The Changing Mortality of Cerebrovascular Disease

Cerebrovascular disease mortality trends in England and Wales are discussed, concentrating on data relating to years after 1968. Cerebrovascular disease deaths have been found to comprise a decreasing proportion of all deaths and of all cardiovascular disease deaths. For ages under 85 the mortality rates have generally fallen for cerebrovascular disease, with females experiencing the greater improvement. Concerning the main diagnostic categories, the rates for cerebral haemorrhage and thrombosis have fallen, and have risen for subarachnoid haemorrhage and the vague rubrics (436, 437). Possible explanations for these trends are proposed including relationships to other cardiovascular diseases. In particular, the downward trend in cerebral haemorrhage mortality rates is found to be positively correlated at a significant level with that due to hypertensive disease. However, the trends in cerebral thrombosis and ischaemic heart disease mortality rates are found to be in opposite directions—a phenomenon which contradicts the widely-held view that these diseases have a common aetiology.