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Senior Citizen Health & Medicine
Senior Citizens See Decrease in Incidence of Stroke
in Last 50 Years
Death within 30 days decreased significantly in men
but not women
December 26, 2006 - The incidence of stroke in the
U.S. over the past 50 years has declined, although the severity of
stroke has not, according to a study in the December 27 issue of JAMA.
For senior citizens, age 65 and older, the lifetime risk of clinical
stroke by age 90 decreased from 19.5 percent to 14.5 percent in men and
from 18.0 percent to 16.1 percent in women.
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Health & Medicine |
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Stroke continues to be a major public health
concern, with more than 750,000 new strokes occurring each year in the
United States. It is the third leading cause of death behind heart
disease and cancer and the leading neurologic cause of long-term
disability, according to background information in the article.
Prior estimates of long-term trends in the
incidence and severity of stroke have varied. Determining trends could
help guide health programs, public policy, and the allocation of
research funding.
Raphael Carandang, M.D., of Boston University, and
colleagues examined data from the Framingham Study (health study, with
participants initially recruited in 1948) to determine long-term trends
in the incidence, lifetime risk, severity, and 30-day risk of death from
clinical stroke.
This study included 9,152 Framingham Study original
participants and offspring undergoing follow-up for up to 50 years over
three consecutive time-periods (1950-1977, 1978-1989, and 1990-2004),
with ascertainment of stroke risk factor data every 2 years and active
surveillance for occurrence of stroke or death.
The researchers found that the age-adjusted annual
incidence of clinical stroke and atherothrombotic brain infarctions (ABI)
in participants age 55 to 94 years decreased over the 3 periods.
The incidence of clinical stroke decreased
significantly. Across the 3 periods, the lifetime risk of clinical
stroke (by age 90 years) decreased from 19.5 percent to 14.5 percent in
men age 65 years and from 18.0 percent to 16.1 percent in women.
Age-adjusted stroke severity did not vary across
periods; however, death within 30 days of stroke decreased significantly
in men (from 23 percent to 14 percent) but not significantly in women
(from 21 percent to 20 percent).
The severity of stroke has not decreased and
30-day mortality has decreased significantly only in men, perhaps due to
an older age at onset of stroke and more severe strokes in women. These
sobering trends emphasize that while improved control of risk factors
has lowered incidence of stroke, there is a need for greater primary
prevention efforts to reduce the lifetime risk, severity, and 30-day
mortality following stroke, the authors conclude.
Editor's Note: This study was supported by grants
from the National Institute of Neurological Disorders and Stroke and the
National Heart, Lung, and Blood Institutes Framingham Heart Study.
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