Stroke, Vol 13, 290-295, Copyright © 1982 by American Heart Association
RL Sacco, PA Wolf, WB Kannel and PM McNamara
Survival and recurrences after stroke were assessed prospectively in a
general population sample of 5184 subjects followed biennially for 26
years. Initial strokes occurred in 198 men and 196 women. There were 84
second and 27 third strokes and 223 deaths reported. Thirty day case-
fatality rates for initial strokes were: 15% (33/222) for brain infarction,
16% (10/63) for cerebral embolus, 46% (18/39) for subarachnoid hemorrhage,
and 82% (14/17) for intracerebral hemorrhage. Cumulative, age-adjusted 5
year survival rates for brain infarction were reduced by pre-stroke cardiac
disease (coronary heart disease and/or congestive heart failure) and
hypertension prior to initial stroke from .85 to .35 in men and .70 and .56
in women. Hypertension alone reduced survival from .85 to .51 in men, but
not in women. Recurrences were primarily of the same type as the initial
stroke. Cumulative 5 year recurrence rate for brain infarction was .42 for
men, almost double that for women. Rates were reduced by excluding
hypertensives and those with combined cardiac comorbidity and hypertension.
Thus, risk of death or recurrence after stroke is substantial and
profoundly influenced by sex and by cardiac comorbidity and hypertension
present prior to the initial event.
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