Trends in Mortality From Stroke in Baltimore, Maryland: 1940–1941 Through 1968–19691

Death certificates of all Baltimore residents who died in 1940–1941, 1948–1949, 1960–1961 and 1968–1969 were screened to identify those on which a stroke diagnosis was entered at ages 45 to 74 years. Nonspecific diagnoses such as senility and generalized cerebral arteriosclerosis were not considered stroke diagnoses. Age- race- sex-specific and age-adjusted rates of death for each of the aforementioned periods in time are presented. Stroke death rates have declined in the 45–74 age group in Baltimore since 1940–1941. The magnitude and consistency of the decline were greater in women than in men and greater for cerebral hemorrhage than for other types of stroke diagnoses. The substantial decline in the rate of deaths from cerebral hemorrhage accounted for most of the decline in the overall stroke mortality rates. Reasons for the decline in stroke death rates are not clear, but a change in the prevalence of a risk factor, such as obesity, especially in women, is a possibility.