Abstract
IntroductionThe prominent decline in U.S. stroke death rates observed for more than 4 decades has slowed in recent years. CDC examined trends and patterns in recent stroke death rates among U.S. adults aged ≥35 years by age, sex, race/ethnicity, state, and census region.MethodsTrends in the rates of stroke as the underlying cause of death during 2000–2015 were analyzed using data from the National Vital Statistics System. Joinpoint software was used to identify trends in stroke death rates, and the excess number of stroke deaths resulting from unfavorable changes in trends was estimated.ResultsAmong adults aged ≥35 years, age-standardized stroke death rates declined 38%, from 118.4 per 100,000 persons in 2000 to 73.3 per 100,000 persons in 2015. The annual percent change (APC) in stroke death rates changed from 2000 to 2015, from a 3.4% decrease per year during 2000–2003, to a 6.6% decrease per year during 2003–2006, a 3.1% decrease per year during 2006–2013, and a 2.5% (nonsignificant) increase per year during 2013–2015. The last trend segment indicated a reversal from a decrease to a statistically significant increase among Hispanics (APC = 5.8%) and among persons in the South Census Region (APC = 4.2%). Declines in stroke death rates failed to continue in 38 states, and during 2013–2015, an estimated 32,593 excess stroke deaths might not have occurred if the previous rate of decline could have been sustained.Conclusions and Implications for Public Health PracticePrior declines in stroke death rates have not continued in recent years, and substantial variations exist in timing and magnitude of change by demographic and geographic characteristics. These findings suggest the importance of strategically identifying opportunities for prevention and intervening in vulnerable populations, especially because effective and underused interventions to prevent stroke incidence and death are known to exist.
Highlights
The prominent decline in U.S stroke death rates observed for more than 4 decades has slowed in recent years
Agestandardized rates among adults aged ≥35 years declined from 315.7 deaths per 100,000 in 1968 to 73.3 per 100,000 in 2015.* The substantial decline in stroke death rates has been attributed to improvements in modifiable stroke risk factors and in stroke treatment and care over time [1,2]
A recent study suggested that the rate of decline in stroke death rates has slowed in recent years, and the rate has even increased slightly since 2013 [4]
Summary
Stroke death rates in the United States have declined since at least the 1960s; stroke fell from the third to the fourth leading cause of death in 2008 and to the fifth in 2013. Agestandardized rates among adults aged ≥35 years declined from 315.7 deaths per 100,000 in 1968 to 73.3 per 100,000 in 2015.* The substantial decline in stroke death rates has been attributed to improvements in modifiable stroke risk factors and in stroke treatment and care over time [1,2]. Despite this decline, nearly 800,000 persons in the United States have a new or recurrent stroke each year, and approximately 140,000 stroke victims die; stroke accounts for one in every 20 deaths [3]. The findings of this study will help identify populations that could benefit from interventions to prevent and control modifiable stroke risk factors, further improve the quality of care, and reduce stroke prevalence and mortality
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
