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.
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
“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
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
• 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
• 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
“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
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
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.
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:
Drooping – Does
one side of the face droop or is it numb? Ask the
person to smile. Is the person's smile uneven?
– Is one arm weak or numb?
Ask the person to raise both arms. Does one arm
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?
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.
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