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Death Rates from Stroke: 1900-1995
The overall decline in the stroke
mortality rate (stroke deaths per 100,000 population) in the
United States accelerated markedly in the decades between
1950 and 1980, with a continued strong reduction through 1990.
This reduction occurred in both males and females, in Caucasians
as well as African Americans, and in all regions of the country
[Wolf PA, et al. Source: Wolf PA, et al. In: Barnett HJM,
et al (eds). Stroke. Pathophysiology, Diagnosis and
Management. New York, Churchill-Livingstone, 1992:3].
After 1992, a slight upturn in the stroke mortality rate has
been reported.
The
decline in death rates from stroke may have even due to either
decreased incidence of stroke, improved survival of stroke
patients, or a combination of these effects [Wolf PA, et al,
1992.] Evidence for a declining incidence would support
the concept that more aggressive management of modifiable risk
factors for stroke (e.g., hypertension, diet) and/or such
measures as the use of drugs (e.g., aspirin) have been
effective in stroke prevention. Evidence for improved
survival, on the other hand, would point to improved acute
stroke care. The data are conflicting but, overall,
suggest that both decreased incidence and improved survival
probably contributed to a decline in stroke mortality over
defined periods of observation [Brown RD., et al. Stroke.
1996;27:373. Tuomilehto J, et al. Stroke. 1996;27:825.
Falkeborn M, et al. Epidemiology. 1996;7:67. Broderick
JP. Ann Epidemiol. 1993;3:476. Klag MJ,
Whelton PK. Ann Epidemiol. 1993;3:571.
Causes of the recent stabilization
-- and, over the past few years, slight increase -- in the
death rate due to stroke remain to be determined. Apart
from this, the absolute number of strokes occurring in the
U.S. may well rise in the future with the aging of the population.
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Stroke Education
