Stroke remains Hawai‘i’s third leading cause of death and a leading cause of major disability. However, 80 percent of strokes are preventable. And those that do occur, in many cases, are treatable if symptoms are quickly recognized and treatment is quickly sought.

Hawai‘i Emergency Medical Services (EMS) data shows, however, that almost 50 percent of Hawai‘i stroke patients aren’t being delivered to hospitals by EMS ambulances. That can result in treatment delays upon hospital arrival or, in some cases, patients arriving at a hospital that is not prepared to immediately provide treatment. In addition, approximately 70 percent of Hawai‘i stroke patients arrive at a hospital at least 24 hours after first stroke symptoms, outside of the treatment times for therapies that can be used to minimize, and sometimes reverse, stroke effects.

“Stroke patients have the best chance of recovery when 9-1-1 is called immediately,” says Kazuma Nakagawa, M.D., neurologist and American Heart Association (AHA) Hawaii Division Board member.  “For every minute of treatment delay, almost two million brain cells are permanently lost and the risk of permanent disability or death increases. Hawai‘i’s EMS paramedics are trained to diagnose the type of stroke and begin treatment en route to the hospital. They can also alert hospital stroke teams in advance so that treatment can begin immediately upon arrival. Recognizing stroke signs and taking immediate action can mean the difference between a patient walking out of a hospital or being wheeled out.”

The AHA developed the acronym F-A-S-T to help the public recognize stroke signs and quickly call 9-1-1. “F” stands for face drooping, especially on one side. “A” stands for arm weakness or numbness. “S” stands for speech difficulty or slurring. And “T” stands for time to call 9-1-1.

Stroke, in most cases, is preventable through simple lifestyle changes. They include controlling blood pressure, blood sugar and cholesterol levels, maintaining a healthy weight, exercising, improving diet, and not smoking. To learn more about how you can prevent your risk for stroke, go to, or call the AHA Hawaii Division office in Honolulu at the number below.

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