Stroke deaths on the rise for Americans

Since at least the 1960s, the rate of Americans who die from stroke has been on the decline. But that progress has slowed, and in some cases reversed, according to a new federal report.

The report, issued by the Centers for Disease Control and Prevention, found that the rate of stroke deaths among U.S. adults fell 38 percent between 2000 and 2015. But that pace has slowed or even reversed in 38 states in recent years. Florida saw the biggest reversal, with stroke death rates increasing nearly 11 percent each year from 2013 to 2015.

African-Americans are most likely to die from stroke, but stroke death rates among Hispanics rose 5.8 percent each year from 2013 to 2015. Deaths from stroke also increased 4.2 percent each year in the South during that time.

If declines in stroke mortality had maintained the same pace from 2013 to 2015, an estimated 32,593 stroke deaths may not have occurred, the report said.

The findings are “a wake-up call,” said CDC director Brenda Fitzgerald, M.D., and underscore the importance of identifying and treating risk factors, geographic trends and other factors that may be slowing progress.

“We know the majority of strokes are preventable and we must improve our efforts to reduce America’s stroke burden,” she said.

The report did not identify the reasons for the slowdown, but other studies have pointed to increased numbers of Americans with stroke risk factors such as high blood pressure, obesity and diabetes.

Mitchell S.V. Elkind, M.D., a professor of neurology and epidemiology at Columbia University, said the report’s findings are worrisome and underscore the importance of efforts to identify and control risk factors across age groups.

Elkind said maintaining a healthy diet, getting plenty of exercise and avoiding tobacco are important to building healthy habits that can have a big impact over a lifetime.

“It’s never too early to start working on a healthier lifestyle and it’s never too late to change bad habits,” said Elkind, also chair of the American Stroke Association.

About 800,000 Americans have a stroke each year, but 80 percent of strokes are preventable through lifestyle changes, according to the CDC.

Elkind said increases in obesity and chronic conditions such as Type 2 diabetes, high cholesterol and high blood pressure among young people could lead to greater stroke risk as those patients get older.

“This could be the tip of the iceberg because complications of heart disease and these chronic conditions haven’t caught up to them yet,” he said.

Increasing access to health care is important to identify and treat risk factors early, Elkind said. “You can’t screen people and treat them if they can’t get in or afford to see a doctor.”

The increase in stroke death rates among Hispanics and Southerners reveal the need for greater outreach and a closer look at what factors are driving the numbers in specific populations, he said.

“We can’t treat everyone the same,” Elkind said. “We need to treat them with cultural awareness and sensitivity.”

American Heart Association CEO Nancy Brown called the report distressing but not unexpected given previous projections.

“This report gives us even more reason to aggressively continue our efforts, especially in multicultural communities and to reach people at younger ages, as we are seeing more strokes in people in their 30s and 40s,” she said.

The CDC pointed to efforts to reduce stroke risks and improve stroke care, such as the Million Hearts initiative and the Paul Coverdell National Acute Stroke Program.

Million Hearts is co-led by CDC and the Centers for Medicare & Medicaid Services and aims to prevent 1 million heart attacks and strokes by 2022. The Coverdell program improves collaboration between hospitals, emergency medical services and outpatient providers, in addition to educating the community to recognize the signs and symptoms of stroke, which include face drooping, arm weakness and speech difficulty.

“Stroke is a real medical emergency,” said Robert Merritt, who works in the CDC’s Division of Heart Disease and Stroke Prevention. “Know the signs, and call 911 and get people to the hospital.”

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