Despite significant declines in ischemic stroke mortality in the US over the past 45 years, a recent analysis by Anath and colleagues in the International Journal of Epidemiology suggests this measure may begin to increase once again. Using a sequential time series analysis of stroke mortality trends from 4,332,220 individuals between 1975 and 2019, the authors revealed that after 1960, US birth cohorts had a higher risk of death from ischemic stroke compared to those born around 1960, after accounting for age differences. Anath and colleagues found that, compared to those born in 1960, men born around 1980 were about twice as likely to die from an ischemic stroke, while women were 1.5 times as likely. Among those born around 2000, however, this figure increased to three times and twice the likelihood for men and women, respectively. Therefore, if current trends hold, the US could again see an increase in ischemic stroke mortality as younger generations grow older.
According to GlobalData, acute ischemic stroke deaths are predicted to be near 51,000 cases in 2023. Most of these deaths, however, are likely to occur in older populations as the diagnosed prevalence of acute ischemic stroke increases nearly three times in women and four times in men between the ages of 40 and 59 and 60–79. In addition, given that individuals reaching their 60s were born in or around 1960, ischemic stroke mortality will likely soon increase as subsequent generations at higher risk of mortality reach these ages.
While there is a current lack of data regarding why there is a generational difference in these trends, lifestyle change interventions may be a key to reducing this trend. After all, ischemic stroke risk is impacted by hypertension and high cholesterol, which will account for an estimated 77.59 million and 75.28 million total prevalent cases among US adults in 2023, respectively, according to GlobalData. Since both risk factors can result from lifestyle choices such as smoking, lack of exercise, and eating foods high in low-density lipoprotein (LDL), also known as ‘bad’ cholesterol, such a large number of individuals suggests that even small lifestyle interventions may significantly reduce ischemic stroke mortality for future generations. Doing so will require quick action, however, as it takes time for lifestyle changes to take effect.