December 6, 2013
Stroke Mortality In US Has Fallen Dramatically In Recent Decades
redOrbit Staff & Wire Reports - Your Universe Online
Stroke mortality rates have fallen dramatically in the US in recent decades as a result of better treatments and prevention efforts, the American Stroke Association said in a scientific statement published Thursday in the journal Stroke.
The authors note that stroke deaths declined throughout the entire past century, with numbers falling from about 250 per 100,000 population in 1900 to about 60 per 100,000 by 2000. This decline has continued during the past decade, with stroke mortality rates falling to 40 per 100,000 in 2010.
"The decline in stroke deaths is one of the greatest public health achievements of the 20th and 21st centuries," said Daniel T. Lackland, Dr PH, chair of the statement writing committee and professor of epidemiology at the Medical University of South Carolina. "The decline is real, not a statistical fluke or the result of more people dying of lung disease, the third leading cause of death."
The American Stroke Association commissioned the paper to discuss the reasons that stroke fell from the third to fourth leading cause of death.
“As a result of recent striking and more accelerated decreases in stroke mortality, stroke has fallen from the third to the fourth leading cause of death in the United States. This has prompted a detailed assessment of the factors associated with the change in stroke risk and mortality,” the statement read.
A heightened focus on lowering blood pressure and hypertension control that began in the 1970s has contributed greatly to the change, Lackland said.
“There is strong evidence that the decline can be attributed to a combination of interventions and programs based on scientific findings and implemented with the purpose of reducing stroke risks, the most likely being improved control of hypertension,” the statement read.
Other initiatives, such as smoking cessation programs, improved control of diabetes and abnormal cholesterol levels, and better, faster treatment have also prevented strokes.
Improvement in acute stroke care and treatment is also associated with lower death rates.
"We can't attribute these positive changes to any one or two specific actions or factors as many different prevention and treatment strategies had a positive impact," Lackland said. "Policymakers now have evidence that the money spent on stroke research and programs aimed at stroke prevention and treatment have been spent wisely and lives have been saved.”
"For the public, the effort you put into lowering your blood pressure, stopping smoking, controlling your cholesterol and diabetes, exercising and eating less salt has paid off with a lower risk of stroke," he said.
Stroke deaths fell in men and women of all racial and ethnic groups and ages, according to the paper, although “there are still great racial and geographic disparities with stroke risks as well [as] many people having strokes at young ages," Lackland said. "We need to keep doing what works and to better target these programs to groups at higher risk."
“The decline in stroke mortality is real and represents a major public health and clinical medicine success story,” the paper concluded.
The authors said continued application of aggressive evidence-based public health programs and clinical interventions is expected to result in further declines in stroke mortality.