Good news about stroke: death rate continues to decline

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Brain scans: StrokeA new scientific statement in the journal Stroke, published by the American Heart Association (in concert with the American Stroke Association) reveals strikingly good news about the toll of stroke on the American public.

While stroke mortality has been in a slow decline since the early days of the 20th century, this has accelerated in parallel with the drop in rates of all cardiovascular diseases (CVD) since the 1970s: these include stroke, heart attack, and sudden death (the large majority of which are caused by CVD). In fact, stroke deaths have dropped by over 30 percent since 2000.

Stroke has slipped from the third-leading cause of death in the United States to the fourth-leading cause. This, and a similar decline in heart disease, is one of the 10 great public-health achievements of the 20th century, according to the U.S. Centers for Disease Control and Prevention.

Even so, there is still more to be done, as George Howard, a professor of biostatistics in the School of Public Health at the University of Alabama at Birmingham (UAB), told HealthDay News. Dr. Howard is a co-author of the study, which was led by 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.

"Stroke has been declining since 1900, and this could be a result of changes leading to fewer people having a stroke or because people are less likely to die after they have a stroke," Howard said in a university news release. "Nobody really knows why, but several things seem to be contributing to fewer deaths from stroke."

The most likely explanation is the more efficient public health campaign to diagnose and treat high blood pressure (hypertension) more aggressively, with lower target pressure goals. Also important are better control of lipid levels (especially LDL-cholesterol) and the continuing, albeit slow decline in smoking rates.

ACSH s Dr. Gilbert Ross had this perspective: This accelerating decline in stroke death is a truly wonderful public health success. Even more impressive is the ongoing improvement in the face of the obesity epidemic , which has slowed over the past couple of years, and its attendant increase in diabetes. There is no cause for complacency, however, as stroke still kills 160,000 Americans each year, while almost 800,000 suffer a stroke. According to the National Institute of Neurological Disorders and Stroke, it is the most common cause of adult disability. So let s keep alert for risk factors for stroke and other CVDs.