“I had a stroke, I fell on my knees and the next day I couldn’t feel anything on the left or right side of my arms or legs,” he said. “And I couldn’t really speak, so they took me to the emergency room and put me in an induced coma. I thought I was completely gone.”
Alderete is one of thousands of Harris County residents who had a stroke in 2024. Providers are advancing care and raising awareness to address a rise in strokes.
What’s happening
Dr. Sleiman El Jamal, the medical director of neurology at HCA Houston Healthcare Northwest, said nationwide, a stroke occurs every 40 seconds with over 800,000 strokes a year. Stroke cases are up 15.7% for ages 45-64 nationally in the last decade, according to the Centers for Disease Control and Prevention, and up 14.6% among ages 18-44.
“Although stroke is much more common in adults over the age of 65, ... the greatest rise in stroke incidence is actually being seen in individuals under the age of 50,” said Dr. Pam Zelnick, a vascular neurologist at Houston Methodist Willowbrook Hospital.
Strokes are becoming more prevalent in younger populations as risk factors historically seen in older populations, such as hypertension, are now showing up among younger people, health care officials said.
There has been a slight increase in self-reported stroke prevalence in Harris County, said Dr. Ericka Brown, director of Harris County Public Health’s community health and wellness division. The percentage of adults who experienced a stroke in Harris County rose from 2.9% to 3.5% from 2020-22.
At the same time, Harris County is experiencing fewer stroke-related deaths per capita than the state and national levels. From 2018-22, Harris County had a stroke mortality rate of 15.5 deaths per 100,000 residents, which is lower than both the state average of 18.9 and the national average of 22.2, according to data from Harris County Public Health.
Zelnick said a stroke occurs when there is a lack of blood flow to a specific part of the brain.
The most common type of stroke, ischemic, occurs when the blood supply to a blood vessel in the brain is blocked or reduced, preventing brain tissue from receiving oxygen, El Jamal said. Hemorrhagic strokes occur when a blood vessel bursts, causing bleeding and irritation in the brain.
El Jamal said the location of the stroke in the brain determines the effects it has on overall health, mobility and speech.
According to Harris County Public Health, from 2016-24, death rates for the several stroke risk factors have increased.
- Heart disease increased 3.1%
- Hypertension increased 24.1%
- Diabetes and obesity increased 29.8%
Local hospitals and health care providers are working to expand and advance stroke care for patients close to home.
Hospitals can choose to pursue accreditation for different levels of stroke care. For example, The Joint Commission first granted HCA Houston Healthcare Northwest its Gold Seal of Approval for Advanced Comprehensive Stroke Center in 2022, and the hospital was recently reaccredited, Community Impact previously reported.
“There’s a lot of these metrics that have been instituted nationwide to provide the best possible care according to best practice guidelines that have been published, and we, as residents, train on,” El Jamal said. “It’s a very intense and rigorous process for very important reasons because that really impacts patient care.”
According to Texas Health and Human Services, each level must meet the department-approved national stroke standards of care, participate in the hospital’s regional advisory council and stroke plan, and submit data to a certifying body and the state health department.
The stroke care designation system allows first responders to transport patients to the most equipped facilities. From most advanced to least:
- Level I (Comprehensive): HCA Houston Healthcare Northwest and Houston Methodist Willowbrook Hospital
- Level II (Advanced)
- Level III (Primary): St. Luke's Health - The Vintage
- Level IV (Acute Stroke Ready)
What you need to know
El Jamal said about 80% of stroke risk factors are preventable, including poor eating habits, obesity, smoking and drug abuse, which can lead to hypertension, diabetes and heart disease, significantly increasing the risk of stroke. Brown said these chronic conditions often occur together, compounding the risk of severe health outcomes.
El Jamal said a patient should be at the hospital within four hours of suffering a stroke to be eligible for blood thinner medications. Zelnick said only one-third of patients arrive soon enough.
“If you have any symptoms, even if you’re not sure, call 911. Don’t even try to figure it out. Don’t wait it out, because every minute you lose, you’re really losing over a million neurons in your brain,” El Jamal said.
BEFAST is the acronym medical professionals recommend to identify stroke signs and symptoms.
- Balance: Difficulty walking
- Eyes: Loss of vision
- Face: One-sided facial drooping
- Arms: Weakness in the arms or legs
- Speech: Slurred speech
- Time: Call 911 immediately
