Stroke Mortality in the United States, 1970 to 2023

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Disease Research

Background:

• Tracking mortality is crucial for understanding population health trends.
• Long-term stroke mortality trends and subtypes require further evaluation in the U.S. to inform public health and clinical strategies.

Purpose of the Study:

• To analyze long-term trends in stroke mortality and its subtypes (acute ischemic stroke, intracerebral hemorrhage) in the United States from 1970 to 2023.
• To examine these trends by sex and race to identify disparities.

Main Methods:

• Utilized the National Vital Statistics System CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database.
• Included adults aged 25 years and older in the U.S. from 1970 to 2023.
• Analyzed absolute numbers and age-adjusted mortality rates for total stroke, acute ischemic stroke, and intracerebral hemorrhage, stratified by sex and race.

Main Results:

• Overall age-adjusted stroke mortality decreased by 82% (177 to 32 per 100,000).
• Age-adjusted mortality for acute ischemic stroke fell by 81% (135 to 26 per 100,000), and for intracerebral hemorrhage by 86% (42 to 6 per 100,000).
• Significant declines occurred in the 1970s and early 2000s; however, Black individuals consistently showed higher mortality rates for both stroke subtypes.

Conclusions:

• Stroke mortality has substantially declined over the past 50 years due to advancements in public health and clinical interventions.
• Despite overall declines, significant racial disparities in stroke mortality persist, particularly for Black individuals.
• Continued focus on prevention and treatment strategies, with attention to non-White populations, is essential to further reduce stroke mortality and address health inequities.