Feb. 9, 1998 ORLANDO, Feb. 6 -- Approximately 400,000 Americans have a first-ever stroke each year, and according to researchers from the University of Iowa, current trends indicate that number will increase steadily, surpassing the 1 million mark in 2050.
The findings were presented here today at the American Heart Association's 23rd International Joint Conference on Stroke and Cerebral Circulation.
The researchers project that by 2050, a total of 1,017,900 Americans will have a first-ever stroke each year as opposed to the 401,000 Americans who currently each year have their first stroke. This signifies an 167 percent increase in stroke incidence among men and 140 percent among women.
"Stroke is so age-related," says Patricia Davis, M.D., associate professor, department of neurology at the University of Iowa. "More baby boomers are moving into the prime age group to have a stroke. We expect that the elderly population will have the greatest increase in stroke incidence."
While the overall population will increase by 50 percent, the more than doubling of the number of total first stroke cases is attributable primarily to the aging of the population, says Davis.
"We are looking at a big problem in the future unless we devote ourselves to developing better preventive interventions," says Davis.
Davis says that by decreasing the incidence rate of stroke by 20 percent only in those over age 65, the total number of strokes would decline by 16.7 percent.
The greatest rise would be in the most common type of stroke, ischemic strokes, which are caused by clots that prevent blood flow to the brain. The researchers state that ischemic strokes would rise from 324,200 currently to 853,800 in 2050. In addition, they say that the incidence of two types of strokes caused by bleeding in the brain -- intracerebral hemorrhages and subarachnoid hemorrhages -- will nearly double.
No matter what the eventual number is, researchers believe that now is the time to start planning for the substantial rise in strokes if prevention does not prove effective. "Because we're projecting out quite a long way into the future, it is important to understand the limitations of this analysis," says Davis. "But it's useful for health-care planning to start thinking about this eventuality. We feel that by using this model, we can look at where our intervention strategies would have the most impact."
Stroke is the leading cause of disability in the United States and the third leading cause of death. According to the American Heart Association, stroke costs $28.3 billion per year when the cost of care and treatment are factored in. Figuring in indirect costs such as lost productivity, the total rises to $43.3 billion per year.
"It's important to plan ahead so that we have the resources to cope with the increased amount of disability which will result from the increased number of future stroke patients," says Davis. "If it costs almost $30 billion now, it's staggering to think about what it could cost in the future."
The researchers used U.S. Census Bureau data and population-based epidemiological studies and operated under the assumption that stroke incidence rates would remain unchanged as they have been the past 10 years.
Researchers estimated the age-, sex- and race-specific incidence rates for ischemic stroke, subarachnoid hemorrhage, and intracerebral hemorrhage for 1990. The projections for incident stroke cases were calculated by applying incidence rate estimates to the "middle-series" projections of the U.S. population for the years 1995 to 2050 developed by the U.S. Census Bureau.
Co-authors of the study include Thomas N. Taylor, Ph.D., and James C. Torner, Ph.D., of the University of Iowa.
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