What the Million Hearts Initiative Means for Stroke

Abstract

Stroke remains a leading cause of disability and death for people of all races and ethnicities. Nearly 800 000 Americans experience a stroke each year—1 every 40 seconds—and ≈135 000 die.1 Approximately 600 000 of these are first or new strokes, and those who survive are at increased risk of a future stroke.1 In 2010, strokes cost the United States an estimated $53.9 billion, including both healthcare costs and productivity losses.2 There are significant racial and ethnic disparities in stroke rates, with blacks having nearly twice the risk of whites of having a first stroke,1 and blacks and Hispanics are more likely to die after a stroke than are whites.1 There are also geographic disparities, with higher stroke incidence in the southeastern United States.3 And although stroke risk increases with age, strokes can occur at any age; about 25% of strokes occur in people who are <65 years of age.3a Stroke is the leading cause of serious long-term adult disability in the United States. As many as 30% of people who experience a stroke become permanently disabled, losing their speech, sight, mobility, and the ability to perform the simplest life tasks.4 For some, the final years of life can be transformed in an instant from what had been envisioned as an enjoyable time spent with family and friends to one of frustration, isolation, and despair. As the US population ages, the burden of cardiovascular diseases, including stroke, is expected to increase dramatically in coming decades. Assuming no changes in current trends, by 2030, the prevalence of stroke is projected to increase by 25%, and the economic costs of stroke will nearly triple.2 Because improvements in medical care are reducing stroke mortality even further, the prevalence of adult stroke-related disability is likely …