Deaths from stroke and heart attack have decreased by as much as 56 percent and 70 percent, respectively since the 1950s. The decrease in stroke and STEMI are likely the result of primary prevention efforts such as reductions in smoking, blood pressure, and blood cholesterol. However, recent studies have shown that the stroke decrease is flattening or even reversing for some segments of the U.S. population.
[Photo: Dr. Joel Swerdel]
A recent study published in the Journal of the American Heart Association, by lead authors PhD candidate, Dr. Joel N. Swerdel, and Dr. George Rhoads of the Rutgers School of Public Health, along with colleagues at the Rutgers Robert Wood Johnson Medical School, used statewide data from New Jersey to examine changes in incidence rates of stroke and STEMI between 1995 and 2014.
The team utilized data from the Myocardial Infarction Data Acquisition System (MIDAS), a database of hospital discharges in New Jersey maintained by the Cardiovascular Institute at the Robert Wood Johnson Medical School. Using age-period-cohort (APC) analysis, the authors found that individuals between the ages of 35 and 49 years of age had a worrisome increase in the rate of stroke, individuals between the ages of 50 to 54 had a small increase in the risk of stroke, and older age groups had a continuing decline in the rate of stroke. The decline of stroke in the oldest age group, the flattening of stroke in the middle age group, and the increase of stroke in the youngest age group suggests that the decade of birth makes a difference. The researchers suggest that the new trends are associated with lifestyle factors. “This is a wake-up call. People in their 30s and 40s have time and the opportunity to improve their lifestyle and take medications to control risk factors to head off these effects,” says Swerdel.
According to the authors “the present finding of increasing stroke rates in persons younger than 55 years is unsettling and merits vigorous inquiry.” The increase in stroke in people under 55 is not only affecting Americans; other countries like Russia, India, and Mexico are experiencing similar increases. These trends threaten to impact health outcomes and disease burdens globally in both developed and developing nations unless health care systems and individuals are successful in controlling risk factors, especially blood pressure, smoking and blood cholesterol, from relatively early in life.
Ischemic Stroke Rate Increases in Young Adults: Evidence for a General Effect” was published in November in the Journal of the American Heart Association. http://jaha.ahajournals.org/content/5/12/e004245.long