Trends in stroke prevalence between 1973 and 1991 in the US population 25 to 74 years of age

Background and Purpose - Stroke mortality in the United States has declined since 1900. Primary prevention of stroke incidence did not decline and may have increased during the 1980s, whereas survival after stroke improved substantially during the 1970s and 1980s. The effect of these trends on the prevalence and number of stroke survivors in the United States has not been determined. Methods - The prevalence and number of noninstitutionalized stroke survivors in the United States was estimated through self-report for 3 time periods: 1971-1975, 1976-1980, and 1988-1994, using data from the National Health and Nutrition Examination Surveys (NHANES) I, II, and III, respectively. Prevalence and number of stroke survivors were analyzed by age (25 to 59 and 60 to 74 years), race (non-Hispanic whites/Mexican-Americans and non-Hispanic blacks), and sex. Estimates were limited to the US population ages 25 to 74 years because NHANES I and II did not include persons older than 75 years. Results - The age-, race-, and sex-adjusted prevalence of stroke increased from 1.41% to 1.87% from 1971-1975 to 1988-1994, an average increase of 7.5% (95% confidence interval: -2%, +18%) for each 5-year period during this time. Additionally, during this period, the estimated number of noninstitutionalized stroke survivors increased by 930 000 (95% CI: 300 000 to 1.6 million) from 1.5 million to 2.4 million. Additionally, the average "health in general" among stroke survivors was similar in all 3 periods. Conclusions - These data point to the increasing importance of the care and rehabilitation of stroke survivors.