Why US Stroke Deaths Have Declined

Stroke deaths have declined because of high blood pressure reductions and other treatment efforts

(RxWiki News) Rates of death from stroke have steadily declined in the past century. A recent statement investigated what factors are affecting this trend.

A committee of medical researchers recruited by the American Heart Association found that several successful public health interventions, especially those geared toward lowering high blood pressure, have led to the decline in stroke deaths.

The committee also emphasized the importance of quitting smoking and controlling diabetes and cholesterol levels.

"Talk to your doctor about reducing your stroke risk."

The American Heart Association and the American Stroke Association recently released a statement on declining stroke deaths.

Daniel T. Lackland, DrPH, was the chair of the statement writing committee and is a professor of epidemiology at the Medical University of South Carolina.

According to this statement, the rates of stroke deaths have been declining since the early 1900s, but medical professionals do not completely understand why.

To identify the factors affecting the decline in stroke deaths, 11 medical researchers were chosen to investigate previous studies, reviews, public health statistics and more.

These researchers looked at research on patients with multiple strokes, lung disease, high blood pressure, diabetes and various treatments for heart disease.

Additionally, they examined information on other health factors, like smoking status, air pollution, diet and exercise.

The committee found that the decline in deaths related to stroke could be partially explained by recent interventions to reduce heart disease risk factors. According to the authors of this statement, serious efforts to reduce stroke deaths by addressing high blood pressure began in the 1960s.

The statement referenced several clinical trials in which treatment of high blood pressure, sometimes using medications, led to reduced stroke rates. Specifically, a recent review of 32 clinical trials showed that treating high blood pressure significantly reduced the risk of stroke.

The committee also referenced data from the Hypertension Detection and Follow-Up Program, which indicated that a decline of 4.7 mm Hg in blood pressure reduced the risk of dying from stroke by 17.6 percent.

Public health programs to provide education and promote control of high blood pressure have become more prevalent and successful since the 1970s, according to the statement.

The committee also found that programs to address diabetes, high cholesterol and smoking have led to reduced stroke rates, but to a lesser degree than programs to lower high blood pressure.

The committee noted that blood pressure reduction for diabetes patients has been more effective than blood sugar control in reducing stroke deaths.

According to the committee, the prevalence of cigarette smoking in America has declined from 42 percent of the population in 1965 to 19 percent in 2010.

Additionally, research from the National Center of Health Statistics showed that from 2000 to 2009, the number of stroke deaths among smokers significantly declined.

The committee concluded that the decline in deaths from stroke is a public health success which can be largely attributed to interventions to decrease stroke risk.

The committee suggested continuing research and development of public health programs to address stroke risk factors.

This statement was published in Stroke on December 5.

"This study informs us that we have significantly reduced deaths related to stroke over the past 30 years and that the key factors driving this are the recognition of conditions that contribute to stroke risk, and then successful treatment of these," said Mohan Sathyamoorthy, MD, Chief of the Cardiovascular Division at Baylor All Saints Medical Center.

Dr. Sathyamoorthy continued with, "The study concludes that the most important factor far and away is the diagnosis and treatment of high blood pressure that is medically termed clinical hypertension. Other factors include efforts to decrease smoking, lowering high cholesterol, encouraging more exercise and improving control of diabetes. The broad implementation of measures reflects the tremendous benefits of public awareness programs and clinical guidelines sponsored by organizations such as the American Heart Association, American Stroke Association, and the National Institutes of Health."

The paper was commissioned by the American Stroke Association. Six of the 11 writing members disclosed financial ties to health institutes or private health organizations.

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Review Date: 
December 3, 2013