.; Alexandra Dachenhausen, Ph.D.; Yakup Krespi, M.D.; Janika Kõrv, M.D., Ph.D.; Konrad Krolikowski, M.D.; Sergey Kulesh, M.D.; Patrik Michel, M.D.; Lars Thomassen, M.D.; Maria Gugging; Julien Bogousslavsky M.D. and Michael Brainin, M.D., Ph.D.

http://www.americanheart.org