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Stroke rates and deaths from stroke are on the decline, study finds

REUTERS/Kai Pfaffenbach
A nurse checks the pressure in the trachea of an 83-year-old stroke victim.

Here’s some welcome health news: The number of Americans who are having strokes and the number who are dying after those strokes have decreased significantly over the past 20 years, according to a study published online Tuesday in the Journal of the American Medical Association (JAMA).

Furthermore, the declines were similar among men and women and among blacks and whites.

Still, we shouldn’t assume that these positive trends will continue, warn the researchers who conducted the study.

“We can congratulate ourselves that we are doing well, but stroke is still the No. 4 cause of death in the United States,” said Dr. Josef Coresh, a professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health and a co-author of the study, in a released statement. “This research points out the areas that need improvement. It also reminds us that there are many forces threatening to push stroke rates back up, and if we don’t address them head-on, our gains may be lost.”

Of specific concern to him and his co-authors are the currently rising rates of obesity, type 2 diabetes and high blood pressure, which are putting millions of more Americans at risk for stroke.

Each year, more than 795,000 people in the United States have a stroke — 610,000 of them for the first time, according to the Centers for Disease Control and Prevention (CDC). Strokes kill about 130,000 Americans annually.

Strokes are the leading cause of disability in the United States. About 20 percent of people who have a stroke develop cognitive impairments, including dementia.

Study includes Minnesotans

For the study, Coresh and his colleagues analyzed 1987-2011 data involving 14,357 people participating in the long-running Atherosclerosis Risk in Communities (ARIC) study. All were between the ages of 45 and 64 and had not had a stroke when the data-collection began in 1987.

ARIC participants come from four different regions of the country: Maryland, North Carolina, Mississippi — and Minnesota.

The analysis revealed that 7 percent (1,051) of the participants had a stroke between 1987 and 2011.  Of those, 10 percent died within 30 days, 21 percent within one year, 40 percent within five years and 58 percent by the end of 2011.

While those numbers are troubling, the analysis found the chances of having a first-time stroke fell by about 50 percent over the period of the study, and the chances of dying as a result of a stroke declined by about 40 percent.

During every decade of the study, eight fewer people died for every 100 strokes that occurred.

Prevention is key

That lower death rate was mostly due, however, to people under the age of 65 surviving longer after a stroke, the analysis also revealed.  Those longer survivals are likely the result of improvements in treatment, Coresh and his colleagues point out, although the study was not designed to figure that out.

As for the drop in the incidence of stroke, that occurred mostly in people over the age of 65. It was likely due, say the researchers to fewer Americans smoking and to better treatments for the control of other stroke-related risk factors, especially high blood pressure and unhealthy cholesterol profiles.

It’s great news that such prevention efforts are working. But, as an editorial that accompanied the study points out, much work still needs to be done to lower stroke rates and deaths in the U.S. — particularly given the increasing number of Americans who are overweight and obese.

“Greater improvements in brain health, especially with controllable risk factors such as diet, exercise, smoking, and obesity, among younger segments of the population are required to reduce the risk of stroke and enhance the chance of successful cognitive aging for all adults,” the editorial writers stress.

For more information about stroke and its prevention, including a “Know Your Stroke Risk” worksheet that can help you (with the help of your doctor) determine your 10-year probability of having a stroke, go to the National Institute of Neurological Disorders and Stroke webpage.

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