Hypertension-related stroke mortality declined overall, but atrial fibrillation-related stroke mortality increased in males (APC 0.44) and Black individuals (APC 1.23) from 1999-2020.
Do mortality trends differ between hypertension-related and atrial fibrillation-related strokes across different demographics?
While overall stroke mortality declined from 1999 to 2020, atrial fibrillation-related stroke mortality increased in specific demographics such as males and Black individuals, highlighting the need for targeted interventions.
Absolute Event Rate: 0% vs 0%
Abstract Background Stroke remains a leading cause of mortality worldwide, with significant variations in outcomes based on underlying risk factors. Hypertension and atrial fibrillation are two major contributors to stroke risk, yet their impact on stroke-related mortality differs. This study examines long-term trends in stroke mortality to identify disparities across stroke subtypes. Purpose This study aims to compare stroke mortality trends associated with hypertension and atrial fibrillation, identifying disparities across stroke subtypes, gender, race/ethnicity, and age groups. By analyzing long-term trends, we seek to inform targeted interventions to reduce mortality and address disparities in stroke outcomes. Methods Mortality data from 1999 to 2020 were obtained from CDC WONDER. Annual percent changes (APC) in stroke mortality were calculated using JoinPoint to assess trends across stroke subtypes, gender, race/ethnicity, and age groups. Statistical significance was set at p 0.05. Results The study analyzed stroke mortality trends from 1999 to 2020, revealing significant differences between hypertension-related and atrial fibrillation-related strokes. Overall stroke mortality declined (APC: -2.88, p 0.000001), with slower reductions in ischemic strokes (APC: -0.86, p = 0.0459) compared to hemorrhagic strokes (APC: -1.97, p 0.000001). Gender disparities were evident, as males experienced a recent mortality increase in 2020 (APC: 4.92, p = 0.0115), while females did not (APC: 1.97, p = 0.1535). Racial and ethnic disparities persisted, with Black and Hispanic individuals showing significant declines over time but sharp increases in 2020 (APC: 6.54 and 7.56, respectively, p 0.0016). White individuals also saw declines but no significant 2020 increase (APC: 1.72, p = 0.1087). Hypertension-related stroke mortality declined significantly in females (APC: -1.93, p = 0.0399) and Asian/Pacific Islander individuals (APC: -2.92, p = 0.0016), but not in males (APC: -0.94, p = 0.2535) or White individuals (APC: -1.27, p = 0.1811). In contrast, atrial fibrillation-related stroke mortality increased in males (APC: 0.44, p = 0.0051) and Black individuals (APC: 1.23, p 0.000001), while declining in females (APC: -0.22, p = 0.047) and Asian/Pacific Islander individuals (APC: -0.80, p 0.000001). Age-specific analysis showed older age groups (75-84 and 85+ years) had the highest mortality rates. Hypertension-related strokes declined in the 75-84 age group (APC: -2.00, p = 0.0371), while atrial fibrillation-related strokes increased in the 45-54 age group (APC: 4.20, p 0.000001). Conclusion Stroke mortality overall declined, but disparities persist. Ischemic stroke mortality decreased slower than hemorrhagic stroke mortality. While hypertension-related stroke mortality generally declined, atrial fibrillation-related mortality increased in certain demographics, particularly males and Black individuals. The 2020 increases warrant further investigation.Illustration
Durrani et al. (Sat,) reported a other. Hypertension-related stroke mortality declined overall, but atrial fibrillation-related stroke mortality increased in males (APC 0.44) and Black individuals (APC 1.23) from 1999-2020.