From the Guidelines
The incidence of stroke averages around 795,000 cases per year in the United States, with approximately 690,000 being ischemic and 185,000 being recurrent, as reported in the most recent guideline from the American Heart Association/American Stroke Association 1.
Incidence and Risk Factors
The incidence of stroke is influenced by several modifiable risk factors, including hypertension, diabetes, smoking, obesity, physical inactivity, and high cholesterol.
- Controlling these factors can substantially reduce stroke risk.
- For example, maintaining blood pressure below 130/80 mmHg through medications like ACE inhibitors or lifestyle changes can lower stroke risk.
- Similarly, managing diabetes with appropriate glucose control, treating atrial fibrillation with anticoagulants, and addressing high cholesterol with statins are effective preventive strategies.
Lifestyle Modifications
Lifestyle modifications, including:
- Regular exercise (at least 150 minutes weekly)
- Mediterranean diet adoption
- Smoking cessation
- Limiting alcohol consumption to moderate levels also significantly reduce stroke incidence.
Importance of Medical Check-ups
Regular medical check-ups are essential for early detection and management of these risk factors, as stated in the guidelines for the primary prevention of stroke 1 and the prevention of stroke in patients with stroke and transient ischemic attack 1.
Demographic Variations
Stroke incidence per 100,000 for those 20 years old was 223 for blacks, 196 for Hispanics, and 93 for whites, which represents a 2.4-fold RR for blacks and a 2-fold increase for Hispanics compared with whites, as reported in the 2011 guideline on the management of patients with extracranial carotid and vertebral artery disease 1.
From the Research
Incidence of Cerebrovascular Accident (CVA) or Stroke
- The incidence of stroke is approximately 12.2 million cases per year worldwide, with 101 million prevalent cases and 143 million disability-adjusted life-years (DALYs) due to stroke 2.
- In the United States, stroke is the fifth leading cause of death and a leading cause of disability, affecting nearly 800,000 individuals annually 3.
- The incidence of stroke varies by region, with the highest age-standardised stroke-related mortality and DALY rates found in low-income countries 2.
- Ischemic stroke accounts for 62.4% of all incident strokes, while intracerebral haemorrhage constitutes 27.9% and subarachnoid haemorrhage constitutes 9.7% 2.
Risk Factors for Stroke
- The five leading risk factors for stroke are high systolic blood pressure, high body-mass index, high fasting plasma glucose, ambient particulate matter pollution, and smoking 2.
- Other risk factors for stroke include age, race, family history, hypertension, diabetes mellitus, atherosclerosis, cardiac arrhythmias, prosthetic valves, hyperlipidemia, and cigarette smoking 4.
Mortality and Disability due to Stroke
- Stroke is the second-leading cause of death globally, accounting for 11.6% of total deaths, and the third-leading cause of death and disability combined, accounting for 5.7% of total DALYs 2.
- The annual number of strokes and deaths due to stroke increased substantially from 1990 to 2019, despite substantial reductions in age-standardised rates, particularly among people older than 70 years 2.
- The fastest-growing risk factor for stroke between 1990 and 2019 was high body-mass index 2.