CDC: Progress in Reducing Stroke Deaths Has Stalled

The rate of stroke deaths, after declining for decades, is now on an alarming uptick, according to the CDC. In 3 out of 4 states, decreases in stroke deaths have slowed or reversed over time, which the CDC said could be due to rising rates of chronic disease like hypertension and diabetes.

In the Vital Signs report, CDC researchers focused on stroke death rates from 2000 to 2015 among adults 35 years and older. They expected to observe the declines that have continued since the 1960s, but instead found some alarming changes, particularly in more recent years and among certain subpopulations.

Although overall age-standardized stroke death rates decreased by 38% from 2000 to 2015, the rate of decline was not consistent through the years. There was a 3.4% annual decline from 2000 to 2003, a 6.6% annual decline during 2003 to 2006, a 3.1% decline per year from 2006 to 2013, and finally a nonsignificant 2.5% increase per year during 2013 to 2015.

There were also racial and ethnic disparities, as African Americans continued to have the highest stroke death rate and their rate of decline began to stall in 2012. Hispanics saw their stroke death trend reverse in 2013. Rates had been falling by 3.1% per year since 2000, then started to increase by 5.8% per year from 2013 to 2015.

Geographic regions across the United States were also affected differently. The South demonstrated a similar pattern as Hispanics, where a pattern of decreasing deaths reversed to a significant uptick in 2013 to 2015. Declines in stroke deaths either slowed or stalled during that time in the West, Northeast, and Midwest regions. Just 13 states have had steady declines in stroke death rates from 2000 to 2015; in the remaining states and the District of Columbia, the decrease has either slowed down over time or reversed to an increase.

These stalling or reversing improvements in stroke death rates could have resulted in 32,593 excess stroke deaths during 2013 to 2015, the researchers estimated. While they could not pinpoint the exact reasons for these shifting patterns, they pointed to the rising rates of chronic diseases and other risk factors for strokes, including obesity, diabetes, sedentary lifestyles, and unhealthy diets.

“These changes in modifiable stroke risk factors might present new challenges for stroke prevention and for maintaining a sustained decline in stroke mortality in the United States,” the report authors acknowledged.

They also emphasized the importance of receiving prompt treatment for a stroke to prevent disability and death. The odds of acute stroke care could be increased through efforts to educate the public and first responders on the signs and symptoms of a stroke.

CDC Director Brenda Fitzgerald, MD, described the report findings as “a wakeup call” in a news release accompanying the report.

“We’ve made enormous progress in reducing stroke deaths, but that progress has stalled,” Fitzgerald said. “We know the majority of strokes are preventable, and we must improve our efforts to reduce America’s stroke burden.”