20 Year Drop In Stroke Incidence

Silvia Koton, PhD, MOccH, RN Chair, Department of Nursing The Stanley Steyer School of Health Professions Tel Aviv University Tel Aviv, IsraelMedicalResearch.com Interview with:
Silvia Koton, PhD, MOccH, RN
Chair, Department of Nursing
The Stanley Steyer School of Health Professions
Tel Aviv University Tel Aviv, Israel

Medical Research: What are the main findings of the study?

Dr. Koton: Based on data on 14,357 participants in the Atherosclerosis Risk in Communities (ARIC) study who were free of stroke when the study began in 1987 and followed until the end of 2011, we found a 24 percent overall decline in first-time strokes in each of the last two decades and a 20 percent overall drop per decade in deaths after stroke. The results were similar across race and gender, but varied by age: the decline in stroke risk was concentrated mainly in the over-65 set, while the decrease in stroke-related deaths was primarily found among those under age 65.

Medical Research: What was most surprising about the results?

Dr. Koton: Decreases in stroke incidence and mortality have previously been shown, but reports on long-term trends in stroke by gender and race have not been consistent. Some studies in the US showed decreases in stroke incidence over time in whites but not among African-Americans. Our study provides evidence of a decrease in stroke incidence and subsequent mortality among black as well as white communities. In addition, our findings regarding differences by age-group provide important information on specific groups to which both physicians and policymakers may need to pay closer attention.

Medical Research: What should clinicians and patients take away from your report?

Dr. Koton: Stroke is one of the main causes of death in the US as well as in other developed countries. It is also the leading cause of long-term disability in adults; therefore, prevention of stroke is crucial. Since stroke is mainly a disease of older populations, and our population is aging, it is important to learn about changes in stroke incidence and mortality. In addition, our findings pinpoint to specific groups needing more attention. Adopting a healthy life style and controlling cardiovascular risk factors is important for all, but we may need to focus our primary prevention efforts on some population subgroups.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Koton: Our findings suggest that future studies should focus on the reasons for the age disparities in decreases in stroke incidence and subsequent mortality, as well as preventing stroke in people under 65 and reducing the risk of death after stroke in older people.

Citation: Koton S, Schneider AL, Rosamond WD, Shahar E, Sang Y, Gottesman RF, Coresh J.Stroke incidence and mortality trends in US communities, 1987 to 2011. JAMA. 2014 Jul 16;312(3):259-68.