Professor Valery Feigin and colleagues at AUT's National Institute for Stroke and Applied Neurosciences have been awarded this year’s $500,000 Prime Minister’s Science Prize. Photo / Supplied
Professor Valery Feigin and colleagues at AUT's National Institute for Stroke and Applied Neurosciences have been awarded this year’s $500,000 Prime Minister’s Science Prize. Photo / Supplied
When his father died from a stroke, a grieving young Valery Feigin was left searching for answers.
A productive and talented professor at Russia’s Novosibirsk Medical School, enjoying the height of his career, Feigin’s father Lev happened to have few obvious risk factors.
“He was relatively young, 50 years old, overall healthy, just a little bit overweight,” said Feigin, who was himself a recent medical graduate at the time.
“He smoked and the most important risk factor he had was high blood pressure, hypertension.”
Back then, almost half a century ago, the world didn’t have a well-recognised strategy for preventing stroke, even though it was a major killer.
“Effective treatment did not exist - and prevention was at the embryo stage.”
Feigin, now a professor himself, has helped change that, winning prestigious plaudits for ground-breaking stroke research stemming all the way back to his father’s untimely death.
Feigin and his team, members of which include co-investigators Professor Rita Krishnamurthi, Dr Alexander Merkin and Balakrishnan Nair, were presented the $500,000 award at a ceremony at Wellington’s Wharewaka this afternoon.
Professor Valery Feigin (third from left) with AUT colleagues Dr Alexander Merkin, Professor Rita Krishnamurthi and Balakrishnan Nair.
Over four decades, their work has led to the insight that stroke has become the second-leading cause of death and the second-leading cause of disability in the world, with its burden fast increasing over the past two decades.
They were the first to show 30-year trends in ethnic disparities in stroke incidence and outcomes – and that nearly 90 per cent of the global burden was being shouldered by low- to middle-income countries.
New Zealand’s rates – the fourth worst in the OECD – also remain stubbornly high.
The results of the team’s three decades of epidemiology studies have filled the gap in accurate epidemiological data – data on incidence, prevalence, mortality outcomes and risk factors.
“This data is the backbone for policymakers and makes it possible to plan evidence-based healthcare,” Feigin said.
The work had also shown how primary prevention strategies weren’t effective enough as they tended to be heavily biased toward people at higher risk of cardiovascular disease.
“But the problem with that is most strokes and heart attacks occur in people of low and moderate risk – 80 per cent of those who have a stroke are not considered high risk for cardiovascular disease.”
Another big misconception: Stroke wasn’t just a disease of the elderly, with data showing how a growing number of people younger than 65 were having strokes.
Given this was the result of compounding lifestyle factors, Feigin said that, ideally, we could control risk “from conception”.
“By the time we are at higher risk of stroke in later life, we have limited ability to lower our risks,” he said.
“That’s why it’s important that younger people know about the risk factors for stroke and can reduce them with a range of diet and lifestyle factors while there is still time to make a big difference.”
Feigin’s team have also developed some helpful tools for people - including their world-first, free mobile app Stroke Riskometer.
“There are reminders, reminders for medications and a lot of support and tools to continue to motivate people to make changes and to maintain those changes,” he said.
“It provides a perfect interface to communicate health information about stroke, risk factors and how to control them.”
The app had the potential to be a “virtually population-wide intervention” in smartphone-saturated New Zealand – and an invaluable resource in developing nations.
“Four billion people in the world live on $5.50 a day. They have no access to health care,” he said.
“Stroke Riskometer could be the only source of reliable health information about stroke or stroke risk factors that they could have access to.”
The team have also rolled out a desktop tool for doctors, PreventS-MD, which has now been tested in 27 countries – and was nearly ready for use here.
With their $500,000 cash prize, the researchers plan to build more resources.
Meanwhile, Feigin has been part of a group developing new stroke management guidelines for New Zealand and Australia which, if widely followed, could halve incidence within the next five to six years, and shrink the burden of dementia by a third.
