Stroke, Vol 23, 1230-1236, Copyright © 1992 by American Heart Association
B Modan and DK Wagener
BACKGROUND AND PURPOSE: The reasons for decreasing stroke mortality could
be related to either decreasing incidence and/or improved prognosis. Thus
far, secular trends of stroke have been analyzed either through mortality
or morbidity data. This report examines both aspects simultaneously, on a
nationwide basis, for the period 1968-1988. METHODS: Mortality statistics
were based on the Compressed Mortality File. Estimates of morbidity were
based on the National Hospital Discharge Survey. The Area Resource File was
used to obtain county- specific socioeconomic statistics. RESULTS: The
decline in stroke mortality continued through the 1970s and 1980s, whereas
morbidity remained constant and possibly even increased. Mortality and
morbidity rates were similar in both sexes, higher in blacks, and lower in
other (primarily Asian) Americans. There was an inverse correlation between
death rates and socioeconomic status, which was particularly marked in
blacks. Temporal decline occurred in all strata. CONCLUSIONS: The observed
decrease in stroke mortality rates results most probably from an improved
survival rather than from a decline in incidence. The abundance of new
drugs and screening programs may not have affected the overall morbidity of
stroke, possibly because of inefficient treatment regimens.
ARTICLES
Some epidemiological aspects of stroke: mortality/morbidity trends, age, sex, race, socioeconomic status
National Center for Health Statistics, Centers for Disease Control, Hyattsville, MD 20782.
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