Treatment of hypertension is identified as the only significant contributor to the 76% decline in stroke mortality observed in Rochester, Minnesota since 1950.
Does treatment of hypertension reduce stroke mortality and incidence in the general population?
The historical decline in stroke mortality and incidence in the US is strongly associated with the increasing effectiveness of antihypertensive medication.
Stroke mortality in the United States has declined since 1900. The mortality rates from stroke in Rochester, Minnesota, have declined 76% since 1950, and the primary cause for the declines is a decrease in the incidence of new cases of cerebral infarction and cerebral hemorrhage. There are no data on the incidence of stroke prior to 1945 to confirm the US mortality trend. The decline in incidence was noted in women 10-15 years before it was seen in men. Hypertension is the most important risk factor for stroke. Hypertension surveys have shown an increasing effectiveness of antihypertensive medication in lowering blood pressure, and the effect was noted earlier in women. Available evidence is consistent with the idea that treatment of hypertension is the only significant contributor to the decline of stroke.
Jack P. Whisnant (1984) conducted a review in Stroke. Treatment of hypertension was evaluated on Stroke mortality and incidence. Treatment of hypertension is identified as the only significant contributor to the 76% decline in stroke mortality observed in Rochester, Minnesota since 1950.