After 40 years of decline, stroke mortality is rising again

An analysis of stroke deaths in the United States from 1975 to 2019 by Rutgers found that stroke deaths fell sharply and are likely to pick up
significantly.

Between 1975 and 2019, the stroke mortality rate (per 100,000) plummeted from 88 to 31 for women and 39 for men from 112
.

While the age-adjusted risk of stroke deaths has risen, overall stroke deaths have declined because stroke incidence soars
as people age.
A 10 per cent reduction in mortality for 75-year-olds would be enough to offset the doubling of mortality among 35-year-olds, who are 100 times
more likely to have stroke than 35-year-olds.

However, unless there are further improvements in stroke prevention or treatment, the latest data suggest that the total number of stroke deaths will rise
as millennials age.
The age-adjusted number of stroke deaths per 100,000 people bottomed out in 2014 and climbed
again in the last five years of the study period.

Kander Anans, lead author of the study and chair of the Department of Epidemiology and Biostatistics in the Department of Obstetrics, Gynecology and Reproductive Sciences at Robert Wood, Johnson School of Medicine, Rutgers University, said: "From around 1960, the later you are born, the higher
the risk of fatal ischemic stroke at any given age.
" "This study did not identify the cause of this trend, but other studies have shown that the main culprit is the rise
in obesity rates and diabetes rates.
"

The analysis used a comprehensive database of death certificates to identify almost all adults under the age of 85 who died of a stroke over a 44-year period — a total of 4332220 deaths
.

This is the first analysis of stroke death by year of birth (cohort) and the first study
to determine a steady increase in age-adjusted risk of ischemic stroke from the late 50s to the early 90s of the 20th century.

This "age-period-cohort analysis" further divided patients by age of death, and also led to two other novel insights for the research team:

• Ischemic stroke (which occurs when blood vessels leading to the brain are blocked) has a greater
  drop in stroke mortality than hemorrhagic stroke (which occurs when a blood vessel leaks or ruptures).
  During the study period, mortality from ischemic stroke decreased by about 80%, while mortality from hemorrhagic stroke decreased by approximately 65%.
  
  

• The difference between stroke fatality rates in men and women decreases
  with age.
  At age 55, men were more than twice as likely as women to have a fatal stroke, but at age 85, the difference in fatal stroke rates was almost the same
  .
  

According to Ananth, "After nearly 40 years of declining stroke-related mortality, stroke risk appears to be increasing
in the United States.
" Our research highlights the need for new strategies to counter this worrying trend
.
”