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Editorial |

Declining Stroke Incidence and Improving Survival in US Communities:  Evidence for Success and Future Challenges

Ralph L. Sacco, MD1; Chuanhui Dong, MD, PhD1
[+] Author Affiliations
1Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida
JAMA. 2014;312(3):237-238. doi:10.1001/jama.2014.7693.
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Stroke affects an estimated 795 000 Americans each year, remains the fourth leading cause of death, and is the main cause of adult disability in the United States.1 Worldwide, stroke ranks as the second leading cause of death, responsible for 9.5% of total deaths each year, with a greater burden in developing countries.2 Over the past decade, overall stroke mortality has declined, primarily in western countries. Moreover, several studies have documented a decrease in stroke incidence rates.36 These favorable trends are likely due to better vascular risk factor control and improvements in acute stroke treatment at many institutions, including specialized stroke centers.7 In the United States, however, there are persistent racial, ethnic, sex, and regional disparities in age-adjusted stroke mortality rates,810 and long-term temporal trend data on validated stroke incidence by race and ethnicity are scarce.

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