Epidemiology of Stroke Dexter L. Morris, PhD, MD Department of Emergency Medicine University of North Carolina School of Medicine Chapel Hill, NC Stroke Incidence and Prevalence • 600,000 new strokes each year • 160,000 deaths • US: 83% of strokes ischemic, 17% hemorrhagic Dexter L. Morris, PhD, MD Age-Adjusted Stroke Mortality Rates in the United States from 1979 to 1998 by Race and Gender 80 70 60 Black Men Black Women White Men* White Women Total US 50 40 30 20 10 79 19 81 83 85 87 89 Year 91 93 95 97 Dexter L. Morris, PhD, MD Death rates of each HSA compared to U.S. rate (1988-92) Stroke- White Male Dexter L. Morris, PhD, MD Total Deaths from Stroke in the United States by Year,1979-1998 45 165 40 160 35 155 30 150 25 145 20 140 15 135 130 10 125 5 120 0 1979 80 81 82 83 84 85 86 87 88 89 Year 90 91 92 93 94 95 Dexter L. Morris, PhD, MD 96 97 98 Total age-adjusted stroke mortality rate/100,000 170 Stroke deaths in thousands Total Stroke Deaths in the United States by Race and Age, 1998 White Men Black Men Other Men 60 6% White Women Black Women Other Women 1% 1% 5% 50 34% 40 30 20 53% Total Deaths 10 0 <44 45-54 55-64 Age group 65-74 75-84 Dexter L. Morris, PhD, MD >85 Risk Factors For Stroke • • • • • • • Hypertension Previous Stroke/TIA Heart Disease Atrial Fibrillation Carotid Bruit Diabetes Smoking • • • • Older > Younger Black > Hispanic Hispanic > White Male > Female Dexter L. Morris, PhD, MD Natural History of Stroke • Death – 7.5% of ischemic and 37.5% hemorrhagic stroke patients die within 30 days • Disability – Of those who survive 30 days, 20% require institutional care Dexter L. Morris, PhD, MD Stroke Healthcare Costs • Stroke is a leading cause of long term disability in the US • Approximately 1 million hospital admissions per year for stroke • Total costs for stroke in US over 45 BILLION dollars a year Dexter L. Morris, PhD, MD Summary • Stroke is a huge disease in the United States • It causes a tremendous amount of mortality and disability • Although stroke rates may be declining, the number of strokes will become greater because of increases in population and the aging of the population Dexter L. Morris, PhD, MD Summary (cont) • Hypertension is the major controllable/treatable risk factor for stroke • Emergency Medicine Physicians have an increasingly important role in the treatment and prevention of this disease Dexter L. Morris, PhD, MD
