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Health & Medicine for Senior Citizens

Deaths from Stroke Decline Dramatically in U.S. with Better Prevention, Treatment

Stroke deaths fell 23% in 10 years; ‘One of the greatest public health achievements of the 20th and 21st centuries’

Dec. 5, 2013 — Stroke deaths in the United States have declined dramatically in recent decades due to improved treatment and prevention, according to a scientific statement published in the American Heart Association journal Stroke.

According to AHA statistics, the relative rate of stroke deaths fell by 37 percent and the actual number of stroke deaths declined by 23 percent between 1999 and 2009. During the same time, the cardiovascular disease death rate declined by 33 percent.

 

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“The decline in stroke deaths is one of the greatest public health achievements of the 20th and 21st centuries,” said Daniel T. Lackland, Dr. P.H., chair of the statement writing committee and professor of epidemiology at the Medical University of South Carolina, in Charleston, S.C.

“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 this paper to discuss the reasons that stroke dropped from the third to fourth leading cause of death.

Public health efforts including lowering blood pressure and hypertension control that started in the 1970s have contributed greatly to the change, Lackland said.

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 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.

Stroke Statistics for Older Americans

   • Stroke patients >85 years of age make up 17% of all stroke patients.

   • For the 60–79-year-old age group, the following have had a stroke: 6.2% of men; 6.9% of women.

   • For the 80+year-old age group, the following have had a stroke: 13.9% of men; 13.8% of women.

   • Among people 65 to 84 years of age, 53.4% of stroke patients were women, whereas among those ≥85 years of age, women constituted 66.2% of all stroke patients.

   • Very elderly patients have a higher risk-adjusted mortality, have longer hospitalizations, receive less evidenced-based care, and are less likely to be discharged to their original place of residence.

Statistics: “Older Americans and Cardiovascular Disease,” American Heart Association

“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.”

Stroke deaths dropped in men and women of all racial/ethnic groups and ages, he said.

“Although all groups showed improvement, there are still great racial and geographic disparities with stroke risks as well 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.”

Co-authors include Edward J. Roccella, Ph.D., M.P.JN., committee chair; Anne F. Deutsch, R.N., Ph.D.; Myriam Fornage, Ph.D.; Mary G. George, M.D., M.S.P.H.; George Howard, Dr. P.H.; Brett M. Kissela, M.D., M.S.; Steven J.

F.A.S.T. is an easy way to remember the sudden signs of stroke. When you can spot the signs, you'll know that you need to call 9-1-1 for help right away. Remember F.A.S.T. is:

F

Face Drooping – Does one side of the face droop or is it numb? Ask the person to smile. Is the person's smile uneven?

A

Arm Weakness – Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S

Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?

T

Time to call 9-1-1 – If someone shows any of these symptoms, even if they go away, call 9-1-1. Get the person to a hospital immediately. Check the time so you'll know when the first symptoms appeared.

Kittner, M.D., M.P.H.; Judith H. Lichtman, Ph.D., M.P.H.; Lynda D. Lisabeth, Ph.D, M.P.H.; Lee H. Schwamm, M.D.; Eric E. Smith, M.D., M.P.H.; and Amytis Towfighi, M.D., on behalf of the American Heart Association Stroke Council, Council on Cardiovascular and Stroke Nursing, Council on Quality of Care and Outcomes Research, and Council on Functional Genomics and Translational Biology.

For the latest heart and stroke news, follow on Twitter: @HeartNews.

For updates and new science from Circulation, follow @CircAHA.

The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions from pharmaceutical companies and device manufacturers, is available at www.heart.org/corporatefunding.

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