Research Spotlights Decline in Stroke Risk and Mortality

Research suggests that fewer Americans are having strokes and individuals who have sustained a stroke have a lower risk of death. The results yield from a study led by Johns Hopkins Bloomberg School of Public Health researchers. According to the study, there is a 24% overall decline in first-time strokes in each of the last 2 decades, as well as a 20% drop per decade in fatalities post-stroke.

Yet, the researchers note in a release from Johns Hopkins that this decline in stroke risk was concentrated primarily in the “over-65 set”; little progress was reportedly seen in the risk of strokes among young people. The decline in stroke-related fatalities observed among individuals each decade was found primarily in individuals under the age of 65, with mortality rates remaining consistent in older individuals.

The release reports that researchers used results from the Atherosclerosis Risk in Communities (ARIC) study, a prospective study of 15,792 residents of four US communities between the ages of 45 and 64 years old at the study’s start in the late 1980s. The researchers then followed 14,357 participants who were free of stroke in 1987, looking to investigate all stroke hospitalizations and deaths between then and the end of 2011.

Among the participants, 7% of the study sample sustained a stroke during that time period. A total of 10% among these individuals expired within 30 days, and 21%, 40%, and 58% expired within 1 year, 5 years, and by the end of the study in 2011. The results suggest that each decade, the number of deaths that occurred within 10 years of a stroke declined by roughly eight deaths per 100 cases. The researchers add that this decrease was not consistent across the study population and was instead, primarily the result of stroke victims younger than 65 years of age surviving longer. The study also indicates that while the results varied by age, the results were similar across race and gender.

Successful control of risk factors including blood pressure, smoking cessation, and the use of statin medications for controlling cholesterol is partially attributed to the decline. The release also states that an increase in diabetes may have also have had an opposite impact, increasing stroke rates, though to a lesser extent. The data was also likely impacted by stroke severity and treatments, the researchers say, however the study was not able to measure their exact role.

The results may  provide physicians and researchers a key age margin to focus on in the future, emphasizing stroke prevention in individuals under the age of 65 years old and reducing mortality in individuals older than 65 years old.

Silvia Koton, PhD, MOccH, visiting faculty member at the Bloomberg School, and incoming nursing department chair at Tel Aviv University, explains that “Stroke is not only one of the main causes of death, but a leading cause of long-term disability in adults. Therefore, prevention is the best strategy,”

Koton adds that since stroke rates are not equally declining across the board, physicians and policymakers should pay close attention to specific subgroups, “These data are also helpful in monitoring the results of how we care for people of all ages, hopefully helping them even before they have a stroke.”

[Source: Johns Hopkins Bloomberg School of Public Health]