Decline in US stroke mortality. Demographic trends and antihypertensive treatment.
Decline in US stroke mortality. Demographic trends and antihypertensive treatment.
复制标题
美国中风死亡率下降。
DOI：
10.1161/01.str.20.1.14
复制
发表时间：
1989
期刊：
影响因子：
8.3
通讯作者：
Seidler,AJ
中科院分区：
文献类型：
--
作者：
Klag,MJ;Whelton,PK;Seidler,AJ
自1973年以来，这个国家的中风死亡率一直在迅速下降。为了研究年龄-种族-性别对中风死亡率的影响，我们研究了1950-1972年和1973-1981年美国55-64岁、65-74岁和75-84岁种族-性别组的生命统计数据。自1973年以来，中风死亡率的加速下降对公共卫生产生了重大影响，中风死亡人数比其他情况下减少了20多万人。对于所有组，中风死亡率在1973-1981年的下降率（p <0.05）高于1950-1972年。1973-1981年期间的下降率随着年龄的增长而增加（p <0.05），并且对于年轻的黑人来说更重要。性别之间的下降率没有一致的差异。老年组和黑人中绝对卒中死亡率下降率更高的原因是这些组的基线死亡率更高。总体而言，1950-1972年卒中死亡率每年下降约2%，1973年后每年下降约7%。1973年以后，按年龄-种族-性别分组的平均年下降百分比的等级顺序与从三次全国性调查中获得的高血压治疗或控制的变化率不一致。1973年后的加速下降率可能是由于抗高血压治疗的改善，但我们的研究结果未能证实这一假设，并表明高血压的治疗可能不是中风死亡率下降的主要原因。
Stroke mortality has been falling rapidly in this country since 1973. To investigate age-race-sex effects on stroke mortality, we studied US vital statistics during 1950-1972 and 1973-1981 in 55-64-, 65-74-, and 75-84-year-old race-sex groups. The accelerated rate of decline in stroke mortality since 1973 has had a substantial public health impact, with greater than 200,000 fewer stroke deaths than would otherwise have occurred. For all groups, stroke mortality declined at a greater rate (p less than 0.05) in 1973-1981 than during 1950-1972. The rates of decline during 1973-1981 were greater with increasing age (p less than 0.05) and were more substantial for younger blacks. There were no consistent differences in the rate of decline by sex. The greater rate of decline in absolute stroke mortality in the older age groups and blacks was explained by higher baseline mortality in these groups. Overall, stroke mortality decreased by approximately 2%/yr in 1950-1972 and by approximately 7%/yr after 1973. Rank order of average annual percent decline after 1973 by age-race-sex groups did not correspond to rates of change in treatment or control of hypertension obtained from three national surveys. The accelerated rate of decline after 1973 may have resulted from improved antihypertensive therapy, but our findings fail to confirm this hypothesis and suggest that treatment of hypertension may not be the principal reason for the decline in stroke mortality.