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Incidence of stroke decreases over last 50 years
December 27, 2006The 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.
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.
JAMA and Archives Journals
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.
JAMA and Archives Journals
Stroke Current Events and Stroke News RSSNew understanding about mechanism for cell death after stroke leads to possible therapy
Scientists at the Brain Research Centre, a partnership of the University of British Columbia Faculty of Medicine and Vancouver Coastal Health Research Institute, have uncovered new information about the mechanism by which brain cells die following a stroke, as well as a possible way to mitigate that damage.
Surgery not linked to memory problems in older patients
For years, it has been widely assumed that older adults may experience memory loss and other cognitive problems following surgery. But a new study from researchers at Washington University School of Medicine in St. Louis questions those assumptions.
Pushing the brain to find new pathways
Until recently, scientists believed that, following a stroke, a patient had about six months to regain any lost function. After that, patients would be forced to compensate for the lost function by focusing on their remaining abilities.
Night Beat, Overtime and a Disrupted Sleep Pattern Can Harm Officers' Health
A police officer who works the night shift, typically from 8 p.m. to 4 a.m., already is at a disadvantage when it comes to getting a good "night's" sleep.
Vitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with CAD
The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows.
The benefits of exercise
Physical exercise is one of the most effective methods of preventing disease. The current issue of Deutsches Arzteblatt International is devoted to this important topic.
Heart and bone damage from low vitamin D tied to declines in sex hormones
Researchers at Johns Hopkins are reporting what is believed to be the first conclusive evidence in men that the long-term ill effects of vitamin D deficiency are amplified by lower levels of the key sex hormone estrogen, but not testosterone.
New study links vitamin D deficiency to cardiovascular disease and death
While mothers have known that feeding their kids milk builds strong bones, a new study by researchers at the Heart Institute at Intermountain Medical Center in Salt Lake City suggests that Vitamin D contributes to a strong and healthy heart as well - and that inadequate levels of the vitamin may significantly increase a person's risk of stroke, heart disease, and death, even among people who've never had heart disease.
Early end to key study on benefits of niacin, a B vitamin, in keeping arteries open was premature
Heart experts at Johns Hopkins are calling premature the early halt of a study by researchers at Walter Reed Army Medical Center and Washington Hospital Center on the benefits of combining extended-release niacin, a B vitamin, with cholesterol-lowering statin medications to prevent blood vessel narrowing.
Study finds many people with hemianopia have difficulty detecting pedestrians while driving, advocates for individual testing
Schepens Eye Research Institute scientists have found that--when tested in a driving simulator--patients with hemianopia (blindness in one half of the visual field in both eyes) have significantly more difficulty detecting pedestrians (on their blind side) than normally sighted people.
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