Stroke Mortality in the United States, 1970 to 2023

Tracking mortality is essential to advance understanding of population health. Further evaluation of long-term stroke mortality trends and subtypes in the United States is needed to guide preventive public health and clinical interventions.

This study used the National Vital Statistics System CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) data for adults aged 25 years and older in the United States from 1970 to 2023. Outcomes included absolute number and age-adjusted mortality of total stroke, and its subtypes acute ischemic stroke and intracerebral hemorrhage. Data were analyzed overall and by sex and race.

From 1970 to 2023, overall age-adjusted stroke mortality decreased by 82% from 177 to 32 per 100 000. The age-adjusted mortality of acute ischemic stroke decreased by 81% from 135 to 26 per 100 000, and the age-adjusted mortality of intracerebral hemorrhage declined by 86% from 42 to 6 per 100 000. Sex and race trends were similar, though notably age-adjusted mortality of acute ischemic stroke and intracerebral hemorrhage among those identifying as Black remained highest throughout the time period. Joinpoint regression models identified the 1970s and early 2000s as significant periods of mortality decline.

Stroke mortality has significantly declined over the last half century, with decreases in both acute ischemic stroke and intracerebral hemorrhage corresponding to public health and clinical advancements, though disparities remain. Continued efforts in prevention and treatment strategies should be made to further this decline, with particular attention to those identifying as non-White race.