Stroke Rate on the Decline in the US

Stroke and death from stroke dropped in long term study of US adults

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Positive change in the health of Americans is always welcomed news. New research suggests we may have something to celebrate in terms of strokes in the US.

The study examined a large sample of US adults from 1987 to 2011. Data from this sample was then used to estimate long-term health trends.

The study found that rates of both strokes and deaths from strokes declined during the study period.

"Exercise regularly to help reduce your risk of stroke."

According to the authors of this study, which was led by Josef Coresh, MD, PhD, of the  Departments of Epidemiology, Biostatistics, & Medicine at Johns Hopkins University in Baltimore, Maryland, strokes are a leading cause of both death and serious disability in the US. A stroke occurs when blood flow to the brain is reduced due to a blockage in an artery or bleeding in the brain.

The researchers wanted to examine long-term trends in the rates of strokes and stroke deaths.

To do so, they used data from Atherosclerosis Risk in Communities for the years 1987 to 2011. This study followed 14,357 participants who did not have a stroke history at the study's start.

The participants came from several locations across the US and were between the ages of 45 and 64 when the study started. The participants underwent an initial physical examination, along with annual follow-up phone interviews to look for instances of stroke. 

In total, 1,051 participants (7 percent) experienced a stroke. Of these patients, 614 died (58 percent). The overall rate was found to be 3.73 strokes per 1,000 person-years.

As the study period went on, the overall stroke rate declined 0.93 strokes per 1,000 person-years. For people 65 and older, the decrease was 1.35 strokes per 1,000 person-years. The study authors found no change in the stroke rate among participants younger than 65.

The rate of deaths from stroke also declined as the study period went on — by an amount of 8.09 deaths (within 10 years after the stroke) per 100 strokes.

"In a multicenter cohort of black and white adults in US communities, stroke incidence and mortality rates decreased from 1987 to 2011," Dr. Coresh and team wrote in the study. "The decreases varied across age groups but were similar across sex and race, showing that improvements in stroke incidence and outcome continued to 2011."

In an interview with dailyRx News, Albert Favate, MD, Division Chief of Vascular Neurology and Assistant Professor in the Department of Neurology at NYU Langone Medical Center, explained that several factors likely have contributed to a decline in strokes, including more aggressive treatments, improved medications and increased awareness.

"This increased awareness is getting people to change their lifestyles: they are exercising and dieting better; becoming more conscious of risk factors such as high blood pressure, high cholesterol, diabetes and heart disease; they are curbing other toxic habits like smoking and drinking; and they are better complying with their doctors’ advice and taking their prescribed anti-hypertensive medications or medications for other diseases that raise risk," said Dr. Favate.

"Hypertension is behind roughly 40 percent of all strokes," he explained. "The medications have improved and are more tolerable, and people are now more likely to take them."

Though this study suggests that progress has been made, Dr. Favate stressed that stroke is still a serious issue.

"While it’s great to see stroke dropped from the third-leading cause of death to the fourth, there are still 800,000 strokes per year and more needs to be done to prevent this leading cause of disability," he said.

"The quickest ways to lower stroke risk are to curb salt intake and adapt a healthy diet, exercise and avoid toxic habits," Dr. Favate told dailyRx News.

Further research is needed to confirm these findings from a wider population.

The study was published online July 15 in JAMA. The National Heart, Lung, and Blood Institute provided some funding for the study. The researchers reported no conflicts of interest.

Review Date: 
July 13, 2014
Last Updated:
July 16, 2014